Quality Health Associates Of North Dakota

REDUCING DISPARITIES IN CRC SCREENING RATES FOR RURAL, FRONTIER, AND NATIVE AMERICAN POPULATIONS IN NORTH DAKOTA

DELIVERY OF MENTAL HEALTH FIRST AID TRAINING TO RURAL NORTH DAKOTA COMMUNITIES - SUMMARY: NORTH DAKOTA IS A VERY RURAL STATE WITH SERVICE GAPS IN THE ACCESSIBILITY OF MENTAL HEALTH SERVICES LEAVING CRITICAL ACCESS HOSPITALS AND LONG TERM CARE FACILITIES TO ADDRESS THESE NEEDS. THIS PROJECT WILL UTILIZE THE MENTAL HEALTH FIRST AID EVIDENCE BASED PROGRAM TO ANNUALLY TRAIN 1080 NEW INDIVIDUALS IN RURAL COMMUNITIES AND LONG TERM CARE FACILITIES TO ADDRESS INDIVIDUALS WITH MENTAL ILLNESS AND INCREASE REFERRALS TO MENTAL HEALTH PROVIDERS BY 25%. ABSTRACT: NORTH DAKOTA IS A VERY RURAL STATE WITH 49.5% OF RESIDENTS LIVING IN RURAL AREAS. THIRTY-EIGHT OF FIFTY-THREE NORTH DAKOTA COUNTIES ARE DESIGNATED AS FRONTIER. FORTY-NINE OF THE FIFTY-THREE COUNTIES ARE IDENTIFIED AS MENTAL HEALTH PROFESSIONAL SHORTAGE AREAS. OVER 19% OF NORTH DAKOTA ADULTS REPORT HAVING MENTAL ILLNESS IN THE PAST YEAR WITH ALMOST 5% REPORTING SERIOUS MENTAL ILLNESS. THE MENTAL HEALTH AWARENESS TRAINING (MHAT) UTILIZED IN THIS PROPOSAL, MENTAL HEALTH FIRST AID (MHFA), IS INTENDED TO HELP THE GENERAL PUBLIC IN RURAL NORTH DAKOTA COMMUNITIES WITH AN ADDITIONAL FOCUS ON OLDER ADULTS RESIDING IN THE COMMUNITY AND IN LONG TERM CARE FACILITIES. QUALITY HEALTH ASSOCIATES OF NORTH DAKOTA (QHA) WILL UTILIZE THE MENTAL HEALTH FIRST AID (MHFA) EVIDENCE BASED MHAT TO ACCOMPLISH THE TRAINING. THE CURRICULUM INTRODUCES PARTICIPANTS TO RISK FACTORS AND WARNING SIGNS OF MENTAL HEALTH AND SUBSTANCE USE DISORDERS, BUILDS UNDERSTANDING OF THE IMPORTANCE OF EARLY INTERVENTION, AND REVIEWS COMMON RESOURCES. QHA INTENDS TO INCREASE STAFF CAPACITY CERTIFIED AS MHFA INSTRUCTORS TO OFFER 36 TO 40 VIRTUAL IN-PERSON TRAININGS PER YEAR WITH 25 TO 30 PARTICIPANTS PER TRAINING SESSION WITH THE GOAL OF TRAINING 1,080 PARTICIPANTS PER YEAR OVER THE COURSE OF THE 5 YEAR PROJECT. IN ADDITION TO INCREASING THE NUMBER OF INDIVIDUALS TRAINED IN MHFA, ANOTHER OBJECTIVE OF THE PROJECT IS TO INCREASE REFERRALS TO LICENSED MENTAL HEALTH PROVIDERS. UTILIZING YEAR ONE OF THE GRANT AS A BASELINE, OUR GOAL IS TO INCREASE REFERRALS TO COMMITTED MENTAL HEALTH PROVIDERS BY 25% IN YEAR TWO OF THE PROJECT. A BARRIER TO IMPLEMENTATION OF A STATEWIDE MHAT PROGRAM IS HAVING MENTAL HEALTH PROVIDERS CAPABLE OF ACCEPTING REFERRALS FROM ACROSS THE STATE. THIS BARRIER HAS BEEN MITIGATED FOR THIS PROJECT BY GAINING THE COMMITMENT OF TWO ORGANIZATIONS EACH WITH PROVIDERS COVERING THE ENTIRE STATE, THE NORTH DAKOTA REGIONAL HUMAN SERVICE CENTERS AND THE VILLAGE FAMILY SERVICE CENTER HAVE A COMBINED 13 OFFICES IN NORTH DAKOTA IN LOCATIONS THAT GEOGRAPHICALLY SPREAD ACROSS THE STATE. IN ADDITION, MATERIALS WILL BE CREATED TO INCREASE PUBLIC AWARENESS OF MENTAL HEALTH SERVICES AVAILABLE IN THEIR COMMUNITY. IN ADDITION TO WORKING WITH THESE REFERRAL CENTERS QHA WILL PARTNER WITH OTHER KEY STAKEHOLDERS INCLUDING THE NORTH DAKOTA DEPARTMENT OF HEALTH, THE UNIVERSITY OF NORTH DAKOTA CENTER FOR RURAL HEALTH (CRH), AND THE NORTH DAKOTA LONG TERM CARE ASSOCIATION (NDLTCA).

RURAL COMMUNITIES OPIOID RESPONSE PROGRAM-OVERDOSE RESPONSE - THE PROPOSED PROJECT UNDER THE RCORP – OVERDOSE RESPONSE INITIATIVE AIMS TO ENHANCE HEALTHCARE IN RURAL AREAS BY ADDRESSING THE IMMEDIATE AND SHORT-TERM NEEDS RELATED TO SUBSTANCE USE DISORDER (SUD) WITHIN THE SPIRIT LAKE NATION IN NORTH DAKOTA. THE PROJECT FOCUSES ON REDUCING AND PREVENTING THE RISK OF OVERDOSES THROUGH A COMPREHENSIVE APPROACH THAT INCLUDES TERTIARY PREVENTION, HARM REDUCTION, AND EDUCATION. THE OPIOID CRISIS POSES A SIGNIFICANT THREAT TO ADOLESCENTS, WITH MANY FIRST EXPOSURES OCCURRING AT HOME DUE TO POOR STORAGE PRACTICES OF PRESCRIPTION OPIOIDS. ADOLESCENTS WHO MISUSE OPIOIDS ARE AT A HIGHER RISK OF DEVELOPING DEPENDENCE AND TRANSITIONING TO HEROIN OR ILLICIT FENTANYL USE. THE PROJECT ADDRESSES THESE ISSUES BY PROVIDING NALOXONE, DISTRIBUTING MEDICATION SAFETY PRODUCTS, AND CONDUCTING EDUCATIONAL SESSIONS. KEY INITIATIVES INCLUDE: PROVIDING NALOXONE: DISTRIBUTING NALOXONE AT ELDER'S DAY MONTHLY EVENTS TO EMPOWER COMMUNITY MEMBERS TO RESPOND EFFECTIVELY TO OVERDOSE SITUATIONS. DISTRIBUTING MEDICATION SAFETY PRODUCTS: PROVIDING MEDICATION LOCKBOXES AND DISPOSAL BAGS TO PROMOTE SAFE MEDICATION PRACTICES WITHIN HOUSEHOLDS. EDUCATIONAL SESSIONS: OFFERING CULTURALLY TAILORED EDUCATIONAL SESSIONS TO RAISE AWARENESS ABOUT THE RISKS OF OPIOID USE, SAFE MEDICATION PRACTICES, AND THE AVAILABILITY OF RESOURCES FOR TREATMENT AND RECOVERY. THE PROJECT TARGETS THE SPIRIT LAKE NATION, A COMMUNITY FACING UNIQUE CHALLENGES SUCH AS LIMITED ACCESS TO HEALTHCARE SERVICES, CULTURAL BARRIERS, AND SOCIOECONOMIC FACTORS. BY IMPLEMENTING THESE STRATEGIES, THE PROJECT AIMS TO CREATE A SAFER AND HEALTHIER ENVIRONMENT FOR THE COMMUNITY, PROVIDING IMMEDIATE TOOLS AND RESOURCES TO PREVENT AND ADDRESS OVERDOSES WHILE FOSTERING LONG-TERM BEHAVIORAL CHANGES AND COMMUNITY RESILIENCE. THE PROJECT ALIGNS WITH THE GOALS OF THE RCORP-OVERDOSE RESPONSE INITIATIVE AND LEVERAGES THE EXPERTISE AND RESOURCES OF NORTH DAKOTA STATE UNIVERSITY (NDSU) AND QUALITY HEALTH ASSOCIATES (QHA) OF NORTH DAKOTA. BOTH ORGANIZATIONS HAVE A PROVEN TRACK RECORD OF EXECUTING COMPLEX HEALTHCARE PROJECTS AND ENGAGING RURAL AND TRIBAL COMMUNITIES. THE STAFFING PLAN INCLUDES KEY POSITIONS SUCH AS PROJECT DIRECTOR, PROJECT COORDINATOR, CULTURAL LIAISON, AND DATA MANAGER, ENSURING EFFECTIVE MANAGEMENT AND IMPLEMENTATION OF THE PROJECT. THE PROJECT WILL ALSO INVOLVE COMMUNITY CONSULTATIONS, PARTNERSHIPS WITH LOCAL HEALTHCARE PROVIDERS, AND A MOBILE OUTREACH PROGRAM TO INCREASE ACCESSIBILITY. TO ENSURE SUSTAINABILITY, THE PROJECT WILL IDENTIFY ONGOING FUNDING OPPORTUNITIES, TRAIN COMMUNITY MEMBERS TO CONTINUE ACTIVITIES POST-PROJECT, AND DEVELOP A SUSTAINABILITY PLAN. DATA COLLECTION AND REPORTING WILL BE INTEGRAL TO MONITORING PROGRESS AND MAKING NECESSARY ADJUSTMENTS TO IMPROVE SERVICE DELIVERY. BY ADDRESSING THE CRITICAL ISSUE OF OPIOID OVERDOSE WITHIN THE SPIRIT LAKE NATION COMMUNITY, THE PROJECT AIMS TO REDUCE OVERDOSE DEATH RATES AND IMPROVE OVERALL COMMUNITY HEALTH AND WELL-BEING.

CHANGING HEALTH SYSTEMS USING EVIDENCE-BASED INTERVENTIONS TO INCREASE COLORECTAL CANCER SCREENING - PROJECT ABSTRACT SUMMARY BACKGROUND/NEED: QUALITY HEALTH ASSOCIATES OF NORTH DAKOTA (QHA) IS SUBMITTING THIS APPLICATION TO PARTICIPATE IN THE PUBLIC HEALTH AND HEALTH SYSTEMS PARTNERSHIP TO INCREASE COLORECTAL CANCER SCREENING IN CLINICAL SETTINGS. ND RANKS 26TH IN COLORECTAL CANCER (CRC) SCREENING RATES, WITH A RATE OF 72.4% (2022 BRFSS). HOWEVER, THIS DATA CONCEALS SIGNIFICANT DISPARITIES IN CRC SCREENING RATES AMONG TRIBAL POPULATIONS AND INDIVIDUALS SERVED BY FEDERALLY QUALIFIED HEALTH CENTERS (FQHCS). IN 2022, BRFSS DATA REVEALED THAT COLORECTAL CANCER (CRC) SCREENING RATES AMONG NATIVE AMERICANS IN ND WERE 27% LOWER THAN THOSE OF THE NON-NATIVE AMERICAN POPULATION. ADDITIONALLY, THE 2023 FQHC UNIFORM DATA SYSTEM REPORTED CRC SCREENING RATES FOR THE FOUR HEALTH CENTERS IN ND RANGING FROM 27.72% TO 61.70%. OBJECTIVES/PURPOSE: THE PURPOSE OF THIS PROGRAM IS TO HELP NORTH DAKOTA’S PRIMARY CARE CLINICS INCREASE CRC SCREENING PREVALENCE AMONG UNDERSERVED POPULATIONS IN NORTH DAKOTA, PARTICULARLY FOCUSING ON AMERICAN INDIAN COMMUNITIES AND PATIENTS SERVED BY FQHCS. THE GOAL IS TO ENHANCE SCREENING PREVALENCE, PREVENT COLORECTAL CANCERS, REDUCE LATE-STAGE DIAGNOSES, AND DECREASE CRC MORTALITY. APPROACH: IN THE FIRST YEAR, QHA WILL PARTNER WITH THE ND FQHC WITH THE LOWEST CRC SCREENING RATES AND TWO TRIBAL CLINICS TO IMPLEMENT EVIDENCE-BASED INTERVENTIONS (EBIS). THESE INTERVENTIONS WILL INCLUDE PROVIDER AND PATIENT REMINDERS, REDUCING STRUCTURAL BARRIERS, AND PATIENT NAVIGATION. IN SUBSEQUENT YEARS, QHA WILL EXPAND ITS EFFORTS TO 3-5 ADDITIONAL FQHCS AND TRIBAL CLINICS EACH YEAR. THE STRATEGY INVOLVES CONDUCTING COMPREHENSIVE READINESS ASSESSMENTS AND DEVELOPING CLINIC-SPECIFIC ACTION PLANS. QHA STAFF WILL PROVIDE TECHNICAL ASSISTANCE ROOTED IN QUALITY IMPROVEMENT METHODOLOGY, SHARE RESOURCES, TOOLS, AND MATERIALS, AND CONDUCT FREQUENT SITE VISITS AND COACHING CALLS TO MONITOR PROGRESS, IDENTIFY BARRIERS, AND DEVELOP MITIGATION STRATEGIES. ADDITIONALLY, QHA STAFF WILL ASSIST CLINIC STAFF IN LEVERAGING THEIR ELECTRONIC HEALTH RECORDS (EHRS) TO COLLECT AND REPORT CRC SCREENING PROGRAM MEASURES. THIS SUPPORT WILL INCLUDE A ROBUST DATA QUALITY VALIDATION AND FEEDBACK PROCESS. STAFFING AND CAPACITY: QHA HAS A PROVEN TRACK RECORD OF SUCCESSFULLY IMPLEMENTING QUALITY IMPROVEMENT INITIATIVES. OUR CRC TEAM WILL INCLUDE EXPERIENCED PROJECT MANAGERS, QUALITY IMPROVEMENT SPECIALISTS, AND EHR SPECIALISTS ADEPT AT LEVERAGING EHRS TO COLLECT QUALITY AND POPULATION HEALTH DATA. ADDITIONALLY, OUR CRC SCREENING PROGRAM EVALUATION TEAM, CONSISTING OF BOTH INTERNAL AND EXTERNAL PARTNERS AND STAKEHOLDERS WITH EXTENSIVE PROGRAM EVALUATION EXPERIENCE, WILL SUPPORT THE PROGRAM'S EFFECTIVENESS. EXPECTED OUTCOMES: THE PROJECT AIMS TO ACHIEVE A SIGNIFICANT INCREASE IN CRC SCREENING RATES, WITH EACH PARTICIPATING CLINIC IMPLEMENTING AT LEAST THREE EBIS. IMPROVED SCREENING RATES WILL LEAD TO EARLIER DETECTION AND TREATMENT OF COLORECTAL CANCER, ULTIMATELY REDUCING CRC INCIDENCE AND MORTALITY IN THE TARGETED POPULATIONS.