The purpose of this study was to determine if a short video presentation, about music therapy in behavioral health, had a positive effect on staff members’ beliefs about music therapy in that setting. A total of 26 staff members, from different departments, participated in the study and completed a pre- and post-presentation questionnaire. Responses were analyzed and compared to investigate whether the video had a positive effect on staff members’ beliefs about music therapy in behavioral health. Participant demographics and pre- and post-video questionnaire responses were also analyzed and compared to explore the differential impact of the video by subgroups of specific demographic categories. Based on the results, there was evidence that there was favorable change in participants’ relevance beliefs about music therapy in behavioral health. In addition, pre- and post-questionnaire differences in means scores were larger for those working in activities than those working in nursing, larger for those who had not observed a music therapist working in behavioral health than for those who had, and larger for those who did not have a musical background when compared with those that did.

Interprofessional education (IPE) is essential for enhancing students’ critical thinking skills and ability to integrate other professionals’ knowledge to ensure mutual respect and shared values for patient-centered care. The needs of medically underserved populations (MUPs) to receive behavioral health and nutritional care integrated with primary care services are significant. This research highlights the data outcomes from six offerings of a graduate IPE course on integrated health care. Funding from a Health Resources and Services Administration (HRSA) Behavioral Health Workforce and Education Training (BHWET) grant provided stipends for graduate social work and school counseling students in their final year of field working with MUPs in integrated care settings. Findings indicate significant increases in integrated care knowledge from pre- to post-course. Students reported appreciating the social justice framework of the course including food security and access to care. Students suggest that the course be required of all, not just stipend recipients. This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under Behavioral Health Workforce Education and Training Program Grant No. M01HP313900100. This information or content and conclusions are those of the authors and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS, or the U.S. Government.

This paper describes an empirical approach to assessing pediatric residents' attitudes, knowledge and skills in primary care behavioral health. Outcomes from that assessment approach are presented from two pediatric residency training programs in the northeastern United States. Thirty-six pediatric residents completed attitudes, knowledge and skills surveys. The survey was developed to align with the American Academy of Pediatrics’ Policy Statement in 2009 citing aspirational competencies for pediatricians in primary care behavioral health. This alignment addressed both learner variables (attitudes, knowledge, and skills) as well as clinical presentations (ADHD, anxiety, depression, and suicide) highlighted in the policy statement. The survey specifically inquired about self-reported confidence and comfort in managing behavioral health concerns using evidence-based practice parameters (attitudes and knowledge) and their measured ability to deliver evidence-based care in response to clinical vignettes (skills). Findings largely revealed no statistically significant differences in attitudes, knowledge or skills between interns and upper-level residents. Training programs can use the approach described in this paper and the assessment instrument with some possible modifications to monitor annual progress and evaluate any changes in didactic and clinical training.

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Background: A diet rich in vegetables, fruits, grains, fat-free or low-fat dairy, and proteins is known to have multiple beneficial health effects. However, a very limited number of studies have characterized food group intake and its association with cardiometabolic risk factors in Hispanic children. Objectives: The objectives of this study were to 1) assess food group intake in a sample of Hispanic children; and 2) examine the association between food group intake and overweight and elevated blood pressure in the same population. Methods: Data came from a pilot study of metabolic syndrome in Hispanic children. The study sample consisted of 116 2-to-10-year-old children receiving well-child care at a community health center in Johnson City, TN, from June 2015 to June 2016. Blood pressure, height and weight were measured using standard protocols. Food group intake was ascertained using the Block Kids Food Screener, a validated instrument. Child’s age, sex, and mother’s educational attainment were included as covariates. Binomial test of proportions was used to compare the study sample with the National Health and Nutrition Examination Survey (NHANES) gender-age group proportions not meeting recommended daily food group intake. Two sample t-test was used to examine differences in mean food intake by outcome variables of elevated blood pressure (>=90th percentile for age and sex) and being overweight (>85th percentile of the 2000 CDC growth charts). Multiple logistic regression was used to examine the association between food group intake and elevated blood pressure and being overweight while accounting for child's sex, age, and mother's educational attainment. Results: Hispanic children exceeded minimum fruit and legume national recommendations. Compared with the corresponding NHANES gender-age groups, a larger proportion of the sample met legume recommendations. However, similar proportions met fruit, vegetable, wholegrain, fiber and dairy recommendations. Children with elevated blood pressure ate less fruits, vegetables, and legumes than children with normal blood pressure. Legume intake (OR: 0.052, 95% CI: 0.04-0.64), dairy intake (OR: 0.61, 95% CI: 0.37-0.99), and fiber intake (OR: 0.88, 95% CI: 0.81-0.96) were protective against elevated blood pressure. In contrast, only fruit intake was protective against overweight (OR: 0.93, 95% CI: 0.87-0.99). Conclusion: Public health nutrition programs aimed at reducing the prevalence of overweight and elevated blood pressure in Hispanic children should consider supporting the intake of legumes, dairy, and fiber (for decreasing elevated blood pressure), and fruits (for reducing overweight).

Maternal obesity, physical inactivity, and negative perceptions of neighborhoods have been identified as obesogenic factors in older children; however, no study has explored this relationship in young Hispanic children. Furthermore, the relation between obesogenic maternal factors and blood pressure in Hispanic children has not been examined. Objectives: This study aimed to assess the association between Hispanic mother’s physical activity (PA) levels, body mass index (BMI), and PA-related perceptions of neighborhoods and their children’s PA, TV screen time, blood pressure (BP), and BMI. Methods: Data of 118 mother-child dyads enrolled in a cross-sectional study of metabolic syndrome in Hispanic children at a community health center in Johnson City, TN were used. Parent and child questionnaires were used to ascertain mother’s BMI, PA, perception of the safety and availability of PA amenities in their children’s neighborhoods, satisfaction with their children’s neighborhoods as a place to bring up children, and children’s PA and TV screen time. Children’s height, weight, and BP were measured. Multiple logistic regression was used to examine the association between child and maternal variables, adjusting for mother’s education and the child’s sex and age. Results: Children of obese mothers were more likely than children of mothers with normal BMI to engage in less than three days of at least 60 minutes of vigorous PA per week (OR: 6.47: 95% CI: 1.61-26.0). Children whose mothers did not engage in moderate PA were more likely to engage in less than three days of at least 60 minutes of vigorous PA per week (OR: 2.92, CI: 1.18-7.24); and have elevated BP (OR: 2.50, 95% CI: 1.02-4.53) than children whose mothers engaged in moderate PA. Conclusion: Our results suggest the need for interventions to help Hispanic mothers model physical activity and achieve and maintain healthy weight; if successful, these strategies could potentially influence their children’s blood pressure and physical activity levels.

Background: Patients engaged in evidence-based opioid use disorder (OUD) treatment can obtain prescriptions for buprenorphine containing products from specially trained physicians that are subsequently dispensed by community pharmacists. Despite the involvement of physicians and community pharmacists in buprenorphine prescribing and dispensing, respectively, our understanding of their interactions in this context is limited. Objective: To qualitatively describe the communication and collaborative experiences between Drug Addiction Treatment Act 2000 (DATA)-waivered physicians and community pharmacists from the perspective of the physician. Methods: Ten key informant interviews were conducted with DATA-waivered physicians practicing in Northeast Tennessee. A semi-structured interview guide was used to explore communication and collaborative experiences between the physicians and community pharmacists. Interviews were audio recorded and transcribed verbatim. A coding frame was developed using concepts from the scientific literature and emerging codes from physician interviews. Interviews were coded using NVivo 11, with the data subsequently organized and evaluated for themes. Results: Four themes were identified: (1) mechanics of communication; (2) role specification and expectations; (3) education and understanding; and (4) climate of clinical practice. Physician-pharmacist communication primarily occurred indirectly through patients or staff and perceived challenges to collaboration included; lack of trust, stigma, and fear of regulatory oversight. Physicians also indicated the two professionals may lack clear roles and responsibilities as well as common expectations for treatment plans. Conclusions: Communication between DATA-waivered physicians and community pharmacists is influenced by multiple factors. Further research is warranted to improve physician-community pharmacist collaboration (PCPC) in the context of OUD pharmacotherapy and addiction treatment.

OBJECTIVES: This study examined implementation of telehealth for contraceptive care among health departments (HDs) in 2 Southern US states with centralized/largely centralized governance structures during the early phase of the COVID-19 pandemic. Sustaining access to contraceptive care for underserved communities during public health emergencies is critical. Identifying facilitators and barriers to adaptive service provision helps inform state-level decision making and has implications for public health policy and practice, particularly in states with centralized HD governance. DESIGN: Mixed-methods study including a survey of HD clinic administrators and key informant interviews with clinic- and system-level staff in 2 states conducted in 2020. SETTING: Health department clinics in 2 Southern US states. PARTICIPANTS: Clinic administrators (survey) and clinic- and system-level respondents (key informant interviews). Participation in the research was voluntary and de-identified. MAIN OUTCOME MEASURES: (1) Telehealth implementation for contraceptive care assessed by survey and measured by the percentage of clinics reporting telehealth service provision during the pandemic; and (2) facilitators and barriers to telehealth implementation for contraceptive care assessed by key informant interviews. For survey data, bivariate differences between the states in telehealth implementation for contraceptive care were assessed using χ2 and Fisher exact tests. Interview transcripts were coded, with emphasis on interrater reliability and consensus coding, and analyzed for emerging themes. RESULTS: A majority of HD clinics in both states (60% in state 1 and 81% in state 2) reported a decrease in contraceptive care patient volume during March-June 2020 compared with the average volume in 2019. More HD clinics in state 1 than in state 2 implemented telehealth for contraceptive services, including contraceptive counseling, initial and refill hormonal contraception, emergency contraception and sexually transmitted infection care, and reported facilitators of telehealth. Medicaid reimbursement was a predominant facilitator of telehealth, whereas lack of implementation policies and procedures and reduced staffing capacity were predominant barriers. Electronic infrastructure and technology also played a role. CONCLUSIONS: Implementation of telehealth for contraceptive services varied between state HD agencies in the early phase of the pandemic. Medicaid reimbursement policy and directives from HD agency leadership are key to telehealth service provision among HDs in centralized states.

Federally qualified health centers (FQHCs) provide essential contraceptive services to low-income individuals; yet, access to all method options, notably intrauterine devices (IUDs) and implants, may be limited at non-Title X FQHCs. The South Carolina (SC) Choose Well initiative is a statewide contraceptive access initiative that was launched in 2017 and extends into 2022. Choose Well established a collaborative network between training and clinical partners and is aimed at facilitating implementation of contraceptive care best practices through capacity-building and training of clinical and administrative staff in partner organizations. The initiative provided funding for workforce expansion and contraceptive methods. We examined perceptions of staff from Choose Well-participating FQHCs regarding contraceptive access during the first 2 years of the initiative, including factors that facilitated or posed access challenges as well as sustaining factors. This study informs the process evaluation of Choose Well while providing data critical for uncovering and scaling up contraceptive access initiatives. Interviews were conducted with FQHC staff ( = 34) in 2018 and 2019 to assess Choose Well implementation and were recorded, transcribed, and double-coded at least 80% interrater reliability or consensus coding. Data were analyzed according to clinical and administrative factors influencing contraceptive access. Increased capacity for contraceptive counseling and provision through training and external funding for IUDs and implants were the most noted clinical factors facilitating access. Streamlining workflow processes was also a facilitator. Buy-in and engagement among staff and leadership emerged as a facilitator at some clinics and as a barrier at others. Policy/structural factors related to costs of devices and insurance coverage were identified as threats to sustainability. The Choose Well initiative contributed to the perception of an increase in contraceptive access at participating FQHCs in SC. Statewide contraceptive access initiatives have the potential to support FQHCs in meeting their clients' contraceptive needs. Organizational buy-in, sustainability of funding, and training are key to realizing the full potential of these initiatives.

No description available.