"A Lot of Things Stopped with COVID": Screening Pregnant Patients for Opioid Use and Related Conditions During the COVID-19 Pandemic.

OBJECTIVE: We explored the impact of COVID-19 on universal screening programs for opioid use and related conditions among practicing clinicians or staff who work with pregnant patients. METHODS: Semi-structured, in-depth qualitative interviews (n = 15) were conducted with practicing clinicians or staff in West-Central Florida between May and October 2020, representing both a range of professions and clinical settings that serve pregnant patients. Interviews were recorded, transcribed verbatim, and reviewed for accuracy. Independent coders conducted thematic content analysis iteratively in MaxQDA to identify emergent themes. RESULTS: Four main themes were identified: worsening health and life conditions of pregnant patients, impaired patient-provider interactions, lack of priority and resources, and conducting opioid screening remotely. Pregnant patients often faced worsening mental health, lack of connection with health care providers, and socioenvironmental factors that increased the risk of overdose and intimate partner violence. Health care providers and facilities faced an infectious disease pandemic that simultaneously increased mental burden and reduced resources. Telehealth improved access to health care for many, but also came with implementation challenges such as inadequate technology, the need to address barriers to developing rapport with patients, and difficulty with certain social screens. CONCLUSION: These themes describe facilitators of and barriers to implementing opioid and related screening programs during the COVID-19 pandemic, as well as the increasing urgency of screening because of socioenvironmental factors. Patients, health care providers, and health practices may benefit from emergency plans that anticipate screening challenges given their increased importance during times of heightened risk, including disasters and epidemics.

MCH Leadership Training Program: An Innovative Application of an Implementation Science Framework.

INTRODUCTION: MCH training programs in schools of public health provide specialized training to develop culturally competent and skilled MCH leaders who will play key roles in public health infrastructure. Previous literature has reported on the effectiveness of MCH training programs (e.g., number of trainees, improvement in knowledge/skills); less attention has been devoted to understanding factors influencing program implementation during times of rapid change, while considering internal and external contexts (e.g., global pandemic, social unrest, uncertainty of funding, mental health issues, and other crises). PURPOSE: This article describes a graduate-level MCH leadership training program and illustrates how an implementation science framework can inform the identification of determinants and lessons learned during one year of implementation of a multi-year program. ASSESSMENT: Findings reveal how CFIR can be applicable to a MCH training program and highlight how constructs across domains can interact and represent determinants that serve as both a barrier and facilitator. Key lessons learned included the value of accountability, flexibility, learner-centeredness, and partnerships. CONCLUSION: Findings may apply to other programs and settings and could advance innovative training efforts that necessitate attention to the multi-level stakeholder needs (e.g., student, program, institution, community, and local/regional/national levels). Applying CFIR could be useful when interpreting process and outcome evaluation data and transferring findings and lessons learned to other organizations and settings. Integrating implementation science specifically into MCH training programs could contribute to the rigor, adaptability, and dissemination efforts that are critical when learning and sharing best practices to expand leadership capacity efforts that aim to eliminate MCH disparities across systems.

COVID-19 and college students: health literacy experiences and training needs.

OBJECTIVE: To explore health literacy (HL) experiences, needs, and future training directions among college students enrolled in health-related degree programs during the COVID-19 pandemic. PARTICIPANTS: Students (n = 169) enrolled in a health-related degree program at a state university in the mid-western U.S. completed an online survey. METHODS: Forty-five questions were developed assessing: (1) demographics; (2) HL; (3) health behaviors; (4) health/well-being; and (5) academic/financial impacts. A HL score across four domains (access, understand, appraise, apply) was calculated. Participants were categorized as having sufficient or insufficient HL. Associations between HL and categorical variables were tested (Chi-square/Fisher's exact tests). Comparisons between sufficient and insufficient HL were performed (Wilcoxon rank-sum tests). RESULTS: Participants had sufficient (55.6%) and insufficient (44.4%) HL. Age was statistically significant with HL (p < 0.5). The top three future training needs were identified (psychological impact, diagnostic/prevention/treatment, racial/ethnic disparities). CONCLUSIONS: Emerging health professionals reported sufficient HL, yet information gaps and training needs remain.