Evaluation of the Substance Abuse Research and Education Training (SARET) program: Stimulating health professional students to pursue careers in substance use research.

BACKGROUND: We developed and implemented the Substance Abuse Research Education and Training (SARET) program for medical, dental, nursing, and social work students to address the dearth of health professionals pursuing research and careers in substance use disorders (SUD). SARET has 2 main components: (1) a novel online curriculum addressing core SUD research topics, to reach a large number of students; (2) a mentored summer research experience for in-depth exposure. METHODS: Modules were integrated into the curricula of the lead institution, and of 5 external schools. We assessed the number of Web modules completed and their effect on students' interest in SUD research. We also assessed the impact of the mentorship experience on participants' attitudes and early career trajectories, including current involvement in SUD research. RESULTS: Since 2008, over 24,000 modules have been completed by approximately 9700 individuals. In addition to integration of the modules into curricula at the lead institution, all 5 health-professional partner schools integrated at least 1 module and approximately 5500 modules were completed by individuals outside the lead institution. We found an increase in interest in SUD research after completion of the modules for students in all 4 disciplines. From 2008 to 2015, 76 students completed summer mentorships; 8 students completed year-long mentorships; 13 published in SUD-related journals, 18 presented at national conferences, and 3 are actively engaged in SUD-related research. Mentorship participants reported a positive influence on their attitudes towards SUD-related clinical care, research, and interprofessional collaboration, leading in some cases to changes in career plans. CONCLUSIONS: A modular curriculum that stimulates clinical and research interest in SUD can be successfully integrated into medical, dental, nursing, and social work curricula. The SARET program of mentored research participation fostered early research successes and influenced career choice of some participants. Longer-term follow-up will enable us to assess more distal careers of the program.

Text message reminders for improving patient appointment adherence in an office-based buprenorphine program: A feasibility study.

BACKGROUND AND OBJECTIVES: Missed visits are common in office-based buprenorphine treatment (OBOT). The feasibility of text message (TM) appointment reminders among OBOT patients is unknown. METHODS: This 6-month prospective cohort study provided TM reminders to OBOT program patients (N = 93). A feasibility survey was completed following delivery of TM reminders and at 6 months. RESULTS: Respondents reported that the reminders should be provided to all OBOT patients (100%) and helped them to adhere to their scheduled appointment (97%). At 6 months, there were no reports of intrusion to their privacy or disruption of daily activities due to the TM reminders. Most participants reported that the TM reminders were helpful in adhering to scheduled appointments (95%), that the reminders should be offered to all clinic patients (95%), and favored receiving only TM reminders rather than telephone reminders (95%). Barriers to adhering to scheduled appointment times included transportation difficulties (34%), not being able to take time off from school or work (31%), long clinic wait-times (9%), being hospitalized or sick (8%), feeling sad or depressed (6%), and child care (6%). CONCLUSIONS: This study demonstrated the acceptability and feasibility of TM appointment reminders in OBOT. Older age and longer duration in buprenorphine treatment did not diminish interest in receiving the TM intervention. Although OBOT patients expressed concern regarding the privacy of TM content sent from their providers, privacy issues were uncommon among this cohort. Scientific Significance Findings from this study highlighted patient barriers to adherence to scheduled appointments. These barriers included transportation difficulties (34%), not being able to take time off from school or work (31%), long clinic lines (9%), and other factors that may confound the effect of future TM appointment reminder interventions. Further research is also required to assess 1) the level of system changes required to integrate TM appointment reminder tools with already existing electronic medical records and appointment records software; 2) acceptability among clinicians and administrators; and 3) financial and resource constraints to healthcare systems. (Am J Addict 2017;26:581-586).

Addiction Research Training Programs: Four Case Studies and Recommendations for Evaluation.

: The presence of structured addiction research training programs helps to ensure that the scientific workforce includes well-trained, diverse scientists necessary to reduce the negative impact of alcohol, drug, and tobacco use disorders. Although the field has made significant progress in the development of standards for clinical training in addiction medicine, there remains significant room for improvement in the training of addiction researchers, and also opportunities to synergize across addiction research training programs. The purpose of this commentary is to describe 4 National Institutes of Health (NIH)-sponsored addiction research training programs, highlight critical components, and provide recommendations for more comprehensive and effective program evaluation. Moving forward, evaluation of addiction research training programs would be enhanced by the use of conceptual models to inform process and outcome evaluations, the application of innovative methods to ensure long-term data collection, the improvement of mentorship evaluation measures, and the integration of training methods from other fields of study. We encourage NIH and others in the field to be proactive in establishing core metrics for evaluation across programs. Furthermore, centralized tracking of NIH-funded addiction research trainees, analysis of aggregate data across programs, and innovative methods to effectively disseminate program materials and processes are recommended.

Integration and Evaluation of Substance Abuse Research Education Training (SARET) into a Master of Social Work program.

BACKGROUND: The Substance Abuse Research and Education Training (SARET) program is funded by the National Institutes of Drug Abuse in 2006 as a novel approach to spark interest in substance abuse research among medical, dental, nursing, and social work graduate students through a Web-based curriculum and research mentorships. This report presents the initial integration of the intervention in a Master of Social Work (MSW) program, the components of the program, and the mixed-methods evaluation of its effect on students' attitudes towards substance abuse research and treatment. METHODS: SARET comprises 2 main components: stipend-supported research mentorships and a Web-based module series, consisting of 6 interactive, multimedia modules addressing core SA research topics, delivered via course curricula and in the research mentorships. An initial evaluation was designed to assess SARET's acceptability and short-term impact on participants' interest in SA research. The components of this Web-based curriculum evaluation include focus group feedback on the relevance of the modules to SW students, number of courses into which the modules were integrated with number of module completions, changes in interest in SA research associated with module completion. RESULTS: The full series of Web-based modules has been integrated across several courses in the social work curriculum, and social work students have become integral participants in the summer mentored research experience. One hundred eighteen students completed at least 1 module and 42 students completed all 6 modules. Neurobiology, Screening, and Epidemiology were the most widely viewed modules. Students reported positive impact on their vision of SA-related clinical care, more positive attitudes about conducting research, and in some cases, change in career. CONCLUSIONS: The SARET program's modules and summer mentored research increased clinical and research interest related to SUDs, as well as interprofessional attitudes among social work students. Participants have shown some early research success. Longer-term follow-up will enable us to continue to assess the effectiveness of the program.

Project SARET: An interprofessional education (IPE) lens examines substance use disorders research education for health professional students.

The NIDA funded Substance Abuse Education, Research and Training (SARET) Program addresses the compelling need for health professionals prepared to engage in substance use disorders (SUD) research. The goal of this interprofessional project, structured by an Executive Committee of co-investigators from the disciplines of medicine, nursing, social work and dentistry, is to increase the skills of students from each discipline for interprofessional research collaboration and early career-development opportunities in SUD research. The development of web-based modules, interprofessional seminars and a model mentorship program were designed as well, for dissemination and evaluation by other health professional schools. The educational format is 6 interactive web-based learning modules, providing an overview of core content on Substance Use Disorders (SUD), summer or year-long mentored research experiences with NIH-funded researchers and small interprofessional seminars and site visits. Assessment consists of self-reported annual student learning outcomes and external editorial and advisory board project and curricular materials review. These reviews encourages the updating of materials and provide flexibility for participating "champions" at other schools who use the modules. Quantitative and qualitative outcomes of student research activities and data on dissemination of modules support the fit between project content and interprofessional teaching modalities. The learning modules are available without charge to individuals, students, faculty or health professional programs from the project's website.

Awareness and Attitudes Toward Intranasal Naloxone Rescue for Opioid Overdose Prevention.

Opioid overdose prevention is a pressing public health concern and intranasal naloxone rescue kits are a useful tool in preventing fatal overdose. We evaluated the attitudes, knowledge, and experiences of patients and providers related to overdose and naloxone rescue. Over a six month period, patients and providers within a large community hospital in Staten Island were recruited to complete tailored questionnaires for their respective groupings. 100 patients and 101 providers completed questionnaires between August, 2014 and January, 2015. Patient participants were primarily Caucasian males with a mean age of 37.7 years, of which 65% accurately identified naloxone for opioid overdose, but only 21% knew more specific clinical features. 68% of patients had previously witnessed a drug overdose. Notably, 58% of patients anticipated their behavior would change if provided access to an intranasal naloxone rescue kit, of which 83% predicted an increase in opioid use. Prior overdose was significantly correlated with anticipating no change in subsequent opioid use pattern (p=0.02). 99% of patients reported that their rapport with their health-care provider would be enhanced if offered an intranasal naloxone rescue kit. As for providers, 24% had completed naloxone rescue kit training, and 96% were able to properly identify its clinical application. 50% of providers felt naloxone access would decrease the likelihood of an overdose occurring, and 58% felt it would not contribute to high-risk behavior. Among providers, completion of naloxone training was correlated with increased awareness of where to access kits for patients (p<0.001). This study suggests that patients and providers have distinct beliefs and attitudes toward overdose prevention. Patient-Provider discussion of overdose prevention enhances patients' rapport with providers. However, access to an intranasal naloxone rescue kit may make some patients more vulnerable to high-risk behavior. Future research efforts examining provider and patient beliefs and practices are needed to help develop and implement effective hospital-based opioid overdose prevention strategies.

Text message content preferences to improve buprenorphine maintenance treatment in primary care.

Few studies have evaluated text message content preferences to support evidence-based treatment approaches for opioid use disorders, and none in primary care office-based buprenorphine treatment settings. This study assessed the acceptability and preferences for a tailored text message intervention in support of core office-based buprenorphine treatment medical management components (e.g., treatment adherence, encouraging abstinence, 12-step group participation, motivational interviewing, and patient-provider communication as needed). There were 97 patients enrolled in a safety net office-based buprenorphine treatment program who completed a 24-item survey instrument that consisted of multiple-choice responses, 7-point Likert-type scales, binomial "Yes/No" questions, and open-ended responses. The sample was predominately male (81%), had an average age of 46 years, and was diverse (64% ethnic/racial minorities); 56% lacked stable employment. Respondents were interested in receiving text message appointment reminders (90%), information pertaining to their buprenorphine treatment (76%), supportive content (70%), and messages to reduce the risk of relapse (88%). Participants preferred to receive relapse prevention text messages during all phases of treatment: immediately after induction into buprenorphine treatment (81%), a "few months" into treatment (57%), and after discontinuing buprenorphine treatment (72%). Respondents also expressed interest in text message content enhancing self-efficacy, social support, and frequent provider communication to facilitate unobserved "home" induction with buprenorphine. Older participants were significantly less receptive to receiving text message appointment reminders; however, they were as interested in receiving supportive, informational, and relapse prevention components compared to younger respondents. Implications for integrating a text message support system in office-based buprenorphine treatment are discussed.