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1.
BMC Med Educ ; 23(1): 160, 2023 Mar 15.
Article in English | MEDLINE | ID: mdl-36922813

ABSTRACT

OBJECTIVES: Black, indigenous and people of color (BIPOC) remain underrepresented in research occupations. This report discusses a collaboration to train undergraduate BIPOC students in clinical research between a public health institute, two medical schools, and a historically Black College or University (HBCU). This nine-month program trained BIPOC undergraduates in research methodology, psychology, and addiction science, and immersed trainees in real-world research. The program included didactic seminars, experiential activities, and a mentored research project culminating in a poster and oral presentation. METHODS: Key learnings, program satisfaction survey results, and preliminary outcomes from the first three program cohorts (N = 6 students) are presented. This program addressed several barriers hypothesized to contribute to the limited number of BIPOC students pursuing research careers, including mentorship from BIPOC faculty and financial concerns. RESULTS: Students reported moderate to high satisfaction with the program and endorsed gaining new research skills. Limitations and future directions are discussed. CONCLUSION: The expansion of the BIPOC health and research workforce is an urgent priority given the importance of BIPOC professionals to the health of our nation. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT04650386.


Subject(s)
Behavioral Research , Students , Humans , Learning , Mentors , Occupations
2.
Integr Healthc J ; 4(1): e000125, 2022.
Article in English | MEDLINE | ID: mdl-37440842

ABSTRACT

Objectives: (1) Examine the ability to sustain integrated primary care behavioural health (eg, colocation, communication and coordination) in 40 community health centres, during the COVID-19 pandemic and (2) review adaptations and challenges to provide integrated behavioural health via telehealth. Methods and analysis: This qualitative investigation assessed 55 behavioural health consultants (BHCs), via semistructured interviews, spanning 40 practice sites and 10 organisations, on their adjustment to telehealth delivery, modified practice workflows and challenges of maintaining integration while displaced by the pandemic. Assessment of the level of integrated care was also conducted with available semistructured tools. Results: The results highlight rapid service adjustment, positive patient and provider satisfaction, increased but lowered ratings of remote BHC integration and collaboration with the primary care teams and reduced behavioural health screening, compared with prepandemic levels. This investigation also highlights the co-occurring importance of racial disparities and injustice in patient care. In several settings, BHCs had a significant support role for staff self-care. Conclusion: The COVID-19 pandemic, and its subsequent shelter-in-place mandates and telehealth care provision, has altered standard integrated behavioural health practice, yet harnessed the accessible, generalist and team-based spirit to meet the increasing behavioural health needs in this community.

3.
Nurs Outlook ; 69(5): 848-855, 2021.
Article in English | MEDLINE | ID: mdl-33992445

ABSTRACT

BACKGROUND: Advanced practice registered nurses (APRNs) are increasingly caring for individuals with opioid use disorder. Advances have been made to increase APRN education, outreach, and prescribing privileges, but as demand for medication for opioid use disorder (MOUD) grows, evidence suggests that policy and care barriers inhibit the ability of APRNs to support MOUD. PURPOSE: This paper highlights the significant challenges of expanding access to buprenorphine prescribing by APRNs. FINDINGS: Barriers and recommendations were derived from the culmination of literature review, expert consensus discussions among a diverse stakeholder panel including patient representatives, and feedback from community webinars with care providers. DISCUSSION: We provide an overview of existing care barriers, promising practices, and proposed recommendations to enhance the care of individuals and communities with opioid use disorder.


Subject(s)
Advanced Practice Nursing , Buprenorphine/therapeutic use , Drug Prescriptions/nursing , Health Services Accessibility/organization & administration , Narcotic Antagonists/therapeutic use , Opioid-Related Disorders/drug therapy , Humans , Opioid-Related Disorders/epidemiology , Opioid-Related Disorders/nursing
4.
Fam Syst Health ; 38(1): 87-88, 2020 Mar.
Article in English | MEDLINE | ID: mdl-32202835

ABSTRACT

Don Bloch's legacy is expansive and deep, epitomized by his vision, systemic orientation, innovative work, and a paragon of connecting people. Natalie Levkovich has continued this tradition as past president of the Collaborative Family Healthcare Association (CFHA), Chief Executive Officer of the Health Federation of Philadelphia, and contributor to numerous boards and projects. She is a fervent champion for improving population health by increasing access to high quality care for all, especially the most marginalized. The nomination highlights four central themes to her innovative and remarkable leadership. (PsycInfo Database Record (c) 2020 APA, all rights reserved).


Subject(s)
Awards and Prizes , Family Practice/organization & administration , Leadership , Cooperative Behavior , Family Practice/trends , Humans , Philadelphia
5.
J Clin Psychol Med Settings ; 27(4): 704-715, 2020 12.
Article in English | MEDLINE | ID: mdl-31520183

ABSTRACT

Peer recovery specialists (PRSs) combine their personal experiences with substance use and recovery with clinical skills to support patients in treatment for or recovery from substance use. This paper provides evaluation findings from a SAMHSA-funded program that integrated a PRS team into a primary care clinic to assess the efficacy of PRS support on patients' substance use, healthcare involvement, and criminal justice involvement. PRSs provided a range of services to patients with histories of incarceration and substance use, including facilitating support groups, providing one-on-one individualized support, and navigating services. Data were collected from PRS-supported patients at intake, discharge, and 6 months post-intake. Results revealed reductions in the percentage of patients using substances in the past 30 days, decreased number of days using alcohol, increased engagement in more medical services after program enrollment, increased school enrollment, and increased rates of employment for PRS-supported patients.


Subject(s)
Peer Group , Primary Health Care/methods , Program Evaluation/methods , Substance-Related Disorders/therapy , Female , Humans , Male , Middle Aged , New England , Specialization , Treatment Outcome , Urban Population
6.
Fam Syst Health ; 35(2): 174-183, 2017 06.
Article in English | MEDLINE | ID: mdl-28459259

ABSTRACT

INTRODUCTION: The Health Federation of Philadelphia, which hosts a network of Behavioral Health Consultants (BHC) operating within the Primary Care Behavioral Health model (PCBH), identified a need to systematically evaluate PCBH model fidelity and to rigorously evaluate the competency assessment process to further their workforce development. A simulated patient exercise was developed for evaluating BHC PCBH specific competencies. METHOD: A simulated BHC encounter was held at a clinical learning center using standardized patients, repeated twice over 2 years. A competency based rating scale was developed by the network for the simulation (BHC-ORS), patient feedback was captured using the Working Alliance Inventory (WAI), and BHC feedback was collected using a questionnaire. Dedicated consultants were hired to develop the internal process, as well as conduct the evaluation in a way that might make a contribution to research. RESULTS: Targeted PCBH competencies generally improved after being identified as training needs in Year 1 of the simulation. Patient feedback showed average ratings for the majority of the BHCs. BHCs identified the experience as valid and useful. Important changes in methodology between Years 1 and 2 of the pilot limited a more complete analysis. DISCUSSION: The use of simulated patients to evaluate BHC adherence to the PCBH model was helpful for training and adds to the workforce development literature. The authors suggest that doing practice based research will always entail unanticipated needs that interfere with quantitative research but that there are ways in which researchers can attempt to anticipate these changes. Review of possible applications to community PCBH practice is included. (PsycINFO Database Record


Subject(s)
Patient Simulation , Program Evaluation/methods , Staff Development/methods , Behavioral Medicine/methods , Clinical Competence/standards , Delivery of Health Care, Integrated/standards , Humans , Needs Assessment , Philadelphia , Primary Health Care/methods , Teaching/standards , Workforce
7.
Psychosom Med ; 69(9): 944-51, 2007 Dec.
Article in English | MEDLINE | ID: mdl-17991820

ABSTRACT

OBJECTIVE: To investigate differences in social problem solving (SPS) between individuals with noncardiac chest pain (NCCP) and persons with chest pain who tested positive for underlying cardiac disease. METHODS: The major design involved a matched case-control methodology and compared a group of patients with NCCP (n = 53) with a group of patients with cardiac disease-related chest pain (n = 53) with regard to a battery of psychological distress, stress, and pain measures as well as a multidimensional measure of SPS. RESULTS: Initial analyses found no differences between the groups regarding reported levels of chest pain intensity or frequency. However, patients with NCCP, as compared with their matched counterparts, reported significantly higher levels of depression, anxiety, perceived stress, and anger. In the analysis that addressed SPS differences between groups, general negative affectivity and prior history of cardiac disease served as covariates and revealed that individuals with NCCP were characterized by less effective problem solving on three of five dimensions assessed as compared with their matched counterparts. Moreover, the relationship between SPS and pain among patients with NCCP was found to be above and beyond that related to general negative affectivity. CONCLUSIONS: These findings both support and add to the literature regarding psychosocial correlates of NCCP and identify SPS as a potentially important factor in its pathogenesis.


Subject(s)
Chest Pain/psychology , Interpersonal Relations , Problem Solving , Psychophysiologic Disorders/psychology , Adult , Aged , Anger , Angina Pectoris/diagnosis , Angina Pectoris/psychology , Anxiety/diagnosis , Anxiety/psychology , Case-Control Studies , Cohort Studies , Coronary Artery Disease/diagnosis , Coronary Artery Disease/psychology , Depression/diagnosis , Depression/psychology , Female , Humans , Male , Middle Aged , Myocardial Ischemia/diagnosis , Myocardial Ischemia/psychology , Pain Measurement , Personality Inventory , Psychophysiologic Disorders/diagnosis , Stress, Psychological/complications
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