Using ECHO Clinics to Promote Capacity Building in Clinical Supervision.

INTRODUCTION: Project Extension for Community Healthcare Outcomes (ECHO™) is a hub-and-spoke knowledge-sharing network, led by expert teams who use multipoint videoconferencing to conduct virtual clinics with community providers in order to improve the quality of care. For this project, members of the Addiction Technology Transfer Center network applied this model in order to enhance workforce capacity to deliver clinical supervision for the treatment of substance use disorders. METHODS: Clinical supervisors (n=66) employed in substance use disorder treatment programs were recruited to participate in this pilot study. The virtual ECHO clinic consisted of 12 total sessions, each lasting 1 hour and comprising a 15-minute mini-lecture on a clinical supervision topic and a 45-minute case presentation and review. All data were collected and analyzed between September 2016 and June 2017. RESULTS: Forty-eight staff attended at least one ECHO session (mean=6.38) and results are presented for 20 staff who completed the follow-up survey. Participants were highly satisfied with the overall intervention, organization of the clinic and the facilitation of Hub experts, relevance of the technical assistance to their work, and with the impact of the intervention on their effectiveness as a supervisor. Results also indicate that there were significant self-reported improvements in clinical supervision self-efficacy following participation in the ECHO clinic. CONCLUSIONS: Results from this pilot study suggest that ECHO virtual clinics are feasible to implement for the purpose of workforce development, are well liked by participants, and can enhance clinical supervision self-efficacy among participants. Further research should explore the impact of self-efficacy on the effective implementation of clinical supervision practices. SUPPLEMENT INFORMATION: This article is part of a supplement entitled The Behavioral Health Workforce: Planning, Practice, and Preparation, which is sponsored by the Substance Abuse and Mental Health Services Administration and the Health Resources and Services Administration of the U.S. Department of Health and Human Services.

Cardiorespiratory endurance, muscular flexibility and strength in first-episode schizophrenia patients: use of a standardized fitness assessment.

AIM: This study determined the fitness status and examined potential correlates of fitness in first-episode schizophrenia patients using a standardized fitness test protocol. METHODS: A certified fitness instructor administered the Young Men's Christian Association (YMCA) fitness test to 70 recent-onset schizophrenia participants within 3 months of entry into the study. RESULTS: Percentile ranks of scores on muscular strength and endurance, muscular flexibility and cardiorespiratory fitness in our sample were all below the 50th percentile when compared with national norms in the United States. As expected, patients with a higher body mass index and those who smoked had poorer cardiorespiratory fitness. A non-significant trend indicated that patients with a longer duration of illness had worse cardiorespiratory fitness. Exposure to antipsychotic medication was unrelated to cardiorespiratory fitness. CONCLUSION: Results suggest that physical fitness is impaired and might decline over time in first-episode schizophrenia patients, but this needs to be confirmed in a longitudinal study.