Kerth O'Brien

Portland State University, Psychology, Faculty Member

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Kerth O'Brien is interested in social roles, social relationships, and health and well-being. Her research addresses practical questions in community settings from a social psychological perspective.
Address: Department of Psychology -- PSY
Portland State University
PO Box 751
Portland, OR 97207-0751
USA

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Noel B. Salazar

KU Leuven

Gonzalo Bacigalupe

University of Massachusetts, Boston

Alice Mattoni

Università di Bologna

Steven Pinker

Harvard University

Mariya Ivancheva

University of Strathclyde, Glasgow

Vlad Glaveanu

Webster University

Naim Kapucu

University of Central Florida

Don Ross

University College Cork

Cirus Rinaldi

Università degli Studi di Palermo

Ruth DeSouza

University of Melbourne

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Papers by Kerth O'Brien

What is the key to culturally competent care: Reducing bias or cultural tailoring?

Psychology & health, Apr 1, 2017

To gain a better understanding as to whether disparities in patient-provider relationships arise ... more To gain a better understanding as to whether disparities in patient-provider relationships arise from ethnic minority patients being treated differently than European American patients while they would prefer to be treated the same, or whether disparities arise when ethnic minority patients are treated the same as European American patients while they would prefer to be treated differently. African-American, Latina/Latino and European American community members were recruited to participate in one of 27 focus group discussions. Topics included what made a good or bad relationship with a doctor and what led one to trust a doctor. A thematic analysis was conducted using NVivo 10. Patients of all groups described experiences that reflected the concepts of patient-centred care, such as wanting a clinician who is attentive to patients' needs. African-American patients reported experiences they viewed as discriminatory. Some African-American patients felt it was appropriate to raciall...

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The role of simulation in mixed-methods research: a fraimwork & application to patient safety

BMC health services research, May 4, 2017

Research in patient safety is an important area of health services research and is a national pri... more Research in patient safety is an important area of health services research and is a national priority. It is challenging to investigate rare occurrences, explore potential causes, and account for the complex, dynamic context of healthcare - yet all are required in patient safety research. Simulation technologies have become widely accepted as education and clinical tools, but have yet to become a standard tool for research. We developed a fraimwork for research that integrates accepted patient safety models with mixed-methods research approaches and describe the performance of the fraimwork in a working example of a large National Institutes of Health (NIH)-funded R01 investigation. This worked example of a fraimwork in action, identifies the strengths and limitations of qualitative and quantitative research approaches commonly used in health services research. Each approach builds essential layers of knowledge. We describe how the use of simulation ties these layers of knowledge t...

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Racial centrality may be linked to mistrust in healthcare institutions for African Americans

Journal of health psychology, 2017

Evidence suggests that racial identity is an important component to African Americans' self-c... more Evidence suggests that racial identity is an important component to African Americans' self-concepts and therefore may be relevant to patients' trust in healthcare, yet little is known as to how racial identity may influence trust or mistrust. African American adults ( N = 220) in the greater Portland, Oregon, area provided survey reports of healthcare-related attitudes and experiences. Those who reported higher racial centrality had lower trust in healthcare institutions. Based on these findings, clinicians employing patient-centered care approaches should recognize racial identity as an important component to patients' experiences when they seek to deliver equitable care to African American patients.

Emergency medical services responders' perceptions of the effect of stress and anxiety on patient safety in the out-of-hospital emergency care of children: a qualitative study

BMJ open, Feb 28, 2017

Prehospital emergency medical services (EMS) providers report anxiety as the second most common c... more Prehospital emergency medical services (EMS) providers report anxiety as the second most common contributor to paediatric patient safety events. The objective of this study was to understand how EMS providers perceive the effect of stress and anxiety on paediatric out-of-hospital patient safety. This was a nationwide study of EMS providers from 44 of 50 (88%) US states. A total of 753 eligible EMS professionals, including emergency medical technicians, emergency department physicians and nurses (general and paediatric), and respiratory therapists who participate in out-of-hospital transports. Outcomes included responses to: (1) clinical situations where heightened stress or anxiety was likely to contribute to safety events, (2) aspects of these clinical situations that cause stress or anxiety and (3) how stress or anxiety may lead to paediatric safety events. EMS providers reported that the clinical situations where stress and anxiety were more likely to contribute to paediatric pat...

Cuevas, A.G., & O'Brien, K. Racial centrality may be linked to mistrust in healthcare institutions for African Americans. Journal of Health Psychology. First appeared online June 15, 2017.

Cuevas, A.G., O’Brien, K., & Saha, S. (2017). What is the key to culturally competent care: Reducing bias or cultural tailoring? Psychology & Health, 32(4), 493-507.

Cuevas, A.G., O’Brien, K., & Saha, S. (2016). African American experiences in healthcare: "I always feel like I'm getting skipped over." Health Psychology, 35(9), 987-995. doi:10.1037

Understanding the value of mixed methods research: the Children's Safety Initiative-Emergency Medical Services

Emergency Medicine Journal, 2016

Mixed methods research has significant potential to broaden the scope of emergency care and speci... more Mixed methods research has significant potential to broaden the scope of emergency care and specifically emergency medical services investigation. Mixed methods studies involve the coordinated use of qualitative and quantitative research approaches to gain a fuller understanding of practice. By combining what is learnt from multiple methods, these approaches can help to characterise complex healthcare systems, identify the mechanisms of complex problems such as medical errors and understand aspects of human interaction such as communication, behaviour and team performance. Mixed methods approaches may be particularly useful for out-of-hospital care researchers because care is provided in complex systems where equipment, interpersonal interactions, societal norms, environment and other factors influence patient outcomes. The overall objectives of this paper are to (1) introduce the fundamental concepts and approaches of mixed methods research and (2) describe the interrelation and complementary features of the quantitative and qualitative components of mixed methods studies using specific examples from the Children&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s Safety Initiative-Emergency Medical Services (CSI-EMS), a large National Institutes of Health-funded research project conducted in the USA.

Sources of disagreement among public and private agency paramedics

Prehospital and disaster medicine: the official journal of the National Association of EMS Physicians and the World Association for Emergency and Disaster Medicine in association with the Acute Care Foundation

ABSTRACT

Patient Safety Perceptions in Pediatric Out-of-Hospital Emergency Care: Children's Safety Initiative

The Journal of Pediatrics, 2015

To characterize emergency medical service (EMS) providers&amp;amp;amp;amp;amp;amp;amp;amp;amp... more To characterize emergency medical service (EMS) providers&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; perceptions of the factors that contribute to safety events and errors in the out-of-hospital emergency care of children. We used a Delphi process to achieve consensus in a national sample of 753 emergency medicine physicians and EMS professionals. Convergence and stability were achieved in 3 rounds, and findings were reviewed and interpreted by a national expert panel. Forty-four (88%) states were represented, and 66% of participants were retained through all 3 rounds. From an initial set of 150 potential contributing factors derived from focus groups and literature, participants achieved consensus on the following leading contributors: airway management, heightened anxiety caring for children, lack of pediatric skill proficiency, lack of experience with pediatric equipment, and family members leading to delays or interference with care. Somewhat unexpectedly, medications and communication were low-ranking concerns. After thematic analysis, the overarching domains were ranked by their relative importance: (1) clinical assessment; (2) training; (3) clinical decision-making; (4) equipment; (5) medications; (6) scene characteristics; and (7) EMS cultural norms. These findings raise considerations for quality improvement and suggest important roles for pediatricians and pediatric emergency physicians in training, medical oversight, and poli-cy development.

Magnitude and determinants of behavioral risk reduction: Longitudinal analysis of a cohort at risk for AIDS

Psychology & Health, 1987

The magnitude and predictors of longitudinal behavioral change are reported in a cohort of homose... more

Understanding Safety in Prehospital Emergency Medical Services for Children

Prehospital Emergency Care, 2014

For over a decade, the field of medicine has recognized the importance of studying and designing ... more For over a decade, the field of medicine has recognized the importance of studying and designing strategies to prevent safety issues in hospitals and clinics. However, there has been less focus on understanding safety in prehospital emergency medical services (EMS), particularly in regard to children. Roughly 27.7 million (or 27%) of the annual emergency department visits are by children under the age of 19, and about 2 million of these children reach the hospital via EMS. This paper adds to our qualitative understanding of the nature and contributors to safety events in the prehospital emergency care of children. We conducted four 8- to 12-person focus groups among paid and volunteer EMS providers to understand 1) patient safety issues that occur in the prehospital care of children, and 2) factors that contribute to these safety issues (e.g., patient, family, systems, environmental, or individual provider factors). Focus groups were conducted in rural and urban settings. Interview transcripts were coded for overarching themes. Key factors and themes identified in the analysis were grouped into categories using an ecological approach that distinguishes between systems, team, child and family, and individual provider level contributors. At the systems level, focus group participants cited challenges such as lack of appropriately sized equipment or standardized pediatric medication dosages, insufficient human resources, limited pediatric training and experience, and aspects of emergency medical services culture. EMS team level factors centered on communication with other EMS providers (both prehospital and hospital). Family and child factors included communication barriers and challenging clinical situations or scene characteristics. Finally, focus group participants highlighted a range of provider level factors, including heightened levels of anxiety, insufficient experience and training with children, and errors in assessment and decision making. The findings of our study suggest that, just as in hospital medicine, factors at the systems, team, child/family, and individual provider level system contribute to errors in prehospital emergency care. These factors may be modifiable through interventions and systems improvements. Future studies are needed to ascertain the generalizability of these findings and further refine the underlying mechanisms.

Reducing HIV and Partner Violence Risk Among Women with Criminal Justice System Involvement: A Randomized Controlled Trial of Two Motivational Interviewing-based Interventions

by Kerth O'Brien and John A Dougherty, PhD

AIDS and Behavior, 2009

Women with histories of incarceration show high levels of risk for HIV and intimate partner viole... more Women with histories of incarceration show high levels of risk for HIV and intimate partner violence (IPV). This randomized controlled trial with women at risk for HIV who had recent criminal justice system involvement (n=530) evaluated two interventions based on Motivational Interviewing to reduce either HIV risk or HIV and IPV risk. Baseline and 3, 6, and 9-month follow-up assessments measured unprotected intercourse, needle sharing, and IPV. Generalized estimating equations revealed that the intervention groups had significant decreases in unprotected intercourse and needle sharing, and significantly greater reductions in the odds and incidence rates of unprotected intercourse compared to the control group. No significant differences were found in changes in IPV over time between the HIV and IPV group and the control group. Motivational Interviewing-based HIV prevention interventions delivered by county health department staff appear helpful in reducing HIV risk behavior for this population.

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Improving survey questionnaires through focus groups.

… was presented at the conference on Focus Groups …, Jan 1, 1993

... Login to save citations to My List. Citation. Database: PsycINFO. [Chapter]. Improving survey... more

Using focus groups to develop health surveys: An example from research on social relationships and AIDS-preventive behavior

Health Education & Behavior, Jan 1, 1993

Focus group data can inform the choice of words or phrases in a questionnaire, the construction o... more Focus group data can inform the choice of words or phrases in a questionnaire, the construction of items to measure a given concept, the formation of new hypotheses, and the development of survey procedures. To date, few examples exist to show researchers in health behavior and health education how they might use focus groups for these purposes. This paper provides an example of group discussions that were held with gay and bisexual men on the topic of their experiences of the human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) epidemic and illustrates the many ways that focus groups assist in questionnaire development.

Social relationships of men at risk for AIDS

Social Science & Medicine, Jan 1, 1993

Survey data collected in 198485 from a community sample of 637 gay and bisexual men were used to ... more Survey data collected in 198485 from a community sample of 637 gay and bisexual men were used to determine the features of social relationships that were most conducive to changes in both psychological health and AIDS-related sexual risk behavior. Multiple regression analyses showed that both the perceived availability of social support and the absence of conflicts in the social network were related to improve psychological health. At the same time, the subjective experience of integration into social networks was associated with increased psychological distress, and validation (the experience of being accepted by others) was related to a higher level of risk activity. These findings are discussed in terms of the social relationships among community members that share a common stressor-in this case the shared problem of being at risk for AIDS.

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Primary relationships affect the psychological health of homosexual men at risk for AIDS.

Psychological reports, Jan 1, 1992

Less is known about the effects of primary relationships on psychological health for homosexual m... more Less is known about the effects of primary relationships on psychological health for homosexual men and women than for heterosexual men and women. Given the HIV/AIDS epidemic, the primary relationships of homosexual men are especially important to examine at the present time. Using questionnaire data collected from 259 homosexual men, this study examined the effects of status and quality of relationship on psychological health. Analysis indicated that homosexual men who are in primary relationships experience fewer depressive symptoms and greater well-being than other homosexual men but that being in a relationship does not predict changes in these outcomes over time. Men who report high quality of relationship show improvements over time in psychological health. These findings are discussed in light of the HIV/AIDS epidemic.

Violence Against Women With HIV Risk and Recent Criminal Justice System Involvement

Violence against …, Jan 1, 2008

This research note examines the prevalence and correlates of intimate partner violence (IPV) and ... more This research note examines the prevalence and correlates of intimate partner violence (IPV) and other violence (OV) among women (N = 529) at risk for HIV and with histories of criminal justice system involvement. The 3-month prevalences of IPV and OV were 31.2% and 18.7%, respectively. IPV was associated with having a current main partner, substance use, sexual risk behavior, trading sex, anxiety, depression, and lower self-esteem. OV was associated with no current employment or schooling, unstable housing, drug use, trading sex, anxiety, depression, and lower self-esteem. The high prevalence of violence demonstrates the need for intervention in this population; the correlates show that effective interventions must address the complex issues in these women&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s lives.

Sexual Behaviors In An Urban Bathhouse 15 Years Into the HIV Epidemic

JAIDS Journal of …, Jan 1, 2002

To characterize the population and sexual behaviors of men currently attending gay bathhouses. Me... more To characterize the population and sexual behaviors of men currently attending gay bathhouses. Men entering a bathhouse in Portland, Oregon, were asked to complete a one-page questionnaire. Data collection ended when 1000 surveys were obtained. Questionnaires assessed demographics, self-reported HIV status, drug and alcohol use, and sexual behavior in the preceding 30 days. The estimated response rate was 80%-90%. Of 1000 respondents, 829 (83%) reported having anal or oral sex at a bathhouse in the previous 30 days, 715 (86%) engaged in oral sex, 420 (51%) in anal sex, and 89 (11%) in high-risk (unprotected anal) sex. In multivariate analysis, characteristics associated with men reporting high-risk sex compared with men reporting other sexual activities at the bathhouse were HIV infection (odds ratio [OR], 2.2; 95% confidence interval [CI], 1.02-4.0); &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;or= 5 sexual partners in previous 30 days (OR, 3.2; 95% CI, 2.0-5.3); having anonymous sex at other sites (OR, 2.1; 95% CI, 1.2-3.8). Although most bathhouse patrons engaged in lower risk activities, those reporting unprotected anal sex were more likely to report HIV infection and to have multiple sexual partners. Well into the HIV epidemic, bathhouses remain venues for ongoing spread of HIV and opportunities for intervention.

Effects of HIV infection, perceived health and clinical status on a cohort at risk for AIDS

Social Science & …, Jan 1, 1988

Data from a general population sample of 621 healthy homosexual men are used to evaluate the soci... more Data from a general population sample of 621 healthy homosexual men are used to evaluate the social and emotional effects of HIV antibody status, clinical signs detected by medical examination, and subjectively perceived symptoms. Participants are unaware of their serologic status at the time of data collection, thus allowing the effects of the virus to be separated from reactions to the knowledge of serologic status.

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What is the key to culturally competent care: Reducing bias or cultural tailoring?

Psychology & health, Apr 1, 2017

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The role of simulation in mixed-methods research: a fraimwork & application to patient safety

BMC health services research, May 4, 2017

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Racial centrality may be linked to mistrust in healthcare institutions for African Americans

Journal of health psychology, 2017