Literature Collection

BACKGROUND: Integrated behavioral health care (IBH), a team-based approach to care, involves behavioral health providers (BHP) to be utilized in primary care settings. Unfortunately, many BHP and primary care advanced practice nursing students do not receive IBH content in their educational curriculum. This article describes an innovative interprofessional simulation project (ISP) in a virtual IBH setting with primary care nurse practitioner and master's level counseling students. METHOD: The ISP involved students role-playing using case studies while enacting the roles exemplified in the Collaborative Care model (CoCM). Interprofessional faculty collaborated in developing the project and training facilitators and interprofessional students. RESULTS: Of the students and faculty who completed a postsurvey, 87.7% reported an increase in preparedness in learning the CoCM, and 92.6% responded the preparation time for the project was "appropriate." CONCLUSION: The ISP project resulted in high satisfaction and perceived increased preparedness for students and faculty to practice and teach IBH. [J Nurs Educ. 2024; 63(X):XXX-XXX.].

INTRODUCTION: The profession of pharmacy has been continuously evolving, redefining scope of practice in every practice settings to meet the ongoing needs of the health care system and to meet patient expectations and need. Pharmacists are increasingly becoming part of primary care teams in countries such as Canada, the United Kingdom and Australia. In British Columbia, Canada, the Pharmacists in Primary Care Network (PCN) Program integrated primary care clinical pharmacists (PCCPs) as core members of the interprofessional team (IPT). The IPT members' experiences of collaborating with a pharmacist in a team-based primary care setting have not been extensively studied. AIM: To describe the experiences of IPT members and PCCPs while working collaboratively for the shared care of mutual patients to identify the enablers, barriers, and development of interprofessional collaborations within the primary care setting in a province-wide program. METHOD: Based upon the evaluation of the Pharmacists in the PCN Program, this work was informed by Qualitative Description methodology. Interview and focus group data were performed during two time periods (T1 and T2) of program implementation. Study participants included PCCPs, prescribers (family physicians and nurse practitioners), and PCN IPT members (social workers, dieticians, physiotherapists, and clinical counsellors). Each participant was invited via e-mail to attend a Zoom interview or focus group session. RESULTS: In T1 we interviewed 15 PCCPs and in T2, we interviewed 39 PCCPs, 12 IPT members and 11 prescribers. Data analysis developed four themes: (i) awareness shaping early acceptance and role clarity; (ii) deepening interprofessional collaboration over time; (iii) communication strategies which facilitated relationship building with the PCN providers; and (iv) impact of the co-location model on teamwork and improved care coordination. CONCLUSION: The interprofessional collaboration between PCCPs, prescribers, and IPT members was strengthened through efforts of relationship building, improved role clarity, and easily accessible communication methods. The PCN teams addressed the initial integration challenges and provided the support for effective shared patient care.

OBJECTIVE: The Children's Depression Rating Scale-Revised (CDRS-R) is widely used in clinical research to assess depression in adolescents; however, limited research explores its measurement properties. This study aimed to test the interrater reliability of the CDRS-R and describe the corresponding measurement error. METHOD: A cross-sectional design was used in the context of a controlled clinical trial. The sample consisted of help-seeking adolescents (N = 55, ages 13-18 years, inclusive) experiencing depressive symptoms. A research analyst administered and coded the CDRS-R to adolescents through a virtual video-based platform with audio and video recordings. A second research analyst independently watched and coded recordings. The lower bound of the 95% CI of the intraclass correlation coefficient with respect to absolute agreement between 2 independent raters was hypothesized to be ≥0.70. RESULTS: The reliability of CDRS-R was calculated as an intraclass correlation coefficient of 0.84 (95% CI 0.71 to 0.91), indicating acceptable reliability. The associated standard error of measurement was 4.67, and the mean difference in scores between raters was 1.13. The limits of agreement were -11.59 to 13.84. CONCLUSION: The findings provide support for the CDRS-R as a tool with adequate interrater reliability to assess depressive symptoms in adolescents. The measurement error parameters can assist in clinical interpretation of differences in scores when adolescents are assessed by multiple raters. CLINICAL TRIAL REGISTRATION INFORMATION: Effectiveness of an Integrated Care Pathway for Depression: Cluster Randomized Controlled Trial (CARIBOU-2); https://clinicaltrials.gov/study/NCT05142683.; This study evaluated the reliability of the Childhood Depression Rating Scale-Revised (CDRS-R), a common interview tool used to assess depression among youth. Researchers found strong agreement among different raters, with a high statistical reliability score of 0.84. These results suggest that the CDRS-R is a consistently reliable assessment tool.; eng

INTRODUCTION: Medications for opioid use disorder (MOUD) are evidence-based treatments, yet can be controversial among some populations. This study provides a systematic review of prejudice and discrimination toward MOUD, a form of "intervention stigma," or stigma associated with a particular medical treatment. METHODS: A systematic search strategy was used in PsychInfo and PubMed to identify studies published between 1998 and 2018. Studies that empirically examined stigma toward MOUD were included if the manuscript was of moderate or high quality. Studies were analyzed using thematic synthesis. RESULTS: The search yielded 972 studies, of which 28 were included. Most studies utilized qualitative methods to examine intervention stigma toward methadone or buprenorphine, with one including naltrexone. Studies demonstrated that intervention stigma among healthcare providers was influenced by lack of training and abstinent treatment preferences. Providers equated MOUD with illicit substance use and at times refused to care for MOUD patients. Stigma among peer patients seeking treatment was also influenced by abstinent treatment preferences, and among the general public stigma was influenced by lack of MOUD knowledge. Intervention stigma was also driven at the policy level by high regulation of methadone, which fueled diversion and hindered social functioning among patients. Few studies indicated how to reduce intervention stigma toward MOUD. CONCLUSIONS: Intervention stigma affects both provision and perceptions of methadone and buprenorphine, decreasing access and utilization of MOUD. Future research should further develop and test MOUD stigma reduction interventions in a variety of social contexts to improve access to care and reduce patient barriers.