Thursday, February 27, 2014

Clinical Research Oriented Workshop (CROW) Meeting: February 20, 2014

Present:  Marianne Burke, Kairn Kelley, Rodger Kessler, Ben Littenberg, Connie van Eeghen

Start Up: Good places to eat in Old San Juan – check with Ben and Rodger.  Also, there are 550,000 VT driver license records with zip code, state, age, height, and weight being – data analysis jeopardy awaits!  Analysis focused on building density and BMI to test walking vs. non-walking hypotheses on body size.

1.                  Discussion: SBIRT (Screening, Brief Intervention, Referral & Treatment) Training Grant – Research Questions and Aims – Rodger & Connie
a.       This training grant broadly focuses on substance abuse (SA), with the goal of training 3 cohorts of students, IM residents, FM residents, advance practice nursing, counseling, and social work to use team based interventions in a primary care setting.  The training program recognizes that not everything can be done to meet the SA needs of patients in a 15 minute period and brings together a team of providers working at the top end of their licenses.
b.      The training grant includes evaluation, with required reports.  This discussion is intended to think about the research value of this work, starting with research question and aims.  Clarifications:
                                                  i.      Students will enter the project over three years, and followed for the remaining period of the grant.
                                                ii.      Less than a dozen faculty are involved that were themselves trained in the key components of SBIRT (4 modules) and 2 sets of experiential trainings (including standardized patients).  In some departments, faculty act as preceptors (Rich Pinckney for IM – with additional didactic added; John King for FM).
                                              iii.      At this time, the students have started the didactic training.
c.       The research question currently: Does access to SBIRT have an effect on evidence-supported, team-based, behavioral intervention skills and implementation in practice?  Possible measures:
                                                  i.      Student knowledge, attitudes, and skills
1.      Perceived by students
2.      Perceived by preceptors
                                                ii.      Observable data (consider selective, convenience sampling)
1.      Patient encounters – preceptor structured questionnaire
a.       Residents many have clinical experience prior to training
b.      Other students may need a different data collection plan
2.      Referrals (may be too difficult)
3.      Prescriptions
                                              iii.      Pilot the data collection process on cohort 1
1.      Cohort 2: pre- and post- data collection as similar as possible
2.      Cohort 3: pre- and ???post-data collection
d.      Data collection
                                                  i.      Knowledge: prescribed by the SBIRT modules; content from didactic (memorized facts)
                                                ii.      Attitudes:
1.      Medical problem; requires support and continuity; also prescribed by SBIRT
2.      Attitude about self-efficacy (how hopeless is the patient’s condition or the provider’s ability to act on it)
3.      Other…
                                              iii.      Skills: Using a case scenario to demonstrate application (cognitive skills)
1.      Screening
2.      Brief Intervention
3.      Referral
4.      Treatment
                                              iv.      Skills: (practical skills) observed by preceptor (see above)
                                                v.      Post-only, evaluation by students (opinions)
1.      Value of the program in terms of new knowledge, helpfulness, novelty, perceived value (ease, relevance, usability)
e.       Does this program have measurable impact on Knowledge, Attitudes, and skills relative to SBIRT
f.       Does this program influence the chronic structure of service delivery
                                                  i.      After grant based training program is done, did the SBIRT curricular training program get adopted in the UVM programs
                                                ii.      How much SBIRT activity is taking place before, during, and after the training program
1.      Structured screening program
2.      Use of Brief interventions
                                              iii.      Trainees evaluate their clinics
1.      At start up
2.      Part way through
3.      At end
                                              iv.      Alumni evaluations post-training
g.      Next steps:
                                                  i.      Rodger to ask SAMHSA for tools and examples
                                                ii.      SBIRT Evaluation Meeting to refine
                                              iii.      Return to CROW in a month (March 27)

2.                  Next Workshop Meeting(s): Thursdays, 11:30 a.m. – 12:45 p.m., at Given Courtyard South Level 4.   Remember: the first 15 minutes are for checking in with each other.
a.       February 27: Cancelled
b.      March 6: Marianne Burke
c.       March 13:
d.      March 20:
e.       March 27: Rodger and Connie on SBIRT plan

Recorder: Connie van Eeghen

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