Opioid overdose prevention training needs: Findings from emergency medical services providers in Baltimore County, Maryland.

Emergency Medical Services (EMS) providers are on the frontlines of the opioid response. This study explored the EMS training needs in Baltimore County, Maryland. An online survey conducted between January-June 2021 assessed knowledge, attitudes, awareness, and self-efficacy to use opioid overdose prevention strategies; burnout, compassion fatigue, stress, and wellness; and training needs among EMS providers (N = 256). Participants reported positive attitudes toward the use of opioid treatment guidelines and confidence in their ability to use the guidelines. They indicated positive attitudes toward harm reduction, but less favorable attitudes toward opioid use disorder (OUD). Although the participants understood the role of a peer recovery specialist moderately well, they were not fully comfortable with making a referral. They reported relatively low levels of burnout and compassion fatigue and good wellness practices, but indicated a moderate level of stress associated with COVID-19. Perceived training needs included: lifetime fitness and wellness, trauma-informed care, stigma awareness, stages of change, and harm reduction. Offering these trainings and enhancing EMS providers' comfort to make referrals to peer recovery support services may strengthen the referral systems and connect overdose survivors to a continuum of care.

Minority primary care physicians' knowledge, attitudes, and practices on eye health and preferred sources of information.

BACKGROUND: Racial and ethnic disparities exist in the prevalence of certain eye diseases. Minority primary care physicians are in a unique position to help prevent vision loss and blindness, especially among minority populations. METHODS: To measure physicians' knowledge and attitudes regarding eye health and to better understand the facts regarding patient information and counseling concerning eye health and disease, the National Eye Institute included key eye health knowledge, attitude, and practice questions in the 2007 DocStyles Survey, a Web-based survey of primary care physicians about physician perceptions and attitudes concerning communication with patients. RESULTS: A total of 428 minority primary care physicians responded to the survey. Results indicate that minority primary care physicians have favorable attitudes regarding eye health and the role they should play in talking with patients about eye health. Approximately 60% indicated that they could identify patients at higher risk for eye disease; however, only 52% of physicians indicated that they have adequate knowledge to advise their patients on vision health. Regarding information sources, most minority physicians prefer to obtain information about vision and eye health from professional journals, medical Web sites, and continuing medical education. CONCLUSIONS: Findings from this research reveal both a need and an opportunity with regard to increasing physician confidence in identifying patients at higher risk for eye disease and advising their patients on eye health.

Perceived Behavioral Control as a Key to Integrative Medicine.

The purpose of the present study was to identify the factors that are the strongest predictors of intentions and use of integrative medicine approaches in clinical practice. Ajzen's theory of planned behavior was used to guide our examination of these questions. Health care professionals exposed to a Veterans Health Administration program (N = 288) who completed survey instruments prior to and immediately after the program and 3 months later were the participants for this study. Findings suggest that the theory of planned behavior performs reasonably well in explaining our data showing the integration of integrative medicine approaches into clinical practice. We found that self-efficacy to use integrative health approaches and perceived preparedness to discuss nonpharmaceutical approaches with patients were the strongest predictors of intentions to use integrative health approaches and self-reported change in clinical practice. The implications of these findings are discussed.

Evaluation of a Health Coaching Course for Providers and Staff in Veterans Health Affairs Medical Facilities.

BACKGROUND: The purpose of this study was to determine whether a health coaching (HC) course for providers and staff in Veterans Health Affairs medical facilities resulted in increased attitudes toward, intentions to use, and actual use of HC. METHODS: A Whole Health Coaching Course was developed and implemented in national sites in 2014. A pre-post intervention group only design was used to assess changes in HC outcomes, including use of HC skills. RESULTS: There were large pre- to posttest increases in preparedness and self-efficacy that were sustained at follow-up. Initial small increases in attitudes toward patient-centered care and intentions to use HC skills were not sustained at follow-up. There was a medium-sized increase in actual use of HC skills between pre-test and follow-up. CONCLUSIONS: Findings suggest that participation in the HC course is an effective means for providers and staff to increase preparedness, self-efficacy, and actual use of health coaching skills.