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Advancing the Implementation of Medication-Assisted Treatment in Residential Treatment

Description

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

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.

Contributors

Agent

Created

Date Created
2021-04-12

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Preschool Teacher Training on Trauma and Resilience

Description

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

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.

Contributors

Agent

Created

Date Created
2021-04-12

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Advocating for Routine ADHD Screening in Young Girls

Description

Objective: Attention Deficit Hyperactivity Disorder is a pervasive neurodevelopmental disorder among children. Research has shown that young girls are underserved in diagnosing and treating ADHD or never diagnosed compared males. Utilizing the Health Promotion Model, this project aims to determine

Objective: Attention Deficit Hyperactivity Disorder is a pervasive neurodevelopmental disorder among children. Research has shown that young girls are underserved in diagnosing and treating ADHD or never diagnosed compared males. Utilizing the Health Promotion Model, this project aims to determine if primary care providers are aware of sex differences in ADHD and if a brief education on sex differences in ADHD affects the primary care setting's screening rate.
Design/Methods: With the Arizona institutional review Boards' approval, primary care providers (PCP) in a Southwest family practice in Arizona (n=35) are provided with virtual education on sex differences in ADHD. Pre- post-intervention surveys were electronically administered to five PCPS. Data were deidentified. A two-tailed paired t-test was conducted to examine the mean difference of responses.
Results: Analysis of responses demonstrate that primary care providers are well aware of sex differences in ADHD but screened less for ADHD before the education intervention. Major themes emerged from provider comments on ADHD symptom recognition, time constraints, and increased screening to identify girls in the primary setting. A significant increase in ADHD screening is seen four weeks post-intervention t(4) = -6.32, p = .003.
Conclusion: Future research is needed to identify other factors that could strengthen ADHD screening during well-child visits overall. Also, the use of a pediatric screener which can highlight inattentive symptoms would assist in the process of identifying girls with ADHD.

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Agent

Created

Date Created
2021-04-27

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Reducing Polypharmacy with Mobile Apps Among Mental Health Patients

Description

Polypharmacy among psychiatric patients is a concerning trend. From 2007-2010, 58.2% of women and 41.8% of men reported taking five or more prescription drugs within the last 30 days (CDC, 2014). Negative outcomes include prescription drug abuse, side effects, interactions,

Polypharmacy among psychiatric patients is a concerning trend. From 2007-2010, 58.2% of women and 41.8% of men reported taking five or more prescription drugs within the last 30 days (CDC, 2014). Negative outcomes include prescription drug abuse, side effects, interactions, treatment failure, patient dissatisfaction, and lack of treatment control. The associated practice challenges have led to the following PICOT question. In persons with mental health issues receiving care at an outpatient mental health clinic, does engaging in mindfulness practice versus no mindfulness practice change polypharmacy use over a 3-month period?

The project purpose was to evaluate the effectiveness of Insight Timer mobile mindfulness app at helping patients self-manage distressing symptoms and reduce polypharmacy. Over three weeks, mental health clinic nurse practitioners (NPs) voluntarily recruited patients (n=12) over age 18 using as needed prescriptions (PRNs), and agreed to use Insight Timer mobile mindfulness app for adjunct symptom management. Consenting participants downloaded the mobile app, and completed a brief questionnaire measuring PRN use at the start of app use, and PRN use at their next visit. A Wilcoxon signed-rank test indicated a 10-week mindfulness app trial did not significantly lower total PRN doses compared with pre-app dosing (Z = -.534, p = .593). Paired t-tests revealed no significant change in pre (M = 65.17, SD = 28.64) versus post (M = 67.75, SD = 20.22) OQ45 life functionality results (t(11) = -.420, p = .683) (d = .121) as a result of app use.

Clinically relevant results illustrated 83.33% of participants taking greater than nine PRN doses over the study period used the app six times or more in place of medication. High PRN users employed the app frequently in place of medication regardless of total PRN doses taken. Practice implications and sustainability recommendations include incorporating mobile app use in treatment plans for high PRN users and educating NP’s on the tangible benefits of mindfulness apps in reducing polypharmacy and easing symptom distress on an ongoing basis.
Keywords: mindfulness, mhealth, mobile apps, mobile smart phone, online, RCT, behavior change, polypharmacy.

Contributors

Agent

Created

Date Created
2019-04-29