Area Health Education Center Research Articles

Practice Report: Student Health Ambassadors at Residential Campuses Contribute to Safer Campus Living and Learning During the COVID-19 Pandemic

In summer 2020 six residential institutions of higher education (IHE) and the Mountain Area Health Education Center (MAHEC) in Western North Carolina chose a collaborative approach to mitigating COVID-19 infection rates on campus. This approach shares the practices and successes of this concerted effort with a focus on a large public, medium public, and small private IHE. The campuses promoted a healthy and safe culture through a rigorous and transformational learning experience and focused on engaging Student Health Ambassadors (SHAs) in applying the Diffusion of Innovations model to peer-to￾peer gain-framed messaging for health. Three institutions’ programs are presented and cross-case analysis is used to illuminate transferable promising practices. Promising transferable practices across the schools include: selecting the right students, strong institutional support, the three Ps (positive, proactive and prevention-focused), building leadership skills, and peer-led campus culture change. Transferable insights from the practices at three campuses focused on the role and impact of peer-to-peer student health ambassadors on campus to mitigate the spread of COVID-19.

Nursing, education partnership to train Montana MH providers

A collaboration between Montana State University's College of Nursing, the Montana Office of Rural Health and Area Education Center, MSU Billings and the Billings Clinic aims to help address a shortage of mental health providers in eastern Montana, a news release from Montana State University stated Aug. 9. The partnership, known as Montana Behavioral Health Workforce Education and Training — Eastern and North Central Montana, or BHWET‐East, will provide training opportunities and financial support for students working to become psychiatric mental health nurse practitioners, mental health counselors or psychiatrists. The work is supported by a four‐year, $1.8 million grant from the U.S. Health Resources and Services Administration. The partnership's goal is to increase access to high‐quality and culturally appropriate behavioral health services in 38 of Montana's counties in eastern and north central Montana. “Supporting behavioral health professional trainees through their academic careers, providing comprehensive integrated behavioral health education, and creating team‐based training opportunities in our communities is a successful model for growing Montana's health care workforce,” said Kailyn Mock, director of the Montana Office of Rural Health and Area Health Education Center at MSU.

Developing and implementing a co‐curricular IPE program: AHEC Scholars Program

As part of a new directive, the Human Resources Services Administration (HRSA) mandated Area Health Education Center (AHEC) Programs across the nation to implement an interprofessional education (IPE) program for health professional students, with the goal of fostering collaborative practice among health profession students and motivating students to work in medically underserved areas post-graduation.The South Texas AHEC Program collaboratively developed and implemented a co-curricular IPE initiative, the AHEC Scholars Program, including didactic and practicum components, focused on the needs of communities in our area. A pre-post quasi-experimental design was used to evaluate the student outcomes related to IPEC Competencies and knowledge and preparation for the practice of core topic areas mandated by HRSA. Student outcomes showed statistically significant improvement in all measures.In order to obtain more detailed accounts of students' practicum experiences, students were asked to complete reflective journals after each practicum.The AHECScholarsProgram provides students with opportunities to work with underserved populations and enables students to explore the benefits of team-based care. This article summarizes the collaborative process of the development and implementation of the AHECScholarsProgram; secondly, it details student outcomes from a 3-month pilot study.

Using the AHEC Scholars Program to Enhance Health Professions Learners' Self-Efficacy for Practice Transformation.

The Indiana Area Health Education Centers Scholars program is a 2-year leadership program designed to supplement health professions students' academic training and enhance practice readiness around 6 core topic areas including practice transformation. The study was a retrospective cohort study assessing learners' reported level of self-efficacy on a set of 6 competencies around practice transformation and quality improvement. A total of 68 students graduating in the first cohort responded to the competency questions. Area Health Education Center Scholars reported a significant increase in self-efficacy on the competencies Identify issues emerging in health care delivery such as accountable care organizations, medical homes, and health insurance exchanges; understand how to practice effectively within the organization and culture of the interprofessional team, practice setting, and local health care system, and use an electronic health record to retrieve relevant information and to document care. This study found that learners reported a significant increase in self-efficacy related to implementing practiced transformation.

Meeting the Challenge of Perinatal Care in Rural Communities.

The complexities of providing quality perinatal care within rural communities provide significant challenges to providers and policy makers. Provision of healthcare in rural communities is challenging on individual as well as community-based levels. A quality improvement lens is applied to consider key challenges that pertain to patients, providers, place, and policy. Potential solutions from a provider perspective include nurse-midwifery care and inclusion of advanced practice providers in a variety of specialties in addition to creating care models for registered nurses to practice at the top of their scope. To enhance access in the rural place, telehealth and coordination activities are recommended. Finally, policy approaches such as Perinatal Care Collaboratives, Area Health Education Centers, and enhanced financial resources to eliminate socioeconomic disparities will enhance perinatal care in rural communities.

Librarian Contributions to a Regional Response in the COVID-19 Pandemic in Western North Carolina

At the start of the COVID-19 pandemic, the Mountain Area Health Education Center formed a response team with the goal of building capacity across Western North Carolina health systems to collectively identify needs, coordinate resources to fill gaps, and strategically manage the regional threats of the pandemic. The library team collaborated on interprofessional projects by gathering information and using LibGuides to quickly and easily organize and share resources. The team met challenges, including moving to telecommuting, balancing a growing workload, and navigating a changing information landscape, and in doing so, strengthened relationships across the organization and the region.

Service-Learning in the Virtual Space: Mixed Method Analysis of STEPS Pipeline Program

North Central Indiana Area Health Education Center (NCI-AHEC) aims to develop the healthcare infrastructure by encouraging rural students to pursue healthcare professions. In light of rural healthcare shortages found in Indiana, they implemented a pipeline program, Successfully Training and Educating Pre-medical Students (STEPS). This program offers mentoring and educational assistance to pre-health-professional undergraduate students at Indiana University – Kokomo. During the COVID-19 pandemic, the Purdue research team partnered with NCI-AHEC to conduct a completely virtual mixed method study that examined the initial impact of the STEPS program and made recommendations for improvement. The opportunities for virtual collaboration created during the COVID-19 pandemic allowed for thorough evaluation of NCI-AHEC’s STEPS program. Initial evaluation suggests that the STEPS program is beneficial in assisting rural students on their path to a career in healthcare. Using the actionable recommendations that came from this study, NCI-AHEC will contribute to a growing generation of capable, well-prepared healthcare providers in rural Indiana.

Community-engaged research in translational science: Innovations to improve health in Appalachia.

Health disparities between Appalachia and the rest of the country are widening. To address this, the Appalachian Translational Research Network (ATRN) organizes an annual ATRN Health Summit. The most recent Summit was held online September 22-23, 2020, and hosted by Wake Forest Clinical and Translational Science Institute in partnership with the Northwest Area Health Education Center. The Summit, titled "Community-Engaged Research in Translational Science: Innovations to Improve Health in Appalachia," brought together a diverse group of 141 stakeholders from communities, academic institutions, and the National Center for Advancing Translational Science (NCATS) to highlight current research, identify innovative approaches to translational science and community-engaged research, develop cross-regional research partnerships, and establish and disseminate priorities for future Appalachian-focused research. The Summit included three plenary presentations and 39 presentations within 12 concurrent breakout sessions. Here, we describe the Summit planning process and implementation, highlight some of the research presented, and outline nine emergent themes to guide future Appalachian-focused research.

Developing interprofessional collaborative practice competencies in rural primary health care teams

BackgroundLeaders from a university, Area Health Education Center, and primary care centers (PCCs) collaborated to integrate Interprofessional Collaborative Practice (IPCP) in PCCs. PurposeDescribe the facilitators and barriers of IPCP implementation in rural clinics and the impact on decision-making and safety culture. MethodsThe implementation team used engagement strategies to support the development of IPCP. PCC team participants completed surveys measuring collaboration and satisfaction with care decisions and safety culture. Qualitative data were analyzed to describe facilitators and barriers to IPCP. FindingsSignificant improvement (p < .035) in the Global Amount of Collaboration made over time. Barriers to IPCP included high turnover, hierarchical culture, lack of role clarity, competing time demands, limited readiness for change, and physical space limitations. Facilitators included structured huddles, alignment of IPCP with organizational goals, and academic-practice partnership. DiscussionPartnering with academic-practice partnerships may facilitate collaboration and team learning as PCCs incorporate IPCP into practice.

North Central Indiana AHEC: STEPS Program Impact

Background/Objective: &#x0D; North Central Indiana Area Health Education Center (NCI AHEC) aims to encourage rural students in their service district to pursue healthcare. In light of rural healthcare shortages found in Indiana, they implemented the Successfully Training and Educating Pre-medical Students (STEPS) program, available to college juniors at Indiana University – Kokomo. Through MCAT prep courses, workshops about interviews, and job shadowing, the goal of the program is for more rural students to be accepted into local medical schools, to then return to practice in that rural area. This case study examines the initial impacts of the STEPS program and the path to healthcare for a student at IU – Kokomo. &#x0D; &#x0D; Methods: &#x0D; A mixed methods study was conducted. First, a survey was administered by NCI AHEC to students who participated in the STEPS program using a retrospective pre/post design. The quantitative data, representing students’ opinions and goals, was aggregated and interpreted. An interview was then done with a previous STEPS student. This student’s experience was analyzed. &#x0D; &#x0D; Results: &#x0D; Participation in the STEPS program resulted in increased knowledge about healthcare careers and plans to pursue further education for healthcare careers across all students. The STEPS program has identified strengths, including activities that increase student commitment to pursuing healthcare and mentorship for students. Areas for growth were also identified, including adding application assistance, decreasing competition for resources, and increasing efforts to keep students in Indiana. &#x0D; &#x0D; Conclusion and Potential Impact: &#x0D; Initial evaluation suggests that the STEPS program is beneficial in assisting rural students on their path to a career in healthcare. Analysis of the interviewee’s experience provides recommendations for improvements of the STEPS program in the future.

Does XR injectable naltrexone prevent relapse as effectively as daily sublingual buprenorphine-naloxone?

YES. MONTHLY EXTENDED-RELEASE INJECTABLE NALTREXONE (XR-NTX) TREATS OPIOID USE DISORDER AS EFFECTIVELY AS DAILY SUBLINGUAL BUPRENORPHINE-NALOXONE (BUP-NX) WITHOUT CAUSING ANY INCREASE IN SERIOUS ADVERSE EVENTS OR FATAL OVERDOSES. (STRENGTH OF RECOMMENDATION: A, 2 GOOD-QUALITY RCTS).

COVID-19 Needs Assessment and Support for Primary Care Practices in Western North Carolina.

It is critical to ensure that Primary Care Providers (PCPs) have adequate personal protective equipment (PPE), supplies, training, staffing, and contingency planning during pandemics, particularly in rural areas. In March 2020, during the onset of the COVID-19 pandemic, the Mountain Area Health Education Center (MAHEC), in collaboration with the Cecil G. Sheps Center for Health Services Research at UNC Chapel Hill, rapidly created and conducted a needs assessment of PCPs in western North Carolina (WNC). A group of twenty volunteers conducted a telephone survey of PCPs in a 16 county region of WNC. Practices were asked about their COVID-19 testing and telehealth offerings, PPE adequacy, and capacity to continue serving patients. The survey's emergency alert feature linked practices to immediate support. Descriptive data were generated to identify regional needs. Out of 110 practices, 48 (43.6%) offered COVID-19 testing, with testing more common in rural counties (56.3% vs 33.9%). Telehealth services, including phone-only visits, were offered by almost all practices (91.8%). PPE needs included N-95 respirators (49.1%), face shields (45.5%), and staff gowns (38.2%). Rural practices were more likely to report the need for PPE. Assistance was requested for staff member childcare (34.5%) and providing or billing for telehealth (31.8%). The most urgent practice requests were related to finances, PPE, and telehealth. MAHEC's Practice Support team linked practices to virtual coaching, tip sheets, case-based video didactics and communication forums, and newsletters. During a pandemic, it is crucial to ensure that PCPs can continue to serve their patients. A rapid needs assessment of PCPs can allow for immediate and ongoing support that matches regional and practice-specific needs. Rural practices may require more assistance than their urban counterparts. Our rapid survey process jumpstarted a statewide system for enhanced communications with PCPs to better prepare for future emergencies.

P59 The Future of Clinical-Community Linkages – Nutrition Education Takes Root in Maine's Underserved Communities Through a Learning Partnership with SNAP-Ed

ObjectiveExplore the impact of exposing health professions students to the social determinants of health through a learning partnership with Maine Supplemental Nutrition Assistance Program-Education (SNAP-Ed).Use of Theory or ResearchSNAP-Ed's program theory is informed by the Social-Ecological Model, supporting training competencies for health professions students to understand the social determinants of health and ensure a Social-Ecological Approach to clinical care.Target AudienceStudents enrolled in health professions programs (eg, medicine, physical therapy, physician assistant, dental medicine).Course/Curriculum DescriptionThe learning partnership exposes Maine's Care for the Underserved Pathways Area Health Education Center Scholars (CUP AHEC Scholars) to SNAP-Ed evidence-based curricula. The two-year program combines didactic and experiential activities for students interested in working in underserved communities. Scholars gain competencies in interprofessional education and practice, social determinants of health, and culturally sensitive clinical care. The collaboration promotes an understanding of how nutrition-related supports create healthier, food-secure communities. Scholars complete an online module covering SNAP-Ed program theory and participate in community-based activities alongside a nutrition educator.Evaluation MethodsPost-activity surveys from scholars collect immediate qualitative information on trainings, focused on quality improvements and learning outcomes. Annual post-surveys collect quantitative and qualitative data measuring competency outcomes. A storytelling approach with photographic evidence will highlight results from the collaboration's first 2 years.ResultsSince 2018, 9 students have participated in the Maine SNAP-Ed learning partnership. The majority of students (89%) report they would recommend the activity to fellow students. Qualitative feedback was overwhelmingly positive, and the most commonly cited learning outcome was increased understanding of “the link between poor nutrition and its impacts on health and wellness.”ConclusionsThe health professions training collaboration demonstrates that exposure to SNAP-Ed's approach to addressing social determinants of health provides valuable real-world clinical-community linkages experience. Scholarly partnerships with SNAP-Ed have the potential to create fundamental, systemic change in local capacity to reduce the burden of hunger and improve health outcomes. Explore the impact of exposing health professions students to the social determinants of health through a learning partnership with Maine Supplemental Nutrition Assistance Program-Education (SNAP-Ed). SNAP-Ed's program theory is informed by the Social-Ecological Model, supporting training competencies for health professions students to understand the social determinants of health and ensure a Social-Ecological Approach to clinical care. Students enrolled in health professions programs (eg, medicine, physical therapy, physician assistant, dental medicine). The learning partnership exposes Maine's Care for the Underserved Pathways Area Health Education Center Scholars (CUP AHEC Scholars) to SNAP-Ed evidence-based curricula. The two-year program combines didactic and experiential activities for students interested in working in underserved communities. Scholars gain competencies in interprofessional education and practice, social determinants of health, and culturally sensitive clinical care. The collaboration promotes an understanding of how nutrition-related supports create healthier, food-secure communities. Scholars complete an online module covering SNAP-Ed program theory and participate in community-based activities alongside a nutrition educator. Post-activity surveys from scholars collect immediate qualitative information on trainings, focused on quality improvements and learning outcomes. Annual post-surveys collect quantitative and qualitative data measuring competency outcomes. A storytelling approach with photographic evidence will highlight results from the collaboration's first 2 years. Since 2018, 9 students have participated in the Maine SNAP-Ed learning partnership. The majority of students (89%) report they would recommend the activity to fellow students. Qualitative feedback was overwhelmingly positive, and the most commonly cited learning outcome was increased understanding of “the link between poor nutrition and its impacts on health and wellness.” The health professions training collaboration demonstrates that exposure to SNAP-Ed's approach to addressing social determinants of health provides valuable real-world clinical-community linkages experience. Scholarly partnerships with SNAP-Ed have the potential to create fundamental, systemic change in local capacity to reduce the burden of hunger and improve health outcomes.

Preparing a Health Literate Workforce: The Role of Area Health Education Centers.

Area Health Education Centers (AHEC) play a vital role in creating health literate organizations. In this report, we highlight the work of three AHECs. The Massachusetts AHEC trains oral language healthcare interpreters who can effectively convey complex medical information to patients with limited English proficiency (LEP). The University of Kentucky AHEC trains providers to use the Universal Precautions Health Literacy Toolkit. Finally, the Wisconsin AHEC prepares community health workers (CHWs) to play a vital role in making it easy for people to navigate the healthcare system. These three AHECs serve as models of health literacy's diffusion.

Homelessness: Understanding unmet needs and identifying resources.

Graduate occupational therapy students collaborated with an Area Health Education Center (AHEC) to address occupational therapy's role in intervening for individuals who are homeless. The purpose was to provide educational resources on specific needs related to health and wellbeing to individuals who are homeless. A variety of methods were used to gather information on common needs of the homeless population related to health and wellbeing, community integration, and development of routines. Initial data was collected through the use of a needs assessment for nine participants with thirteen questions followed with a weekly visit to a homeless shelter. The weekly visits allowed the students to build rapport and trust with the residents to gain an understanding of individual perspectives and barriers to occupation. The students worked with residents how to best access community based resources and services related to occupational needs. Specific needs were identified, and further resources were provided to support community integration, independent living, and self-management. Preliminary findings provided a basic understanding of the foundational needs of individuals to be used to support future research linking occupational therapy to the homeless population to achieve individual goals, improve health and wellbeing, and enhance life skills management.

Assessing a rural academic-community partnership using ripple effect mapping

ABSTRACTAs Area Health Education Centers (AHECs) expand their efforts to improve the distribution and diversity of the healthcare workforce, one common question is how these activities impact their local communities. Ripple Effect Mapping (REM) is an evaluation method designed to assess a program’s intended and unintended impacts, social capital, and partner reciprocity. This study used REM to uncover and explore the intended and unintended impact of a rural AHEC in a 14-county region. The findings of this study provide direction to the AHEC in relation to strengthening their partnerships, social capital, and improving the health workforce in their region.

Characteristics of High-Performing Interprofessional Health Care Teams Involving Student Pharmacists

Objective. To identify key themes of interprofessional models of care that offer experiential education opportunities for pharmacy learners. Methods. Six pharmacists from four Area Health Education Centers in North Carolina participated in individual, 60-minute interviews. Using two pre-established frameworks, the data were analyzed qualitatively by two members of the research team to identify the characteristics of interdisciplinary care teams. Results. At the level of the organization or health care system, the theme of appropriate resources and procedures emerged. At the level of the team, the themes of appropriate resources and procedures, communication, appropriate skill mix, climate, quality and outcomes of care, and respecting and understanding roles emerged. At the level of the individual, the themes of communication, respecting and understanding roles, and individual characteristics emerged. Three themes identified in a previous study failed to emerge in the interviews: leadership and management; personal rewards, training and development; and clarity of vision. Conclusion. Although a growing body of evidence highlights the importance of designing practice models to achieve interdisciplinary care that is patient-centered and effective, capacity to support learners and effectively educate them in the principles and practices of team-based care is limited. This study provides critical insight into characterizations of interprofessional models that integrate pharmacy learners. Further research is needed to better understand the barriers to designing and implementing IPE in experiential settings.

Simulation faculty and staff development: An interprofessional, online approach

Abstract Two academic healthcare programs and a university-affiliated hospital were faced with increasing demands for faculty and staff knowledge in support of expanded use of simulation-based education. While a few authors have published recommendations and innovations for faculty development in simulation programs, 1 best practices have yet to be determined. 2 , 3 Through collaboration by simulation program administrators and educators at the College of Nursing, the School of Medicine, and the hospital, an online program was developed for use by multiple disciplines and facilities. An online approach allows for standardization of simulation faculty development across three entities. Faculty and staff were incentivized by the ability to receive continuing education credits. The online self-directed program includes 10 modules with a learner pretest and posttest. Comparisons of pre- and post-test scores have shown knowledge improvements. Through post-course surveys, learners have indicated favorable responses to the online program. In order to implement this type of online approach to simulation faculty development, a stable web-based learning platform is required. For more information about the course, the lead author may be contacted at XXXX. Format The online simulation educator course consists of 10 modules with pretest, posttest, and module quizzes for 8 of 10 modules. Within the program, learners are asked about their personal objectives at the beginning and whether they accomplished those at the end of the course. The Eastern Area Health Education Center (Eastern AHEC), which hosts the program on its learning platform, requires a learner evaluation to be completed before issuing the continuing education certificate, to assure that the data is obtained.

Reexamining the Academic Partnerships with Federal Pharmacy: 2018-19 Argus Commission Report

The Argus Commission examined the history and current status of progressive pharmacy patient care services across several federal branches of government, including the Veterans Administration, Department of Defense, and the U.S. Public Health Service where officers and civilian pharmacists practice in the Indian Health Service, Bureau of Prisons, Area Health Education Centers and other locations. The engagement of pharmacy faculty, students and residents in these practices was assessed. Colleges and schools of pharmacy advocate for the expansion of the capacity for placement of learners in these progressive practices. AACP is encouraged to establish on going collaborations with federal pharmacy leaders to create new opportunities for partnerships that advance patient care, especially for special populations served in these federal programs.

FACTORS FACILITATING COLLABORATION AND ENGAGEMENT: BUILDING AND SUSTAINING STATEWIDE COALITIONS

Sustaining collaboration across multiple community-based organizations (CBOs) creates synergies and economies of scale to support age-friendly communities beyond the provision of direct services any single CBO can achieve. The Carolina Geriatrics Workforce Enhancement Program (CGWEP) created and sustained multiple statewide coalitions focused on geriatrics syndromes. More than 290 CBOs, including Area Health Education Centers, social services programs and nongovernmental organizations, meet quarterly to form linkages, promote education and build infrastructure to support rural and underserved older adults. Shared governance with pooled resources has been achieved because of a long history of partnership, mutually beneficial relationships, flexibility, and frequent communication. The strength of the partnership is evidenced by continued growth in number of CBOs, number of sponsored events, and number of referrals to CBOs. Two coalitions, focused on falls prevention and mental health respectively, have been adopted by partners and sustained beyond grant funding.