Assessment of Screening, Brief Intervention, and Referral to Treatment Training to Interprofessional Health-Care Students.

Substance abuse and addiction are responsible for an assortment of health and financial concerns in the United States. Tools to identify and assist at-risk persons before they develop a substance use disorder are necessary. Screening, brief intervention, and referral to treatment (SBIRT) can be utilized by health-care professionals to identify those at risk to minimize health-related complications and the potential of developing a substance use disorder. The primary objective of this study was to provide educational training sessions on SBIRT to health-care students utilizing interprofessional education activities and assess perceptions of the training sessions and activities with regard to confidence to utilize SBIRT in at-risk patients and overall student satisfaction with SBIRT instruction. The research protocol enrolled students of pharmacy, nursing, medicine, behavioral health, and physician assistant studies who received interprofessional SBIRT training. Students completed an anonymous posttraining online survey, measuring student perceptions of knowledge gained and confidence to utilize training. A total of 303 students completed the SBIRT training. Approximately 70% of students were satisfied with the training materials, instruction, quality, and experience. After training, 78% were confident that they could perform screening for substance abuse, conduct a brief intervention (80%), and when to refer to treatment (71%). A total 73% of students reported that the asynchronous online-based activity was extremely effective in increasing knowledge of the roles and responsibilities of other disciplines and providing opportunities to interact with students from other health professions. Interprofessional education-trained students from multiple health-care disciplines feel comfortable performing SBIRT to identify persons at risk for substance misuse in practice.

Learning to Overcome Hierarchical Pressures to Achieve Safer Patient Care: An Interprofessional Simulation for Nursing, Medical, and Physician Assistant Students.

To positively impact patient safety, the Institute of Medicine, as well as the Quality and Safety Education for Nurses initiative, has recommended clinician training in structured communication techniques. Such techniques are particularly useful in overcoming hierarchical barriers in health care settings. This article describes an interprofessional simulation program to teach structured communication techniques to preprofessional nursing, medical, and physician assistant students. The teaching and evaluation plans are described to aid replication.

Promoting physical activity in children with MetaKenkoh.

PURPOSE: Over 15% of children aged 6 to 11 yr are overweight, more than three times as high as a generation earlier. Overweight children are at higher risk for diabetes, high blood pressure, high cholesterol, and orthopedic problems, as well as psychological problems. Overweight children are also more likely to become overweight adults, with higher risks for heart disease, stroke, hypertension, diabetes, and some types of cancers. In response to this epidemic, Health Management Consultants of VA, Inc., funded by the National Institute of Child Health and Human Development, developed MetaKenkoh, an Internet-based, activity-contingent game for children 9-11 yr of age. The game promotes physical activity through the use of pedometers that are used to relate game performance to children's own daily activity. METHODS: We conducted a clinical trial in which children aged 9-11 were randomized to groups that either played the game (Intervention Group - IG) or that monitored only (Control Group - CG). RESULTS: Preliminary data indicate that underweight and normal weight children in the IG (n=22) show an increase in activity at one week, as measured by pedometer, whereas there is a drop in steps reported by children in the CG (n=24). In the overweight and at-risk groups, both the IG (n=16) and the CG (n=15) show a slight increase in activity levels. CONCLUSION: Activity-contingent games may have the potential to facilitate increased physical activity in children. However, more research is needed in order to evaluate the effectiveness of this approach.

Clinical trial of an Internet-based case management system for secondary prevention of heart disease.

PURPOSE: Despite demonstrated benefits of cardiac rehabilitation and risk factor reduction, only 11% to 38% of eligible patients with cardiovascular disease (CVD) participate in cardiac rehabilitation programs. Women and older adults are particularly less likely to participate in cardiac rehabilitation. In an effort to broaden access to cardiac rehabilitation, the authors developed an alternative Internet-based program that allows nurse case managers to provide risk factor management training, risk factor education, and monitoring services to patients with CVD. METHODS: The evaluation consisted of a randomized, clinical trial involving 104 patients with CVD, 53 of whom used the program as a special intervention (SI) for 6 months and 51 of whom received usual care (UC). RESULTS: The results indicate that fewer cardiovascular events occurred among the SI subjects (15.7%) than among the UC subjects (4.1%) (P =.053), resulting in a gross cost savings of $1418 US dollars per patient. With a projected program cost of $453 USD per patient, the return on investment is estimated at 213%. More weight loss occurred in the SI group (-3.68 pounds) than in the UC group (+.47 pounds) (P =.003). The differences between the two groups in terms of blood pressure, lipid levels, depression scores, minutes of exercise, and dietary habits were not statistically significant. CONCLUSION: An Internet-based case management system could be used as a cost-effective intervention for patients with CVD, either independently or in conjunction with traditional cardiac rehabilitation.