How would a certification in harm reduction impact service delivery and the harm reduction workforce? A qualitative study.

INTRODUCTION: Harm reduction utilizes evidence-based strategies to reduce the negative health and social impacts of substance use. As harm reduction services expand across the U.S. without the requirement of professional certification, variation in how the workforce is regarded and trained on harm reduction principles and practices persists. This study explores the harm reduction workforce's perspectives on how certification would impact service delivery and their profession. METHODS: The study employed purposive sampling to identify and survey administrators within a publicly available syringe services program directory (N = 168). This sub-study utilized thematic analysis to evaluate 152 respondents' answers to one dichotomous closed-ended question, "Would a certification in the harm reduction field be helpful?" followed by an open-ended response to the follow-up statement, "Based on your answer to the previous question about a certification to work in harm reduction, please explain why or why not." Approximately 45 % of the respondents (n = 68) answered no, while 55 % (n = 84) answered yes. RESULTS: Seven themes emerged in total. Among those against harm reduction certification, the four themes were: (1) certification is exclusionary and creates barriers, (2) lived experience is more important than certification, (3) certification does not equate to skills, and (4) no regulatory body exists to oversee the certification process. The study identified three themes from individuals who indicated harm reduction certification was helpful: (1) certification helps standardize training, (2) certification validates/legitimizes the harm reduction field, and (3) low barriers to receiving certificates. CONCLUSIONS: The study presents participants' perspectives for and against harm reduction certification emphasizing implications for service delivery and the workforce. Despite varying perceptions on how certification may advance or hinder the field, the sample was unified in their commitment to harm reduction practices and endorsement of its integral role in confronting the U.S. drug use epidemic. This study highlights how certification can impact state and federal harm reduction service delivery and promotes future research on ways to address the needs of harm reduction organizations and their workforce.

Examining facilitative services for entry into substance use disorder treatment: A cluster analysis of treatment facilities.

OBJECTIVES: We examined services to facilitate access to entering substance use disorder (SUD) treatment among a national sample of SUD treatment facilities. METHODS: We analyzed data from the National Survey of Substance Abuse Treatment Services (N-SSATS) 2020. Facilities were included in the sample based on criteria such as SUD treatment provision and being in the U.S. Cluster analysis was conducted using variables including ownership, levels of care, and whether facilities provide services or accept payment options aimed at reducing treatment barriers. National and state-level data on the percentage of facilities in each cluster were presented. RESULTS: Among N = 15,788 SUD treatment facilities four distinct clusters were identified: Cluster 1 consisted of for-profit and government outpatient facilities with high proportions of services to reduce barriers (22.2%). Cluster 2, comprised of non-profit outpatient facilities, offered the most comprehensive array of services to minimize barriers to treatment among all four clusters (25.2%). Cluster 3 included facilities with diverse ownership and care levels and provided a moderate to high degree of services aimed at reducing entry barriers to treatment (26.0%). Cluster 4 was primarily for-profit outpatient facilities with a low proportion of these services (26.6%). CONCLUSIONS: This study revealed facility-level groupings with different services to reduce barriers to SUD treatment across various clusters of SUD treatment facilities. While some facilities offered extensive services, others provided fewer. Differences in cluster distributions point to possible facilitators to treatment access for some persons seeking admission to specific treatment facilities. Efforts should be made to ensure that individuals seeking SUD treatment can access these services, and facilities should be adequately equipped to meet their diverse needs.

Screening, brief intervention, and referral to treatment in oral health settings: A scoping review.

OBJECTIVES: Screening, Brief Intervention, and Referral to Treatment (SBIRT) is an effective evidence-based model to provide early intervention and treatment to people with substance use disorders across diverse health settings. Yet, how SBIRT has been implemented within oral health settings and its associated outcomes has not been explored. This scoping review assessed how SBIRT has been implemented in oral health settings in the U.S. and discusses the implications for SBIRT integration in dentistry and oral health research, education and practice. METHODS: Five scholarly databases were searched using a scoping review methodology for relevant literature, yielding seven articles that met inclusion criteria. RESULTS: Findings from seven U.S. studies show that SBIRT has been implemented into oral health settings in three distinct ways: through education/training, as an intervention and in one national survey. Findings of this scoping review support the inclusion of SBIRT education for oral health professionals in both practice and clinical environments and offer examples of existing models for future implementation and study. CONCLUSIONS: The scant literature on SBIRT intervention effects in dental settings-both within and outside of the U.S.-underscores the need for more empirical work to better understand how SBIRT impacts dental providers' knowledge, practices, referrals and ultimately, patient outcomes.

Social work, Parkinson's disease care, and COVID-19.

Parkinson's Disease is a neurological disease affecting over 10 million people worldwide. Interdisciplinary teams provide integrated care to people with Parkinson's Disease, including care for non-motor symptoms such as anxiety and depression, and many of these teams include social workers. This study sought to learn more about (a) clinical social work utilization across the continuum of care of PWP and their family care partners and (b) how patterns in utilization and service provision have shifted during the pandemic. This mixed method study identifies the breadth of roles performed by social workers in the comprehensive care of people with Parkinson's Disease (PWP). Findings underscore the important roles social workers play in providing comprehensive care for PWP and their families and their contributions to interdisciplinary teams providing holistic, integrated care, particularly during COVID-19 and into the future.

Mapping colocation: Using national provider identified data to assess primary care and behavioral health colocation.

INTRODUCTION: Evidence supports that integrated behavioral health care improves patient outcomes. Colocation, where health and behavioral health providers work in the same physical space, is a key element of integration, but national rates of colocation are unknown. We established national colocation rates and analyzed variation by primary care provider (PCP) type, practice size, rural/urban setting, Health and Human Services region, and state. METHOD: Data were from the Centers for Medicare & Medicaid Services' 2018 National Plan and Provider Enumeration System data set. Practice addresses of PCPs (family medicine, general practitioners, internal medicine, pediatrics, and obstetrician/gynecologists), social workers, and psychologists were geocoded to latitude and longitude coordinates. Distances were calculated; those < 0.01 miles apart were considered colocated. Bivariate and multivariate analyses were conducted, and maps were generated. RESULTS: Of the 380,690 PCPs, > 44% were colocated with a behavioral health provider. PCPs in urban settings were significantly more likely to be colocated than rural providers (46% vs. 26%). Family medicine and general practitioners were least likely to be colocated. Only 12% of PCPs who were the sole PCP at an address were colocated compared with 48% at medium-size practices (11-25 PCPs). DISCUSSION: Although colocation is modestly expanding in the United States, it is most often occurring in large urban health centers. Efforts to expand integrated behavioral health care should focus on rural and smaller practices, which may require greater assistance achieving integration. Increased colocation can improve access to behavioral health care for rural, underserved populations. This work provides a baseline to assist policymakers and practices reach behavioral health integration. (PsycInfo Database Record (c) 2020 APA, all rights reserved).