PT - JOURNAL ARTICLE AU - Dunn, Kevin AU - Temte, Jonathan TI - Moral Injury and Planetary Health in Primary Care AID - 10.1370/afm.22.s1.5599 DP - 2023 Nov 01 TA - The Annals of Family Medicine PG - 5599 VI - 21 IP - Supplement 3 4099 - http://www.annfammed.org/content/21/Supplement_3/5599.short 4100 - http://www.annfammed.org/content/21/Supplement_3/5599.full SO - Ann Fam Med2023 Nov 01; 21 AB - Context: Moral injury (MI) is the phenomenon that occurs “when one perpetrates, witnesses, or fails to prevent acts that transgress deeply held moral beliefs.” Climate change is an ongoing public health crisis that adds to the morally injurious circumstances facing primary care clinicians, especially considering their knowledge base, participation in a carbon costly sector of the economy, and lifestyles linked to relatively high incomes. Assessment of MI has not been applied to clinicians in the context of climate change.Objective: Explore MI as experienced by primary care clinicians and health professions students in the context of climate change and planetary health.Study Design and Analysis: Cross-sectional, exploratory evaluation of MI reported by clinicians and trainees in the context of climate change attitude (CCA) using Pearson correlation.Setting: University of Wisconsin School of Medicine and Public Health (UWSMPH) during June and July of 2023.Population Studied: Primary care clinicians (physicians, resident physicians, and advanced practice providers [APP]) in the Department of Family Medicine and Community Health, and UWSMPH medical and APP students.Intervention/Instrument: A 23-item survey was distributed to the study population via email using Qualtrics with re-distribution to non-responders. The survey contained sections assessing participant CCA, the MI symptom scale adapted for climate change (MISS-cc), general dysphoria (PHQ-2 plus GAD-2), and participant demographics.Outcome Measures: The rate and extent of MI were assessed, as well as correlation between MI and other assessed variables, including CCA and dysphoria.Results: 131 total surveys were completed (response rate = 42.5%). The average MISS-cc score was 45.5, and 80.2% of participants scored at or above the MI threshold of 36. Moderate, positive correlation (r = 0.56; P<0.0001) was found between CCA and MISS-cc, and MISS-cc and an internal control for functionality (rs=0.46; P<0.0001). Low correlation was found between MISS-cc and dysphoria (rs=0.16; P=0.065).Conclusions: An extraordinarily high rate of MI with respect to climate change was detected among the study population. The degree of MI appears to be associated with CCA. Academic primary care clinicians may represent motivated agents of change in climate response. Further examination of climate change-related moral injury needs to be repeated in larger, more representative study populations.