title: Does expressive writing reduce health care utilization? A meta-analysis of randomized trials.
abstract: This meta-analysis examined whether writing about stressful experiences affects health care utilization (HCU) compared with writing on neutral topics or no-writing control groups. Randomized controlled trials of 30 independent samples representing 2,294 participants were located that contained sufficient information to calculate effect sizes. After omitting one study as an outlier, the effects were combined within 3 homogeneous groups: healthy samples (13 studies), samples with preexisting medical conditions (6 studies), and samples prescreened for psychological criteria (10 studies). Combined effect sizes, Hedges's g (95% confidence interval), with random effects estimation were 0.16 (0.02, 0.31), 0.21 (-0.02, 0.43), and 0.06 (-0.12, 0.24), respectively. Writing about stressful experiences reduces HCU in healthy samples but not in samples defined by medical diagnoses or exposure to stress or other psychological factors. The significance of these effects for individuals' health is unknown.
authors.affiliation: Center for Health Care EvaluationU.S. Department of Veterans Affairs Health Care System, Palo Alto, CA 94025, USA. Alexander.Harris2@va.gov
authors.forename: Alex H S
authors.initials: AH
authors.lastname: Harris
mesh_terms: D006296:Health Services / Q000706:statistics & numerical data*; D006801:Humans; D033262:Narration; D016032:Randomized Controlled Trials as Topic; D013315:Stress, Psychological / Q000453:epidemiology / Q000523:psychology; D014705:Verbal Behavior; D014956:Writing