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- Creators: Guthery, Ann
- Creators: School of Sustainability
Abstract
Objective: To assess the attitudes and knowledge of behavioral health technicians (BHTs)
towards opioid overdose management and to assess the effect of online training on opioid
overdose response on BHTs’ attitudes and knowledge, and the confidence to identify and
respond to opioid overdose situations.
Design/Methods: Pre-intervention Opioid Overdose Knowledge Scale (OOKS) and Opioid
Overdose Attitude Scale (OOAS) surveys were administered electronically to five BHTs in
2020. Data obtained were de-identified. Comparisons between responses to pre-and post-surveys questions were carried out using the standardized Wilcoxon signed-rank statistical test(z). This study was conducted in a residential treatment center (RTC) with the institutional review board's approval from Arizona State University. BHTs aged 18 years and above, working at this RTC were included in the study.
Interventions: An online training was provided on opioid overdose response (OOR) and
naloxone administration and on when to refer patients with opioid use disorder (OUD) for
medication-assisted treatment.
Results: Compared to the pre-intervention surveys, the BHTs showed significant improvements
in attitudes on the overall score on the OOAS (mean= 26.4 ± 13.1; 95% CI = 10.1 - 42.7; z =
2.02; p = 0.043) and significant improvement in knowledge on the OOKS (mean= 10.6 ± 6.5;
95% CI = 2.5 – 18.7; z =2.02, p = 0.043).
Conclusions and Relevance: Training BHTs working in an RTC on opioid overdose response is
effective in increasing attitudes and knowledge related to opioid overdose management. opioid
overdose reversal in RTCs.
Keywords: Naloxone, opioid overdose, overdose education, overdose response program
Childhood traumatic experiences are a prevalent public health issue. Children exposed to trauma often exhibit behaviors that make educating them challenging. Preschool teachers at a southwestern United States preschool receive no training related to childhood trauma and resilience. The purpose of this project was to educate preschool teachers on trauma and resilience to improve attitude related to educating children with trauma.
Following Arizona State University Internal Review Board approval, preschool teachers were recruited from a non-profit metropolitan preschool. Project included two pre-training questionnaires (Adult Resilience Measure-Revised [ARM-R] and Attitudes Related to Trauma Informed Care scale [ARTIC]), one two-hour training via Zoom on childhood trauma and resilience, and post-training ARTIC questionnaire at two and six weeks.
Seven teachers (n=7) participated in pre-training questionnaires, and three of these teachers (n=3) participated in both post-training questionnaires. All participating teachers were female and Caucasian. Average age of participants was 49.43 years (SD=8.40, range 36-60), and experience average was 17.17 years (SD=10.15, range 3-30). AMR-R average score was 72.29 (SD=8.28, range 61-83). Pre-training ARTIC score average was 3.87 (SD=0.16). Post-training ARTIC scores at two weeks and six weeks post-training were 3.65 (SD=0.22) and 3.86 (SD=0.25).
Clinical significance included improved teacher awareness of childhood trauma and improved ability to interact with children exposed to trauma. Teachers exhibited high resilience scores. Additional research needed related to further address educating preschool teachers related to trauma informed care, related to building resilience in children, and related to the impact of teacher resilience on trauma informed care.
Keywords: teacher training, adverse childhood experiences, ACEs, childhood trauma, resilience
For decades, understanding the complexity of behaviors, motivations, and values has interested researchers across various disciplines. So much so that there are numerous terms, frameworks, theories, and studies devoted to understanding these complexities and how they interact and evolve into actions. However, little research has examined how employee behaviors translate into the work environment, particularly regarding perceived organizational success. This study advances research by quantitatively assessing how a greater number of individual employees’ pro-environmental behaviors are related to the perceived success of environmentally sustainable workplace activities. We have concluded that the more pro-environmental behaviors an employee embodies, the more positively they perceive the success of their local government's sustainable purchasing policy. Additionally, other factors matter, including organizational behaviors, like training, innovation, and reduction of red tape.
BACKGROUND: The City of Phoenix initiated the HeatReady program in 2018 to prepare for extreme heat, as there was no official tool, framework, or mechanism at the city level to manage extreme heat. The current landscape of heat safety culture in schools, which are critical community hubs, has received less illumination. HeatReady Schools—a critical component of a HeatReady City—are those that are increasingly able to identify, prepare for, mitigate, track, and respond to the negative impacts of schoolgrounds heat. However, minimal attention has been given to formalize heat preparedness in schools to mitigate high temperatures and health concerns in schoolchildren, a heat-vulnerable population. This study set out to understand heat perceptions, (re)actions, and recommendations of key stakeholders and to identify critical themes around heat readiness. METHODS: An exploratory sequential mixed-methods case study approach was used. These methods focused on acquiring new insight on heat perceptions at elementary schools through semi-structured interviews using thematic analysis and the Delphi panel. Participants included public health professionals and school community members at two elementary schools—one public charter, one public—in South Phoenix, Arizona, a region that has been burdened historically with inequitable distribution of heat resources due to environmental racism and injustices. RESULTS: Findings demonstrated that 1) current heat safety resources are available but not fully utilized within the school sites, 2) expert opinions support that extreme heat readiness plans must account for site-specific needs, particularly education as a first step, and 3) students are negatively impacted by the effects of extreme heat, whether direct or indirect, both inside and outside the classroom. CONCLUSIONS: From key informant interviews and a Delphi panel, a list of 30 final recommendations were developed as important actions to be taken to become “HeatReady.” Future work will apply these recommendations in a HeatReady School Growth Tool that schools can tailor be to their individual needs to improve heat safety and protection measures at schools.
The number of children taking second-generation antipsychotics (SGA) is increasing. While SGAs produce fewer neurological side effects, the metabolic side effects of SGAs increase the risk for future cardiometabolic disease. In 2011, the American Academy of Child and Adolescent Psychiatry endorsed following guidelines established in 2004 recommending that people taking SGAs receive regular metabolic screening including waist circumference measurement, fasting blood glucose, and fasting lipids. Despite recommendations, studies have shown that children do not receive routine metabolic monitoring. Provider attitudes toward following guidelines can influence the rates of monitoring.
Research suggests that monitoring rates improve after psychiatric providers receive educational programs on SGA use and recommended guidelines. In response to these findings, an evidence-based educational intervention discussing SGA use in children and recommended metabolic monitoring was proposed to increase the rates of metabolic monitoring in a community-based psychiatric practice that treats children. While no results were statistically significant, the average attitude score of providers toward following guidelines was higher post-education and the proportion of providers who ordered screening tests post-education increased. To further improve metabolic monitoring, it is recommended that interventions designed to increase the subjective norms and perceived behavioral control of providers be implemented. The main limitations of this project were the small sample size and the use of self-reports to assess provider ordering of screening tests.
Seclusion and restraint are restrictive interventions that continue to be used in both physical care and mental health care settings as a means of controlling dangerous behavior such as aggression. Restrictive interventions place patients and healthcare staff in hostile situations that can lead to physical, mental, and emotional injuries that can last a lifetime. Unfortunately, restrictive interventions continue to be used in many healthcare organizations around the world and the number of patient and staff injuries continue to rise. Stakeholders at a Phoenix area psychiatric inpatient hospital conducted an internal audit on the number of seclusion and restraint episodes in 2019, which revealed an increase in the number of seclusion and restraints episodes on the adolescent unit.
The result of this audit led to the project question: For nurses on an acute adolescent inpatient unit, is a seclusion and restraint education program more effective than usual
practice in changing the knowledge and attitude regarding seclusion and restraint? The purpose of this practice change project was to provide staff education that focused on trauma informed care, de-escalation techniques, and therapeutic communication to improve staff confidence to ultimately lead to the reduction of seclusion and restraint use on an adolescent inpatient unit. A
pre and posttest questionnaire designed to better understand nurse attitude and knowledge regarding restrictive interventions prior to the education session was provided. A convenience sample of nurses (N=9) participated in the project. The findings from the pre and posttest questionnaire suggest that seclusion and restraint education for nurses may improve nurse knowledge and attitude regarding the use of restrictive interventions and reduce rates of use.