Moses-Weitzman Health System Inc

NETWORKS FOR ORAL HEALTH INTEGRATION WITHIN THE MATERNAL AND CHILD HEALTH SAFETY NET. - CONNECTICUT (CT) FACES SIGNIFICANT CHALLENGES IN THE ORAL HEALTH OF YOUNG CHILDREN (6 MONTHS TO 5 YEARS) FROM LOW-INCOME HOUSEHOLDS AND MINORITIZED BACKGROUNDS, WITH ONE IN FOUR KINDERGARTENERS EXPERIENCING TOOTH DECAY IN 2022. THE MOSES/WEITZMAN HEALTH SYSTEM’S (MWHS’) WEITZMAN INSTITUTE PROPOSES A PROJECT IN COLLABORATION WITH KEY STAKEHOLDERS TO ENHANCE ORAL HEALTH FOR THIS DEMOGRAPHIC. OBJECTIVES INCLUDE POLICY IMPROVEMENTS (SCF 1), ENHANCING ORAL HEALTH LITERACY AT FEDERALLY QUALIFIED HEALTH CENTERS (SCF 2), CONDUCTING SOCIAL DETERMINANTS OF HEALTH SURVEILLANCE (SCF 3), TESTING PREVENTIVE ORAL HEALTH SERVICES INTRODUCED THROUGH WELL-CHILD VISITS IN 4 DEMONSTRATION SITES (LCF 1), IMPROVING ORAL HEALTH LITERACY AT DEMONSTRATION SITES (LCF 2), AND BUILDING A DATA INFRASTRUCTURE (LCF 3). STATE-LEVEL ACTIVITIES INCLUDE ENVIRONMENTAL SCANS AND INTERVIEWS, ORAL HEALTH GAP ANALYSIS, CURRICULUM DEVELOPMENT, TRAININGS, AND DATA-DRIVEN EVALUATIONS. LOCALLY, THE FOCUS IS ON WORKFLOW AND SYSTEMS CHANGES TO INTRODUCE SERVICES, REFINING EDUCATIONAL MATERIALS WITH CAREGIVERS, AND ESTABLISHING A ROBUST DATA INFRASTRUCTURE. AN ALLIANCE OF KEY STAKEHOLDERS WILL ADDRESS CHALLENGES COLLABORATIVELY AND INCLUDES (IN ALPHABETICAL ORDER): COMMUNITY HEALTH CENTER ASSOCIATION OF CT, CT DENTAL HEALTH PARTNERSHIP, CT DENTAL HYGIENISTS’ ASSOCIATION, CT DEPARTMENT OF PUBLIC HEALTH, CT DEPARTMENT OF SOCIAL SERVICES, CT ORAL HEALTH INITIATIVE, AND MWHS’ COMMUNITY HEALTH CENTER, INC.

ABSTRACT YOUTH FROM LIMITED-OPPORTUNITY COMMUNITIES, PARTICULARLY YOUTH OF COLOR, ARE DISPROPORTIONATELY IMPACTED BY PERPETRATION, VICTIMIZATION, AND WITNESSING COMMUNITY VIOLENCE. CURRENT ATTEMPTS TO REDUCE COMMUNITY VIOLENCE HAVE LARGELY PRIORITIZED CRIMINAL JUSTICE-ORIENTED RESPONSES. DATA INDICATE, HOWEVER, THAT THESE RESPONSES HAVE NOT IMPROVED PUBLIC SAFETY AND INSTEAD WIDEN INEQUITIES IN YOUTH HEALTH AND OPPORTUNITY, INCREASING RISK FOR TRAUMA-RELATED ISSUES1-3 AND IMPEDING SUCCESS IN EDUCATION AND EMPLOYMENT4 FOR YOUNG PEOPLE OF COLOR AND THOSE IN UNDER-RESOURCED CONTEXTS. IN CONTRAST, RESTORATIVE JUSTICE, WHICH INVOLVES COMMUNITY-ENGAGED CONFLICT RESOLUTION AND RECONCILIATION, AND, MINDFULNESS, WHICH ENHANCES PRESENT-MOMENT AWARENESS, EACH REPRESENT A PARADIGM SHIFT AWAY FROM PUNITIVE RESPONSES TO COMMUNITY VIOLENCE AFTER IT OCCURS TO STRENGTH-BASED PREVENTION STRATEGIES THAT EMPOWER YOUTH AND COMMUNITIES. WHILE RESTORATIVE JUSTICE AND MINDFULNESS (RJM) PRACTICES HAVE POTENTIAL FOR COMPLEMENTARY AND ADDITIVE VIOLENCE PREVENTION EFFECTS, TO OUR KNOWLEDGE, THESE TWO PRACTICES IN COMBINATION HAVE NEVER BEFORE BEEN RIGOROUSLY STUDIED FOR THE PREVENTION OF COMMUNITY VIOLENCE. HEAL OUR YOUTH IS A 10-WEEK, PLACE-BASED INTERVENTION THAT IS INNOVATIVE IN ITS COMBINATION OF RESTORATIVE JUSTICE AND MINDFULNESS TRAINING FOR YOUTH AND ITS DEEPLY COMMUNITY-ENGAGED APPROACH; COMMUNITY MEMBERS TRAIN YOUTH FROM LIMITED-OPPORTUNITY COMMUNITIES IN PRACTICAL APPLICATIONS OF RJM. WE PROPOSE TO CONDUCT A MIXED METHODS, HYBRID TYPE 1 EFFECTIVENESS-IMPLEMENTATION STEPPED WEDGE TRIAL OF HEAL OUR YOUTH. PARTICIPANTS WILL BE 240 HIGH SCHOOL STUDENTS ACROSS SIX SITES WITH HIGH RATES OF COMMUNITY VIOLENCE, THREE IN BROOKLYN, NY, AND THREE IN THE BRONX, NY. TWO YOUTH & COMMUNITY ADVISORY COMMITTEES (YCAC), ONE IN EACH BOROUGH, WILL BE CREATED TO PROVIDE FEEDBACK ON ALL RESEARCH STAGES. DATA WILL INCLUDE AN ONLINE QUANTITATIVE SURVEY ADMINISTERED AT BASELINE, POST-INTERVENTION, AND 3-MONTH FOLLOW-UP, AND POST-INTERVENTION FOCUS GROUPS. THE STUDY WILL ASSESS THE EFFECTIVENESS OF THE INTERVENTION IN REDUCING COMMUNITY VIOLENCE EXPOSURE AMONG HIGH-RISK YOUTH (AIM 1), BARRIERS AND FACILITATORS FOR EFFECTIVE INTERVENTION IMPLEMENTATION (AIM 2), AND NEIGHBORHOOD- AND INDIVIDUAL-LEVEL FACTORS THAT MAY SERVE AS EFFECT MODIFIERS OF THE ASSOCIATION BETWEEN INTERVENTION PARTICIPATION AND VIOLENCE-RELATED OUTCOMES (AIM 3). THE PROPOSED STUDYS USE OF ACTION RESEARCH AND COMMUNITY-BASED PARTICIPATORY RESEARCH METHODS IS ALIGNED WITH NIJS EMPHASIS ON MEANINGFUL ENGAGEMENT WITH THE PEOPLE CLOSEST TO THE SUBJECT OF STUDY, INCLUDING PRACTITIONERS, COMMUNITY MEMBERS, AND MEMBERS OF HIGH-CRIME COMMUNITIES. SIMILARLY, IN ALIGNMENT WITH OJPS MISSION, THIS STUDY REPRESENTS A SIGNIFICANT STEP TOWARD DEVELOPING EVIDENCE-BASED PRACTICES THAT CAN ULTIMATELY ERADICATE THE EPIDEMIC OF COMMUNITY VIOLENCE AND PROMOTE HEALTH EQUITY, PARTICULARLY AMONG YOUTH AND COMMUNITIES DISPROPORTIONATELY IMPACTED BY LONGSTANDING INJUSTICES.CA/NCF

TECHNOLOGY-ENABLED LEARNING COLLABORATIVE PROGRAM - THROUGH HRSA’S TECHNOLOGY-ENABLED COLLABORATIVE LEARNING PROGRAM (TCLP), MOSES/WEITZMAN HEALTH SYSTEM, INC. (MWHS) AND ITS WEITZMAN INSTITUTE (WI) PROPOSE A PRIMARY CARE TELEMENTORING: EXPANDING SPECIALTY ACCESS FOR UNDERSERVED POPULATIONS NATIONALLY PROJECT TO ACHIEVE TCLP’S PURPOSE OF IMPROVING RETENTION OF HEALTH CARE PROVIDERS IN MEDICALLY UNDERSERVED AREAS AND INCREASING ACCESS TO HEALTH CARE SERVICES. LEVERAGING ITS EXISTING PROJECT ECHO INFRASTRUCTURE, EDUCATION EXPERTISE, PARTNERSHIPS, AND RESULTS FROM ITS NEEDS ASSESSMENT FOR THIS APPLICATION, WI WILL TRAIN PRIMARY CARE PROVIDERS, BEHAVIORAL HEALTH PROVIDERS, AND OTHER CARE TEAM MEMBERS IN HEALTH PROFESSIONAL SHORTAGE AREAS, RURAL AREAS, AND MEDICALLY UNDERSERVED AREAS IN HEALTH CENTER PARTNER SITES IN ARIZONA, ARKANSAS, CALIFORNIA, CONNECTICUT, AND NORTH CAROLINA OVER THE FIVE-YEAR PROJECT. WI WILL ALSO RECRUIT PROVIDERS AND CARE TEAM MEMBERS FROM ADDITIONAL FEDERALLY QUALIFIED HEALTH CENTERS (FQHCS)/SAFETY NET SITES ACROSS THE COUNTRY. THROUGH THE TCLP, WI WILL BUILD ON ITS EXISTING HRSA TELEHEALTH TECHNOLOGY-ENABLED LEARNING PROGRAM (TTELP) GRANT ACTIVITIES IN RURAL FQHCS AND EXPAND ITS OUTREACH TO A BROADER AUDIENCE OF PROVIDERS AND CARE TEAM MEMBERS IN MEDICALLY UNDERSERVED COMMUNITIES. BASED ON A REVIEW OF POOR HEALTH INDICATORS IN THE SERVICE AREAS OF ITS PARTNER SITES, WI NOTED CHRONIC DISEASES, WITH DIABETES AND OBESITY BEING HIGHLY PREVALENT, AS WELL AS BARRIERS IN ACCESS TO SPECIALTY CARE AND HIGH MATERNAL MORBIDITY AND MORTALITY RISK FACTORS. IN RESPONSE, WI’S TCLP PROJECT WILL CONCENTRATE ON THREE OF NINE FOCUS AREAS IDENTIFIED BY HRSA. WI WILL DESIGN, IMPLEMENT, AND EVALUATE THE TWO PROJECT ECHO PROGRAMS: 1) CHRONIC DISEASES AND CONDITIONS, COMBINED WITH SPECIALTY CARE, WITH YEAR 1 ON DIABETES AND WEIGHT MANAGEMENT 2) PRENATAL AND MATERNAL HEALTH FACULTY HAVE BEEN RECRUITED FOR BOTH ECHOS. WI WILL WORK CLOSELY WITH THEM TO ENSURE CONTENT IS CULTURALLY RESPONSIVE TO ADDRE SS DISPARITIES EXPERIENCED BY PATIENT POPULATIONS IN FQHCS/SAFETY NET SITES. OVER THE FIVE-YEAR PROJECT, WI WILL DELIVER 86 SESSIONS FOR THE CHRONIC DISEASES AND CONDITIONS ECHO (YEAR 1 ON DIABETES AND WEIGHT MANAGEMENT; YEARS 2-5 TOPICS BASED ON INPUT FROM TARGET COMMUNITIES, ECHO PARTICIPANTS, ADVISORY COUNCIL, HRSA, AND EMERGING NEEDS) FOR A TOTAL OF 375 PARTICIPANTS. WI WILL ALSO DELIVER 86 SESSIONS FOR THE PRENATAL AND MATERNAL HEALTH ECHO OVER THE FIVE-YEAR PROJECT FOR A TOTAL OF 375 PARTICIPANTS. WI WILL ALSO CONVENE A NATIONAL PRIMARY CARE FOR THE UNDERSERVED ADVISORY COUNCIL, CONSISTING OF 10 REPRESENTATIVES WITH LEADERSHIP AND/OR CLINICAL ROLES FROM PARTNER HEALTH CENTERS AND NATIONAL ORGANIZATIONS WHO SERVE UNDERSERVED PRIMARY CARE SETTINGS. THE ADVISORY COUNCIL WILL DISCUSS BEST PRACTICES, CHALLENGES, AND POTENTIAL SOLUTIONS TO ADDRESS PROVIDER RETENTION AND UNMET HEALTH CARE SERVICE NEEDS IN UNDERSERVED SETTINGS AND INFORM WI IN THE DEVELOPMENT, DELIVERY, AND EVALUATION OF THE TWO ECHOS. THROUGH A ROBUST EVALUATION PLAN, WI WILL ASSESS PROGRESS TOWARDS GOALS THROUGH IMPLEMENTATION MEASURES (PROVIDERS/CARE TEAM MEMBERS RECRUITED, SESSIONS DELIVERED, PARTICIPANT ATTENDANCE), LEARNER OUTCOMES (SATISFACTION, SELF-EFFICACY, CHANGES IN KNOWLEDGE OF PARTICIPANTS), AND SERVICE/PATIENT OUTCOMES (ADOPTION OF PRACTICE OR PROGRAM CHANGE RESULTING IN IMPROVEMENT OF PATIENT OUTCOMES). EVALUATION WILL INCORPORATE RELATED CLINICAL MEASURES AND INDICATORS OF THE IDENTIFIED TOPIC AREAS. TWO SPECIFIC RESEARCH THEMES WILL BE STUDIED: 1) WHAT FACTORS INFLUENCE CONTINUED AND SUSTAINED ATTENDANCE AT THE INDIVIDUAL PARTICIPANT LEVEL AND 2) THE IMPACT OF PARTICIPATION ON PROVIDER RETENTION. WI WILL DISSEMINATE EVALUATION FINDINGS FROM THE ECHO ACTIVITIES AND TWO RESEARCH THEMES THROUGH A TOTAL OF 10 NATIONAL CONFERENCES AND THREE PEER-REVIEWED PUBLICATIONS TO CONTRIBUTE TO THE EVIDENCE BASE OF BEST PRACTICES IN UTILIZING TECHNOLOGY-ENABLED COLLABORATIVE LEARNING PROGRAMS.

TRANSLATING RESEARCH INTO PRACTICE ON ALCOHOL AND POLYSUBSTANCE USE DISORDERS BY EDUCATING THE INTERPROFESSIONAL PRIMARY CARE TEAM - PROJECT SUMMARY/ABSTRACT ALCOHOL USE DISORDERS (AUDS) ARE COMMON IN THE UNITED STATES (SAMHSA, 2022), YET PRIMARY CARE PROVIDERS OFTEN OVERLOOK THESE CONDITIONS IN PATIENTS SEEN FOR ROUTINE VISITS; EVEN WHEN IDENTIFIED, REFERRAL TO TREATMENT AND APPROPRIATE INTERVENTIONS DO NOT ALWAYS FOLLOW (ISAACSON AND SCHORLING, 1999). DESPITE THE EXISTENCE OF EFFECTIVE AND EVIDENCE-BASED INTERVENTIONS FOR ADDRESSING AUD, THERE IS AN APPARENT RESEARCH-PRACTICE GAP OF THESE WITHIN THE PRIMARY CARE SETTING (REHM, ET AL., 2016), WITH MANY PCPS REPORTING LOW LEVELS OF PREPAREDNESS TO DEAL WITH SUDS, INCLUDING AUD AND POLYSUBSTANCE USE DISORDERS, ALTHOUGH THESE DISORDERS HAVE THE POTENTIAL TO CAUSE SIGNIFICANT AND LIFELONG HEALTH IMPACTS (SHAPIRO AND MCCANCE, 2013). EFFECTIVE CONTINUING EDUCATION PROGRAMS ARE NEEDED TO SUPPORT PROVIDERS IN IMPLEMENTING THE EVIDENCE BASE ON AUD INTO PRACTICE. TO ADDRESS THESE GAPS, MOSES/WEITZMAN HEALTH SYSTEM AND ITS WEITZMAN INSTITUTE PROPOSE THE TRANSLATING RESEARCH INTO PRACTICE ON ALCOHOL AND POLYSUBSTANCE USE DISORDERS BY EDUCATING THE INTERPROFESSIONAL PRIMARY CARE TEAM PROJECT. THE OVERALL GOALS OF THIS PROJECT ARE TO 1) IMPROVE THE CAPACITY OF PRIMARY CARE MEDICAL PROVIDERS AND BEHAVIORAL HEALTH PROVIDERS IN FEDERALLY QUALIFIED HEALTH CENTERS AND OTHER SAFETY NET PRIMARY CARE SETTINGS ACROSS THE UNITED STATES TO APPLY BEST PRACTICES DERIVED FROM THE CURRENT SCIENCE IN THE PREVENTION, SCREENING, AND TREATMENT OF AUD AND POLYSUBSTANCE USE DISORDER INTO PRACTICE AND 2) ENHANCE THIS AUDIENCE'S INTEREST AND ENGAGEMENT IN FOUNDATIONAL AND EMERGING SCIENTIFIC LITERATURE RELATED TO AUD AND POLYSUBSTANCE USE DISORDERS. THE PROPOSED PROJECT WILL DEVELOP, IMPLEMENT, AND EVALUATE THREE COMPLEMENTARY, VIRTUAL CONTINUING EDUCATION STRATEGIES: 1) TWO, 16-SESSION COHORTS OF PROJECT ECHO ALCOHOL USE DISORDER, 2) 12, ONE-HOUR SCIENCE TO PRACTICE SESSIONS ADAPTING A VIRTUAL JOURNAL CLUB MODULE, AND 3) NINE ON-DEMAND ELEARNING MODULES OFFERING SELF-PACED EDUCATION IN 15-30 MINUTE INCREMENTS. IN ADDITION, THE PROJECT WILL CONVENE AN ALCOHOL USE DISORDER IN PRIMARY CARE ADVISORY COUNCIL OF 10 REPRESENTATIVES INCLUDING MULTIDISCIPLINARY LEADERS AND CLINICIANS FROM THE TARGET AUDIENCE, INDIVIDUALS WITH LIVED EXPERIENCE IN RECOVERY FROM AUD, AND EXPERTS IN AUD RESEARCH TO DISCUSS CURRENT BEST PRACTICES, CHALLENGES, AND SOLUTIONS TO ADDRESS AUD AND POLYSUBSTANCE USE DISORDER IN PRIMARY CARE AND INFORM THE PROJECT. THESE EFFORTS ARE ANTICIPATED TO EDUCATE 670 PROVIDERS, IMPROVE THEIR KNOWLEDGE, SKILLS, ATTITUDES, AND SELF-EFFICACY, AND INCREASE THEIR INTEREST AND ENGAGEMENT IN THE SCIENTIFIC LITERATURE. THE SIMULTANEOUS EVALUATION ACTIVITIES ARE ANTICIPATED TO DEVELOP AND ADVANCE BEST PRACTICES IN UTILIZING THE SELECTED VIRTUAL EDUCATION MODALITIES TO BOTH ACHIEVE AND SUSTAIN OUTCOMES AND TRANSLATE THE SCIENCE ON AUD AND POLYSUBSTANCE USE DISORDERS INTO PRIMARY CARE PRACTICE.

RURAL COMMUNITIES OPIOID RESPONSE PROGRAM-OVERDOSE RESPONSE