Objective: This study looked at three key variables of fear of COVID-19, preventative behaviors, and vaccination intent among college students in the United Sates. In addition, the three key variables were compared between genders, age groups, race groups, and over time to see if there were any significant findings. <br/>Method: This longitudinal study consisted of two anonymous online surveys administered on REDCap before and after a COVID-19 vaccine became available. <br/>Results: The findings suggested positive correlations between students’ fear of COVID-19 and their preventative behaviors with the passing of time. Hispanic/Latino participants had significantly higher fear of COVID-19 scores compared to Non-Hispanic Whites and other races at Wave I and II. Participants between 25 and 30 years old had a marginally greater difference fear of COVID-19 score compared to those less than 25. Females had significantly higher mean preventative behavior score than males at Wave II. There was a significant association between race/ethnicity groups and vaccination intent. <br/>Conclusion: Knowing why different groups do not engage in recommended preventative behaviors or receive vaccinations can tell us more about what tailored interventions may need to be developed and implemented to promote health and wellbeing in this population. Further research needs to be done regarding race, gender, and age and how these different groups of college students are responding to COVID-19 and why.

In a healthcare system already struggling with burnout among its professionals, the COVID-19 pandemic presented a barrage of personal and occupational strife to US healthcare workers. Structural and everyday discrimination contributed to the health inequities of people of color in the US, exacerbated by COVID-19-related racism and xenophobia. There is little research regarding the effects of COVID-19 and related and/or concurring discrimination upon minority nursing staff, despite their importance in supporting the diverse American patient population with culturally competent, tireless care amid the pandemic. This cross-sectional survey study aimed to examine 1) the relationships between discrimination, social support, resilience, and quality of life among minority nursing staff in the US during COVID-19, and 2) the differences of discrimination, social support resilience, and quality of life among minority nursing staff between different racial/ethnic groups during COVID-19. The sample (n = 514) included Black/African American (n = 161, 31.4%), Latinx/Hispanic (n = 131, 25.5%), Asian (n = 87, 17%), Native American/Alaskan Native (n = 69, 13.5%), and Pacific Islander (n = 65, 12.7%) nursing staff from 47 US states. The multiple regression results showed that witnessing discrimination was associated with a lower quality of life score, while higher social support and resilience scores were associated with higher quality of life scores across all racial groups. Furthermore, while participants from all racial groups witnessed and experienced discrimination, Hispanic/Latinx nursing staff experienced discrimination most commonly, alongside having lowest quality of life and highest resilience scores. Native American/Alaskan Native nursing staff had similarly high discrimination and low quality of life, although low resilience scores. Our findings suggest that minority nursing staff who have higher COVID-19 morbidity and mortality rates (Hispanic/Latinx, Native American/Alaskan Native) were left more vulnerable to negative effects from discrimination. Hispanic/Latinx nursing staff reported a relatively higher resilience score than all other groups, potentially attributed to the positive effects of biculturality in the workplace, however, the low average quality of life score suggests a simultaneous erosion of well-being. Compared to all other groups, Native American and Alaskan Native nursing staff’s low resilience and quality of life scores suggest a potential compounding effect of historical trauma affecting their well-being, especially in contrast to Hispanic/Latinx nursing staff. This study has broader implications for research on the lasting effects of COVID-19 on minority healthcare workers’ and communities’ well-being, especially regarding Hispanic/Latinx and Native American/Alaskan Native nursing staff.

Background: The cost of substance use (SU) in the United States (U.S.) is estimated at $1.25 trillion annually. SU is a worldwide health concern, impacting physical and psychological health of those who use substances, their friends, family members, communities and nations. Screening, Brief Intervention (BI) and Referral to Treatment (SBIRT) provides an evidence-based (EB) framework to detect and treat SU. Evidence shows that mental health (MH) providers are not providing EB SU management. Federally grant-funded SBIRT demonstrated evidence of decreased SU and prevention of full disorders. Implementation outcomes in smaller-scale projects have included increased clinician knowledge, documentation and interdisciplinary teamwork.

Objective: To improve quality of care (QOC) for adolescents who use substances in the inpatient psychiatric setting by implementing EB SBIRT practices.

Methods: Research questions focused on whether the number of SBIRT notes documented (N=170 charts) increased and whether training of the interdisciplinary team (N=26 clinicians) increased SBIRT knowledge. Individualized interventions used existing processes, training and a new SBIRT Note template. An SBIRT knowledge survey was adapted from a similar study. A pre-and post-chart audit was conducted to show increase in SBIRT documentation. The rationale for the latter was not only for compliance, but also so that all team members can know the status of SBIRT services. Thus, increased interdisciplinary teamwork was an intentional, though indirect, outcome.

Results: A paired-samples t-test indicated clinician SBIRT knowledge significantly increased, with a large effect size. The results suggest that a short, 45-60-minute tailored education module can significantly increase clinician SBIRT knowledge. Auditing screening & BI notes both before and after the study period yielded important patient SU information and which types of SBIRT documentation increased post-implementation. The CRAFFT scores of the patients were quite high from a SU perspective, averaging over 3/6 both pre- and post-implementation, revealing over an 80% chance that the adolescent patient had a SU disorder. Most patients were positive for at least one substance (pre- = 47.1%; post- = 65.2%), with cannabis and alcohol being the most commonly used substances. Completed CRAFFT screenings increased from 62.5% to 72.7% of audited patients. Post-implementation, there were two types of BI notes: the preexisting Progress Note BI (PN BI) and the new Auto-Text BI (AT BI), part of the new SBIRT Note template introduced during implementation. The PN BIs not completed despite a positive screen increased from 79.6% to 83.7%. PN BIs increased 1%. The option for AT BI notes ameliorated this effect. Total BI notes completed for a patient positive for a substance increased from 20.4% to 32.6%, with 67.4% not receiving a documented BI. Total BIs completed for all patients was 21.2% post-implementation.

Conclusion: This project is scalable throughout the U.S. in MH settings and will provide crucial knowledge about positive and negative drivers in small-scale SBIRT implementations. The role of registered nurses (RNs), social workers and psychiatrists in providing SBIRT services as an interdisciplinary team will be enhanced. Likely conclusions are that short trainings can significantly increase clinician knowledge about SBIRT and compliance with standards. Consistent with prior evidence, significant management involvement, SBIRT champions, thought leaders and other consistent emphasis is necessary to continue improving SBIRT practice in the target setting.

Keywords: adolescents, teenagers, youth, alcohol, behavioral health, cannabis, crisis, documentation, drug use, epidemic, high-risk use, illicit drugs, implementation, mental health, opiates, opioid, pilot study, psychiatric inpatient hospital, quality improvement, SBIRT, Screening, Brief Intervention and Referral to Treatment, substance use, unhealthy alcohol use, use disorders