The Wright State University Boonshoft School of Medicine’s Wright Rural Health Initiative has been awarded $166,000 in funding from Ohio Mental Health and Addiction Services through the State Opioid Response system supported by the Substance Abuse and Mental Health Services Administration. The funds will support expanded training for health care professionals in the region who treat those suffering from opioid use disorder and other ailments stemming from substance misuse.
The goal of the project is to provide Screening, Brief Intervention and Referral to Treatment (SBIRT) training to physicians, resident physicians, certified nurse practitioners, physician assistants, and other health care providers in 14 counties in rural western Ohio that have alarming death rates from substance misuse and opioid overdose.
The co-principal investigators on the Western Ohio Wright SBIRT (WOWS) project are Paul Hershberger, Ph.D., professor and director of the Division of Behavioral Health in the Department of Family Medicine, and Lori Martensen, rural health initiative director.
“Health professionals will be taught how to implement SBIRT in their practices. This involves doing routine and universal screening of adolescents and adults for alcohol and drug use, having a targeted conversation with those using a substance in a risky or harmful manner, and referring those with more severe substance misuse or addiction to specialized treatment,” Hershberger said. “The brief intervention component of SBIRT is based upon motivational interviewing. This evidence-based approach aims to help patients discover their own reasons and motivations for making healthy behavior changes.”
Martensen works closely with the hospital systems and health care providers in the region, and is helping to connect those providing training with the medical professionals who need it. Her efforts as director of the rural health initiative have contributed to the growing number of Wright State University medical students who apply to complete rotations in and around Celina, home to the Wright State Lake Campus.
Medical students will gain additional insight into the surrounding issues, as there is much they already learn through the medical school’s robust curriculum. Health care providers working in the rural health systems will likely benefit the most.
“The western Ohio area has really invested in the rural health initiative by giving medical students significant clinical experiences. This is a good opportunity for us to give back with continuing education opportunities and some training the local health care workforce wouldn’t otherwise receive unless they traveled to larger cities,” Martensen said. “Substance abuse of both drugs and alcohol is a significant issue in rural areas. Obviously, in Dayton, the opioid crisis continues to be an issue. The more information that everybody receives on identifying these patients and the services out there, the better.”
The funding will support at least 25 events to train health professionals in SBIRT, with the goal of training at least 250 health professionals. Hershberger will help to lead some of the training sessions. There will be five extended SBIRT training sessions for medical residents in family medicine, internal medicine and pediatrics.
The SBIRT training team is well positioned to carry out this project as they have completed another training effort through which more than 1,400 health professions students were trained in SBIRT. The WOWS Project will use an adaptation of the same curriculum to train health care professionals. It also will include a PRomoting Engagement for Safe Tapering of Opioids (PRESTO) component developed by the training team. PRESTO is designed to enhance patient motivation to commit to tapering their use of opioid prescriptions.
Research studies indicate that health professionals often don’t discuss use of alcohol and other drugs with their patients. “While there are many reasons for this, one important factor is discomfort on the part of providers in bringing up the topic of alcohol and drugs,” Hershberger said. “Learning the SBIRT approach gives providers a natural opportunity to discuss the topic with their patients. Using the results of the screening, providers can develop a specific plan for engaging patients in a conversation about their use and readiness to make a change.”