About

Katherine McClellan Hastings, MD, is a board-certified family medicine physician practicing at the Madsen Health Center. She has a special interest in the care of adolescents and young adults. Dr. Hastings studied philosophy at Miami University in Oxford, Ohio, attended Georgetown University School of Medicine, and completed her residency training at the University of Utah, where she served as a chief medical resident. She currently directs the Family Medicine Longitudinal Integrated Clerkship for University of Utah medical students. Her professional interests include women's health, pediatric care, birth control management, mental health, stress management, and eating disorder management. She is highly regarded by patients for her thorough, compassionate, and patient-centered approach to care, emphasizing effective communication, understanding, and partnership in health management.

Research topics

• Medicine
• Clinical psychology
• Environmental health
• Psychiatry
• Physical therapy
• Internal medicine
• Psychology
• Surgery

Selected publications

• Factors Influencing the Adoption of a Patient Decision Aid Development Platform: A Qualitative Study

  MDM Policy & Practice · 2026-01-01

  articleOpen access

  Background. Developing patient decision aids (PtDAs) requires considerable resources. We aimed to create a digital platform to streamline the process and investigate stakeholder perceptions of factors influencing the adoption of a mock-up of the platform. Methods. Using the Framework for Innovation, a design team developed an alpha version of the platform, with support from an advisory panel. A convenience sample of key stakeholders involved in the development of PtDAs, who were fluent in English, French, or Spanish, reviewed the mock-up in think-aloud sessions and answered open-ended questions structured along Normalization Process Theory constructs: Coherence, Cognitive Participation, Collective Action, and Reflective Monitoring. A thematic qualitative analysis was conducted by 3 researchers, iteratively improving the mock-up until no major issues emerged. Results. We recruited 20 participants, mainly women ( n = 11), from 4 continents, including clinician–researchers ( n = 15), patients ( n = 4), and a health care manager ( n = 1). Their experience in developing PtDAs ranged from none ( n = 2) to more than 10 PtDAs ( n = 1), with most having developed 2 to 5 PtDAs ( n = 9). Participants noted that the platform could enhance the shared understanding of processes and roles (Coherence), support input from different stakeholders (Cognitive Participation), and streamline development and revision, recommending features such as version tracking (Collective Action). They also emphasized the need for customizable PtDA templates, training, and PtDA certification (Reflective Monitoring). Limitations. Few participants were from middle- or low-income countries, limiting the findings’ transferability to these populations. Conclusions. Next steps include developing and evaluating a minimum viable version of the platform incorporating these findings. Implications. This innovation has the potential to scale the development of PtDAs and ultimately support evidence-based and preference-sensitive clinical decisions. Highlights This formative research presents an innovative infrastructure designed to scale patient decision aids through capacity-building tools and standardized templates. Stakeholder feedback suggests that the platform could enable more timely and resource-efficient development of decision aids, although its effectiveness has yet to be evaluated. The platform’s collaborative features could foster partnerships between developers, clinicians, and patients by promoting a shared understanding of the process and making roles and decisions about content more transparent. To increase confidence in the quality of decision aids, future work should introduce a validation process for decision aids and integrate evidence-synthesis guidance into the platform.

  PublisherDOI

• Child access prevention laws and firearm storage in the US: Associations by law stringency and social vulnerability

  Preventive Medicine · 2026-01-20

  articleOpen access

  OBJECTIVE: It is unclear whether Child Access Prevention (CAP) laws influence firearm storage.We sought to analyze the association of CAP laws with loaded and unlocked firearm storage. METHODS: We used logistic regressions to analyze survey data of 2264 firearm owners from a 2023 nationally representative U.S. SAMPLE: Secondary analyses disaggregated CAP laws by stringency (i.e., liability thresholds for negligent storage) and examined associations by parental status and county social vulnerability. RESULTS: Nearly one-third of U.S. firearm owners reported storing at least one firearm loaded and unlocked (unsecure storage). Residence in a CAP law state was only associated with lower odds of unsecure storage in unadjusted models; however, firearm-owning adults in states with the most stringent CAP laws were less likely to report unsecure storage than those in non-CAP law states even after covariate adjustment. In analyses stratified by county social vulnerability, CAP laws were only associated with lower odds of unsecure storage in the least vulnerable counties. CONCLUSION: Our results suggest that the relationship between CAP laws and firearm storage varies depending on the stringency of the law and county social vulnerability. Understanding how these and other factors drive effect heterogeneity will inform CAP laws and implementation efforts.

  PublisherDOI

• Medical Student Perceptions of Psychological Safety in the Clinical Learning Environment

  The Clinical Teacher · 2026-01-29 · 3 citations

  articleOpen access

  INTRODUCTION: Psychological safety in the learning environment allows students to take risks without fear of humiliation or negative consequences. The psychological safety of healthcare teams has been studied at three levels: organizational, team and individual. Prior work has shown how leadership behaviours contribute to student perceptions of psychological safety in the clinical learning environment, but less is known about the impact of organizational and individual factors. The present study explored student perceptions of facilitators and barriers of psychological safety in the clinical learning environment. METHODS: We conducted a qualitative case study in Academic Year 2022-2023. We held four focus groups with 23 third- and fourth-year medical students at Spencer Fox Eccles School of Medicine. Focus groups were recorded and transcribed verbatim; transcripts were analysed using thematic analysis. RESULTS: Thematic analysis revealed that there were organizational supports and barriers, inclusive and exclusive leadership behaviours and individual student characteristics that affected psychological safety in the learning environment. Psychological safety exists when high levels of organizational support and inclusive behaviour are present. However, it is also possible for an organizational support or an inclusive leader behaviour to overcome an exclusive leader behaviour or an organizational barrier, respectively. CONCLUSIONS: Organizational support and inclusive leadership behaviours foster psychological safety. Furthermore, it appears that psychological safety factors do not exist in isolation, but rather in tandem with one another. This makes it possible for an individual medical educator or organizational support to foster psychological safety even when organizational barriers or exclusionary behaviours from other supervisors exist.

  PublisherOA PDFDOI

• Corrigendum to “Child access prevention laws and firearm storage in the US: Associations by law stringency and social vulnerability” Preventive Medicine Volume 204 (2026), 108516

  Preventive Medicine · 2026-04-21

  article
  PublisherDOI

• Service use patterns among youth reporting suicide ideation in an integrated youth service network in British Columbia, Canada

  International Journal of Integrated Care · 2025-04-09

  articleOpen access1st authorCorresponding

  Background: Addressing suicidal behaviors (i.e., ideation or thoughts, planning, or attempt) among youth is increasingly complex and often requires a comprehensive and integrated approach to care. Integrated youth services (IYS) are a growing model of care in which youth can access a range of non-stigmatizing health and social services all delivered within a single location. In British Columbia (BC), Foundry is one of the largest IYS networks in Canada. To date, little is known about the demographics and help-seeking behaviors among youth experiencing suicidal behaviors in IYS. In this study, we examine service patterns and characteristics of youth reporting suicide ideation to better understand and address their IYS care needs. Methods: We used cross-sectional data from Foundry from May 2018 to January 2023, which includes linked demographic, health, and physician-reported survey data aggregated from 13 IYS centres across BC. Survey data is collected during an initial visit to Foundry. Descriptive statistics and bivariate analyses by various demographics, geographic, and service use variables were compared by youth who reported having suicide ideation (SI) within the ‘past month’ of their visit as compared to youth who reported ‘never’ having SI. Standardized differences (SD) were calculated to determine statistical significance between groups. We examined the proportion of youth reporting SI coming to Foundry by month over the study period. We also examined these trends by certain subpopulations such as gender, sexual identity, race, and age group. Results: A total of 8,347 individuals were included in the study. Of this sample, a total of 6,021 (72%) had reported any lifetime SI. A total of 2,975 (36%) individuals reported having SI in ‘the past month’. We found that youth experiencing SI were more likely to be gender diverse (13% with SI vs. 4% without SI), identified as sexual minorities (45% vs. 22%), Indigenous (11% vs. 8%), insecure housing (8% vs. 4%), and reported as having ‘not always lived with their parents’ (42% vs. 30%) as compared to youth who never had SI. On average, youth reporting SI in the past month had more contact with Foundry services than those without SI (9.1 vs. 5.5 visits), and had accessed other mental health services in the last year (43% vs. 21%). Youth with SI in the past month also had higher distress scores (as measured by the Kessler Psychological Distress score), with 77% having a score over 30 (i.e., ‘likely to have a severe mental health disorder’). We found no substantial change in the overall proportion of youth reporting suicide ideation over the study period, but trends by subpopulations revealed slight increases in the proportion of ‘past month’ suicide ideation among girls and visible minority groups in the last 1-2 few years. Discussion: Many youth seeking IYS services reported having suicide ideation (or thoughts), particularly within the past month of the visit, indicating a major opportunity for low-barrier, early intervention. Our findings characterize those who may be disproportionately impacted and their current help-seeking behaviors within IYS to identify service gaps and needs for targeted intervention.

  PublisherOA PDFDOI

• The multidimensional social ecological needs and service utilization patterns of youth using non-medical prescription opioids: an observational study of routinely collected data in a provincial integrated youth services initiative

  Substance Abuse Treatment Prevention and Policy · 2025-11-26

  articleOpen access

  BACKGROUND: The present study aimed to identify opportunities for earlier intervention of non-medical prescription opioid use (NMPOU) among youth (aged 12-24) by characterizing the multidimensional social ecological needs of youth reporting NMPOU and their service utilization patterns in an expanding integrated youth services network. METHODS: The sample (n = 6181) included youth who accessed a novel integrated youth services (IYS) network in British Columbia, Canada, which delivers five core service streams for youth health and well-being through coordinated services. Analyses were conducted on routinely collected data drawn from youths' self-reported demographic and health measures and service provider-reported service utilization data. Multivariable logistic regression identified factors associated with past 30-day NMPOU and multivariable Poisson regression was used to compare service utilization outcomes between youth with and without NMPOU. RESULTS: A total of 248 (4%) youth reported past 30-day NMPOU. Multidimensional factors independently associated with NMPOU included poor self-rated physical health compared to excellent/very good physical health (adjusted odds ratio (aOR) = 2.51, 95% Confidence Interval (95% CI) = 1.39, 4.56), high likelihood of externalizing mental health disorders compared to low likelihood (aOR = 1.72, 95% CI = 1.03, 2.86), past 30-day illicit polydrug use compared to none (aOR = 10.00, 95% CI = 5.89, 16.99), and past 3-month exposure to violence compared to none (aOR = 2.18, 95% CI = 1.62, 2.92). Rates of service utilization were similar between youth with and without NMPOU (adjusted relative rate = 1.02, 95% CI = 0.95, 1.32). CONCLUSIONS: These findings indicate that youth with NMPOU present to IYS with several individual, interpersonal, and community-related social ecological needs. Integrated care models may be beneficial to address these multidimensional needs and reduce barriers to service utilization, thereby providing opportunity for earlier intervention of NMPOU among youth. Future research should examine the extent to which IYS reduce the incidence of NMPOU and improve opioid-related health and social outcomes among youth.

  PublisherOA PDFDOI

• Parental Firearm Storage and Their Teens’ Perceived Firearm Access in US Households

  JAMA Network Open · 2025-06-10 · 5 citations

  articleOpen access1st authorCorresponding

  Importance: Firearm access increases fatal and nonfatal firearm injury risk among teens. Identifying parental firearm storage behaviors associated with teen access may inform efforts to prevent teen firearm injuries. Objective: To examine the associations between parent-reported household firearm storage behaviors and teen perceived access to firearms. Design, Setting, and Participants: This cross-sectional study used national survey data of US firearm-owning parents and their teens (aged 14 to 18 years) surveyed between June and July 2020, with a response rate of 31% for parents and 21% for teens. Analyses were conducted January to May 2024. Exposures: The number of firearms stored in the household as (1) unlocked, (2) loaded, (3) unlocked and loaded, and (4) unlocked or loaded. Main Outcomes and Measures: Teen perceived firearm access, overall and stratified by teen gender, parental education, and urbanicity. Survey-weighted logistic regression analyses assessed the associations between the number of firearms parents reported storing in each unsecured state (unlocked and loaded, unlocked, loaded, and unlocked or loaded) and teen perceived firearm access, overall and stratified by teen gender, parental education, and urbanicity (metropolitan vs nonmetropolitan). The areas under the receiver operating characteristic curves (AUROC) were used to identify the firearm storage behaviors with the best ability to estimate teen perceived firearm access. Results: Analyses included 487 parent-teen dyad respondents. The mean (SE) ages of parents and teens were 46.6 (0.80) and 16.0 (0.12) years, respectively. Most parent respondents were male (58.1%; 95% CI, 50.3%-65.8%) and White (73.5%; 95% CI, 66.1%-80.9%), and most teen respondents were female (55.7%; 95% CI, 47.8%-63.6%) and White (69.5%; 95% CI, 61.8%-77.2%). All 4 unsecured firearm storage behaviors were associated with greater teen perceived firearm access (odds ratio [OR], 1.27-1.44; 95% CI, 0.99-2.10), but associations disappeared after restricting to those who stored at least 1 firearm unsecured (OR, 0.99-1.18; 95% CI, 0.67-1.89). The number of firearms stored unlocked performed the best in estimating teen perceived access to firearms in US households (AUROC, 65.7; 95% CI, 61.4-70.1), regardless of teen gender, parental education, and urbanicity. However, sensitivity of this measure was universally low (range, 42%-64%). Additionally, 36.3% (95% CI, 23.6%-49.0%) of teens reported access to a firearm in households where all firearms were stored locked and unloaded. Conclusions and Relevance: This study found that parent-reported firearm storage may be a poor estimator of teen perceived firearm access, regardless of teen gender, parental education, and urbanicity. Strictly focusing safety efforts on locked and unloaded firearm storage may not fully negate teen's perceptions that they can access and load household firearms. Storing additional firearms securely may not prevent teen access if at least 1 household firearm remains unlocked.

  PublisherOA PDFDOI

• Self-reported preoperative anxiety and depression associated with worse patient-reported outcomes for periacetabular osteotomy and hip arthroscopy surgery

  Journal of Hip Preservation Surgery · 2024-08-23 · 8 citations

  articleOpen access

  Abstract Adverse mental health status has been linked to less successful surgical outcomes across several orthopaedic subspecialties. Mental health represents a modifiable risk factor that can be optimized preoperatively to maximize outcomes for hip preservation surgery. This study examines the relationship between preoperative mental health status and preoperative and postoperative outcomes for adolescent and adult patients undergoing hip preservation surgery. A prospectively enrolled registry of patients undergoing periacetabular osteotomy or hip arthroscopy at a single institution between 2013 and 2021 was retrospectively reviewed to collect demographics and outcomes before and after surgery. We identified patients self-reporting anxiety/depression or no anxiety/depression preoperatively based on responses to the EuroQol-5D anxiety/depression dimension and compared their preoperative and postoperative Hip disability and Osteoarthritis Outcome Scores (HOOSs) using multivariable linear models and multivariable mixed effects models. Seventy-three patients were included, 40 patients with no anxiety/depression and 33 patients with anxiety/depression. Patients with anxiety/depression had worse preoperative HOOS pain (b = −12.5, P = .029), function in daily living (b = −12.0, P = .045), function in sports and recreational activities (b = −15.1, P = .030), and quality of life (b = −16.3, P = .005) as compared to patients with no anxiety/depression. Patients with anxiety/depression had worse postoperative HOOS compared to patients with no anxiety/depression, but these associations were not statistically significant after adjusting for preoperative HOOS. There were no significant differences between both groups for percent achieving minimal clinically important difference. Patients who reported anxiety/depression preoperatively had worse preoperative pain and function before hip preservation surgery, with both groups achieving similar levels of clinical effectiveness.

  PublisherOA PDFDOI

• Implementing Foundry: A cohort study describing the regional and virtual expansion of a youth integrated service in British Columbia, Canada

  Early Intervention in Psychiatry · 2024-05-12 · 20 citations

  articleOpen access

  AIM: Integrated youth services (IYS) have been identified as a national priority in response to the youth mental health and substance use (MHSU) crisis in Canada. In British Columbia (BC), an IYS initiative called Foundry expanded to 11 physical centres and launched a virtual service. The aim of the study was to describe the demographics of Foundry clients and patterns of service utilization during this expansion, along with the impact of the COVID-19 pandemic. METHODS: Data were analysed for all youth (ages 12-24) accessing both in-person (April 27th, 2018-March 31st, 2021) and virtual (May 1st, 2020-March 31st, 2021) services. Cohorts containing all clients from before (April 27th, 2018-March 16th, 2020) and during (March 17th, 2020-March 31st, 2021) the COVID-19 pandemic were also examined. RESULTS: A total of 23 749 unique youth accessed Foundry during the study period, with 110 145 services provided. Mean client age was 19.54 years (SD = 3.45) and 62% identified as female. Over 60% of youth scored 'high' or 'very high' for distress and 29% had a self-rated mental health of 'poor', with similar percentages seen for all services and virtual services. These ratings stayed consistent before and during the COVID-19 pandemic. CONCLUSIONS: Foundry has continued to reach the target age group, with a 65% increase in number of clients during the study period compared with the pilot stage. This study highlights lessons learned and next steps to promote youth-centred data capture practices over time within an integrated youth services context.

  PublisherOA PDFDOI

• Poster 379: Mentorship and Research Program to Improve Opportunity Among Underrepresented Students Pursuing Orthopaedic Surgery and Sports Medicine

  Orthopaedic Journal of Sports Medicine · 2023-07-01

  articleOpen access1st authorCorresponding

  Objectives: In North America, the orthopaedic specialty has limited diversity with over 80% of orthopaedic surgeons being caucaisan male. Over the last 20 years, many specialty societies have attempted to improve diversity in the specialty, with limited changes over the last 10 years. The purpose of this program was to identify a diverse and under-represented group of potential orthopaedic surgery resident candidates in the last year of college or first 2 years of medical school, and create an educational/mentorship experience that would increase their interest in orthopaedic careers. Methods: Over a 2-year period, we received over 250 applications and selected 17 and 10 students to participate in the summer 2021 and 2022 programs respectively. The program delivered a curriculum from June-August 2021, and 2022 consisting of 1) weekly instructional courses on research-related topics led by a content expert; 2) weekly faculty lectures discussing topics including orthopaedic topics, diversity in medicine, leadership, and work-life balance; and 3) an 8-week summer research experience paired with a faculty and peer mentor. We surveyed students to measure skill progression, satisfaction, and overall program evaluation. Pre/post-program evaluation, mid-program check-in, and student feedback surveys were collected. Results: Program participants represented a range of race and ethnic backgrounds, research experience level, and various geographic locations across the US. The cohort included a high rate of female (48%) and Black (30%) participants. On average, post-program survey scores indicated that participants believed that the summer program improved their research skills (9.4 of 10), improved their orthopaedic interest (9 of 10), and improved mentorship and networking (9.3 of 10). For feedback surveys, respondents (88%) felt they were adequately matched to their faculty mentor. (72% felt they had realistic deliverables for research projects within the 8-week program. 92% indicated they contributed to an abstract or manuscript as a co-author. Over 50% plan to apply to orthopaedic residency. Conclusions: This pilot study demonstrates the feasibility of building a high-impact remote summer program catered to underrepresented students interested in orthopaedics. Although a remote program has some limitations, it has some advantages, including : 1. allowing for a significant mentorship/research experience, that does not involve the cost/complexity of travel for 2 months, and 2. it allows access to people from a larger geographic area. Our findings indicate that students improved their research skills, interest, and confidence to pursue orthopaedic residency, and mentorship/networks in the field. We plan to longitudinally track program alumni and evaluate the overall impact of this program on the field of orthopaedics. This program is simple – a remote mentoring/research opportunity, that requires a small investment for centers to participate – but would benefit from having more mentors for the students. The large number of student applicants confirms a significant number of students that are interested in this program, and access to more mentors could increase the size and impact of the program. We encourage other centers to develop similar programs to support increased diversity in those that will pursue careers in orthopaedics and sports medicine.

  PublisherOA PDFDOI

Frequent coauthors

• Skye Barbic

  University of British Columbia

  40 shared

• Krysta-Leigh Gmitroski

  University of British Columbia

  36 shared

• Gabrielle Legault

  University of British Columbia

  36 shared

• Latha Palaniappan

  Stanford University

  28 shared

• Katerina Politi

  26 shared

• Anna Wurtz

  26 shared

• Scott Gettinger

  Moffitt Cancer Center

  26 shared

• Jungmin Choi

  Korea University Medical Center

  26 shared

Labs

• University of Utah HealthPI

Education

• B.A., Philosophy

  Miami University

• M.D.

  Georgetown University School of Medicine

• Other, Residency Training

  University of Utah