4/5/17 Webinar Moderator PROMOTING SBIRT IN AN INTERPROFESSIONAL SETTING WITH Tracy McPherson, PhD VULNERABLE POPULATIONS Senior Research Scientist Public Health Department NORC at the University of Chicago PRESENTED BY: 4350 East West Highway 8th Floor, THE BIG SBIRT INITIATIVE, NATIONAL SBIRT ATTC, and Bethesda, MD 20814 NORC at THE UNIVERSITY OF CHICAGO esap1234@gmail.com April 6, 2017 Produced in Partnership 2017 SBIRT Webinar Series ¨ 1/19/17 - Strategies for Incorporating Universal Education about Healthy Relationships into Clinical Practice to Reduce Substance Use and Intimate Partner Violence ¨ 2/16/17 - Using SBIRT when Intimate Partner Violence has been Disclosed ¨ 3/2/17 - WINGS: An Evidence-based SBIRT Intervention for Addressing Partner Violence Among Young Women Who Use Drugs or Alcohol ¨ 3/16/17 - When One Size Does Not Fit All: Addressing Issues Throughout an SBIRT Project Life Cycle www.sbirteducation.com ¨ 4/6/17 - Promoting SBIRT in an Interprofessional Setting with Vulnerable Populations ¨ 5/4/17 - SBIRT in Various Settings: Differences & Common Threads www.cswe.org ¨ 6/15/17 - Using SBIRT for Problem Gambling in the Military Download this flyer from our hospitalsbirt.webs.com/webinars.htm website! Access Materials Ask Questions ¨ PowerPoint Slides Ask questions ¨ Materials and through the Resources “Questions” Pane ¨ Recording ¨ Certificate of Will be Completion answered live at the end http://hospitalsbirt.webs.com/vulnerable-populations 1
4/5/17 Technical Facilitator Webinar Presenter #1 Molly Everett Davis, EdD, MSW Misti Storie, MS, NCC Department of Social Work College of Health and Human Technical Consultant Services misti.storie@gmail.com George Mason University www.mististorie.com Mason SBIRT Team Curriculum Coordinator mdavi7@gmu.edu Webinar Presenter #2 Objectives Participants will be able to understand factors that impact 1. the implementation of SBIRT in different interprofessional Shauna P. Acquavita, PhD, MSW settings and the role of faculty and students in supporting this endeavor. Assistant Professor Participants will be able to identify different 2. School of Social Work considerations in implementing SBIRT with vulnerable College of Allied Health Sciences populations with diverse characteristics. Participants will explore strategies to promote an increase University of Cincinnati 3. in interprofessional competencies through the PI for Interprofessional SBIRT SAMHSA implementation of SBIRT. grant Participants will highlight challenges and unique training 4. acquavsa@ucmail.uc.edu opportunities in implementing SBIRT within interprofessional settings with vulnerable populations. What is Interprofessional Interprofessional Education Collaboration? Interprofessional education: When multiple health workers from different professional “ When students from two or more professions learn about, from backgrounds work together with patients, families, and with each other to enable effective collaboration and [careers], and communities to deliver the highest quality improve health outcomes.” (WHO 2010 ) of care.” (WHO 2010) 2
4/5/17 University of Cincinnati: The Academic Health Center Our SBIRT Interprofessional Settings • Medicine • Nursing University of Cincinnati • Pharmacy George Mason University • Allied Health Sciences § Social Work University of Cincinnati: Using Community SBIRT Interprofessional Training Program at UC Agencies to Inform SBIRT Practice ¨ Provide SBIRT trainings to all staff agencies if Support for the University of Cincinnati’s needed and booster sessions. Interprofessional SBIRT Program provided by SAMHSA (1H79TI025942) ¨ Meet with agencies before and after each semester to discuss any concerns, questions, thoughts about clinical experiences. Medicine Nursing ¨ Board of Directors for UC’s SBIRT Grant ¤ Include representatives from two community agencies SBIRT Pharmacy Social Work George Mason University Three Part Student Training for Course Online Education Standardized Patient Clinical Experience Experience Men’s and Women’s Homeless Shelter Food Bank Hospital Federally Qualified Health Center <a href='http://www.freepik.com/free-vector/theater-courtains_763673.htm'>Designed by Freepik</a> 3
4/5/17 College of Health and Human Services ¨ Cultivating SBIRT Champions Training All Behavioral Health and Health Care Professionals to Ask About Substance Use! Nursing, Social Work, Global Health, Health ,Policy, ¨ http://chhs.gmu.edu/sbirt/ Nutrition, Rehabilitation Science, Public Health, Health Informatics Mason and Partners MASON SBIRT: TEAMS- UP (MAP) Clinics ¨ We foster interprofessional collaboration and Free Clinics for the Uninsured Fr education while utilizing a three-pronged approach Clini Cl nicas Gr Gratis Só Sólo At Atendemos Pa Pacientes SI SIN N Seg Segur uro to SBIRT dissemination: ¨ Curriculum Infusion -Classroom and Practica/Clinicals ¨ Experiential Training -Innovating SBIRT Training Models ¨ Community Engagement- Training and Building SBIRT Community capacity Primary Health and Behavioral Health Interprofessional Clinics Serving: • Uninsured • Immigrants • Refugees Services Offered: Acute Primary Care Visits • School Physicals • Depression Screening • Initial treatment for diabetes, • hypertension, asthma, hearing and vision SBIRT Screening • 4
4/5/17 Interprofessional Setting ¨ Primary Health SBIRT and Vulnerable Populations Nursing ¨ Behavioral Health Pharmacy Defining Vulnerable Populations ¨ Community Partnerships Social Work Psychology Health WHO ARE THEY? Informatics Public health Nutrition Community Health Workers Defining Vulnerable Population Developing a Vulnerability Profile ¨ Develop a demographic profile of ¨ Groups of people who are disadvantaged or at risk in some your target population. Consider way due to potential harm based upon their social, economic, physical, legal or psychological condition. Population Groups Based ¨ Vulnerability is based upon susceptibility or risk for harm Upon: Sexual Orientation ¤ Environmental conditions Race Access to ¤ Economic factors Ethnicity Resources(uninsured) ¤ Individual characteristics Age Employment Status Gender ¤ Social Conditions Socioeconomic status ¤ Life challenges Immigrant Status ¤ Health conditions Education ¤ Mental Health conditions Attainment/literacy Disability ¤ Culture Homelessness Health Risk Geographic Residence Language Proficiency MAP CLINIC: CULTURAL DIVERSITY Data Mining Results (MAP clinic data) ¨ Ethnicity(Hispanic ¨ Provided over 10,000 client encounters Diverse (2015) Latino/Black/Arabic/Asian) ¨ Diverse diagnosis ¨ Diverse languages Cultures ¨ Countries of Origin ¨ Mixed Gender ¤ Guatemala Venezuela ¨ Diverse mixture of primary health and ¤ Honduras Philippines' behavioral health issues ¤ El Salvador Egypt ¨ Diagnosis often linked to pain and ¤ Mexico China delayed medical treatment ¤ Peru ¨ Both chronic and acute diagnosis ¤ Nigeria ¨ Behavioral Health Issues: depression, ¤ Ethiopia trauma and anxiety ¤ Columbia 5
4/5/17 What do we know about Immigrants Developing a Vulnerability Profile Refugees and Undocumented? Define Immigrants Refugees Undocumented Vulnerable Population Racism and Discrimination Immigrant issues plus…. Online threat of Language Persecution deportation Engage in Data Loss of social roles Hardship/Torture No legal protection Mining to Target Depression No medical care Not qualified for Suicide Societal rejection government assistance V Factors Parent Child Family conflict Vulnerable to exploitation Trauma Unjust labor practices Substance abuse Housing and food instability Identify Develop Factors that Strategies for Impact SBIRT Adaptation Data Mining Results SUBSTANCE USE RISK STRATIFICATION Traditional Substance Use ¨ Newcomers adopt the alcohol and substance use pattern of the Treatment Disorder host country. Some maintain the pattern from home country. Abstinence ¨ Different groups have different patterns. ¨ Central Americans drink less than Mexicans Brief Intervention Excessive Use Brief Treatment ¨ US born Mexican drink more than non US born Mexicans Promote Behavior ¨ Immigrants from Central American and Mexican males drink Change more than women Primary Prevention ¨ Immigrant and US born males exhibit correlation between No Problem Screening & Feedback depression and drinking level Drink Responsibly Guttman, M.C. (1999).Ethnicity, Alcohol and Acculturation. Social Science and ¨ Medicine.48:173-184. Need a Shared Consensus on Target MAP CLINIC VULNERABILITY PROFILE Vulnerable Populations ¨ Status: Undocumented ¨ Discussion may result in perceived What Immigrant and Refugees differences in vulnerable populations and poses the ¨ Language the criteria for determining vulnerability in greatest ¨ Cultural Patterns an interprofessional setting. threat to ¨ Health Diagnosis ¨ Health Status harm? ¨ Gender Roles ¨ PHQ9 ¨ Language ¨ Behavioral Health Issues ( trauma, anxiety and ¨ Ethnicity depression ¨ Status 6
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