Recent Submissions

  • Promoting a Coordinated Multi-Site Evaluation for Community-Based Opioid Prevention Programs

    Hanson, Bridget; Barnett, Jodi (Center for Behavioral Health Research and Services, 2019)
    The effectiveness of substance use prevention efforts is often difficult to measure over short grant cycles, especially for emerging issues such as prescription opioid misuse where data is less available and evidence-based strategies are not well understood. Coordinating state and community level evaluation efforts adds further complexity. Since 2016, six communities in Alaska, through a single federal funding stream, have worked to prevent opioid misuse among youth and young adults using policy, system, and environmental strategies. The project is focused on three key intervening variables to reduce prescription opioid misuse.The Alaska Partnerships for Success Project is funded by the Substance Abuse and Mental Health Services Administration, Center for Mental Health Services (Grant #SP020783) through the State of Alaska, Division of Behavioral Health.
  • Prevention of Fetal Alcohol Spectrum Disorders: Practice Behaviors, Attitudes, and Confidence among Members of the American College of Nurse-Midwives 2017

    Hanson, Bridget; Neander, Lucia; Porter, Rebecca (Center for Behavioral Health Research and Services, 2017)
    As part of an ACNM collaboration with the Centers for Disease Control and Prevention (CDC) and its partners and grantees on a project to prevent fetal alcohol spectrum disorders (FASDs), ACNM members were surveyed to generate an assessment of practice behaviors of certified nurse-midwives and certified midwives related to the prevention of FASDs. The information will be used as a baseline from which to measure change in nurse-midwives’ and midwives’ practice behaviors over the course of the project. Results from the assessment will also be used to inform detailed collaborative activities between ACNM and CDC grantees whose efforts specifically target nurse-midwives (i.e., University of Alaska Anchorage (UAA), University of California San Diego, University of Pittsburgh).
  • Policy Evaluation During the Opioid Epidemic

    Hanson, Bridget; Barnett, Jodi (Center for Behavioral Health Research and Services, 2019)
    This presentation provides an overview of research in Alaska's policy responses to rises in opioid use between 2016 and 2018. It outlines outcomes from qualitative analysis of interviews.
  • 'Please tell us about a time you administered naloxone': Maximizing data collection opportunities with challenging informants

    Porter, Rebecca; Hanson, Bridget (Center for Behavioral Health Research and Services, 2019)
    This presentation provides a brief overview of results from qualitative study of Naloxone distribution and opioid overdose prevention education program in Alaska, and was presented at a meeting of the American Evaluation Association held in Minneapolis, MN, November 2019.
  • SBIRT Utilization and Billing among Prenatal Providers in Hawaii

    Tanner, Stacy; Porter, Rebecca; Hanson, Bridget (Center for Behavioral Health Research and Services, 2018)
    This report presents findings from key informant interviews that were conducted to understand Hawaii prenatal providers’ use of screening, brief intervention, and referral to treatment (SBIRT) in everyday practice. Five prenatal providers who practice in Hawaii participated in the interviews. Although participants acknowledged the importance of utilizing SBIRT in prenatal care, SBIRT appeared to be underutilized. Most did not have standard SBIRT procedures incorporated within their practice. Participants’ primary concerns regarding routine use of SBIRT included time constraints, lack of technology within the electronic health record, and stigma. Recommendations from prenatal providers regarding SBIRT decision-making, billing process improvements, and provider incentives to enhance reimbursement practices are discussed.
  • Prevention of Fetal Alcohol Spectrum Disorders: Practice Behaviors, Attitudes, and Confidence among Members of the American College of Nurse-Midwives 2018

    Porter, Rebecca; Hanson, Bridget; Mertz, Robyn (Center for Behavioral Health Research and Services, 2018)
    As part of an ACNM collaboration with the Centers for Disease Control and Prevention (CDC) and its partners and grantees on a project to prevent fetal alcohol spectrum disorders (FASDs), ACNM members were surveyed to assess the practice behaviors of certified nurse midwives and certified midwives related to the prevention of FASDs. Two surveys were conducted; the first served as a baseline from which to measure change in nurse-midwives’ and midwives’ practice behaviors over the course of the project. Results from the baseline assessment were also used to inform detailed collaborative activities between ACNM and CDC grantees whose efforts specifically target nurse-midwives (i.e., University of Alaska Anchorage (UAA); University of California, San Diego; University of Pittsburgh). The second survey was conducted 15 months after the baseline as a follow-up and findings were compared to the baseline.
  • Medicaid Policies for Alcohol SBI Reimbursement

    Smith, Oliver; Hanson, Bridget; Porter, Rebecca (Center for Behavioral Health Research and Services, 2017)
    The purpose of this report was to review existing reimbursement policies by state Medicaid agency, including the District of Columbia (D.C.), in order to understand similarities and differences associated with financial compensation for alcohol screening and brief intervention (SBI) services. Alcohol SBI is an evidence-based practice known to help reduce atrisk alcohol consumption among patients who drink too much. 1 Although alcohol SBI was designed to be a population-based approach to address unhealthy alcohol consumption, its current utilization is limited. 2 Implementation of the practice into routine clinical care remains a challenge at the health system level even with support from federal resources (e.g., SBIRT: Screening, Brief Intervention, and Referral to Treatment). One way to encourage the uptake of alcohol SBI/SBIRT among providers is to ensure that the service is reimbursable by third-party payers. However, reimbursement opportunities vary by state and payer, and in some locations are non-existent. Information about the current status of policies will assist in the development of policies and incentives to encourage healthcare providers and systems to submit claims for alcohol SBI/SBIRT and potentially increase the routine uptake of the service in clinical care.
  • Implementing SBIRT in Primary Care: A Study of Three Mat-Su Borough Health Care Practices

    Passini, Jessica; Elkins, Amanda; King, Diane; Frazier, Rosyland (Center for Behavioral Health Research and Services, 2018)
    Despite decades of research evidence that SBIRT is effective for addressing unhealthy patterns of drinking and reducing binge drinking, its adoption within healthcare practices continues to be slow. Providers have identified numerous reasons for not routinely screening and intervening on alcohol, including limited time, training, and resources for patients requiring treatment; lack of confidence in their ability to help patients reduce their drinking; inadequate reimbursement for SBIRT services, and worry about stigmatizing patients.
  • Experiences of Opioid Use Initiation and Progression among Alaskans who Use Heroin

    Barnett, Jodi; Hanson, Bridget (Center for Behavioral Health Research and Services, 2018)
    The opioid epidemic has continued in Alaska and nationwide. Information about the types of opioids that are misused first, the age of first use, and the circumstances and mode of initial and progressive use of opioids can help to inform effective prevention and early intervention efforts. These topics were explored during interviews with adults in Alaska who use heroin for the Partnerships for Success project. Results indicate that most participants were exposed to opioids through a legitimate prescription in their teens to early twenties for a severe injury or multiple surgeries before developing an addiction. Some obtained prescription opioids for misuse initially from social sources such as a friend, at a party, or stealing them from a neighbor. Only two participants began their use of opioids with heroin. All participants eventually went on to use heroin which became cheaper, more effective, and easier to obtain than prescription opioids. Few participants indicated that social influences, rather than price or availability, were a factor in their transition to heroin. Recommendations and an overview of recent state prevention initiatives and policy efforts related to the findings are presented.
  • 2017-2018 Infographics for the evaluation of Project HOPE

    Druffel, Ryan; Porter, Rebecca; Hanson, Bridget (Center for Behavioral Health Research and Services, 2019)
    Opioid Response Programs (ORPs) across Alaska partner with DHHS, Office of Substance Misuse and Addiction Prevention (OSMAP) to distribute opioid overdose rescue kits to members of the general public and to professionals (e.g., first responders, agency/organization staff, etc.). This work consists of two infographics, and is supported by the Substance Abuse and Mental Health Services Administration (SAMHSA) grant 1H79SP022117.
  • Opioids and Young Adults in Alaska: Access, Consumption, Consequences, and Perceptions

    Richie, Andrew; Hanson, Bridget; Davis, Kathryn E. (2020-12-21)
    Over the past 5 years, numerous state and local activities have targeted opioid prevention among Alaskans, particularly youth and young adults. While surveillance data exists for youth, no specific data exists for opioid behaviors and perceptions among Alaskan young adults. Researchers at the University of Alaska Anchorage Center for Behavioral Health Research and Services conducted surveys in 2016 and 2019 to gather information on awareness, opioid and heroin use, social and retail access, and risk perceptions. At each timepoint, Alaskans age 18-27 were randomly selected and invited to participate. Response rates for the surveys were 10.4% and 12.8%, respectively. Survey data were weighted for gender and borough in order to represent Alaska’s population of young adults. Changes from 2016 to 2019: Increase in seeing awareness messages about opioids Increase in rating prescription opioid misuse and heroin use as problems in community. Increase in perceived risk from misusing opioids or using heroin. Among those who had been prescribed opioids in the past three years: Decrease in reported conversations with doctor of pharmacist when receiving prescription The percentage who had leftover pills remained high. Of those, increase in bringing leftover pills to pharmacy or other permanent disposal site. Survey findings indicate success at disseminating opioid prevention messages in the community and promoting disposal of leftover opioids. Additionally, increasing perceived risk among young adults in Alaska may predict future reductions in opioid and heroin use behaviors. Findings indicate opportunities for broader media messaging and communication with healthcare providers.
  • Minimal Intervention Needed for Change: Definition, Use, and Value for Improving Health and Health Research

    King, Diane (PubMed, 2014-03-01)
    Much research focuses on producing maximal intervention effects. This has generally not resulted in interventions being rapidly or widely adopted or seen as feasible given resources, time, and expertise constraints in the majority of real-world settings. We present a definition and key characteristics of a minimum intervention needed to produce change (MINC). To illustrate use of a MINC condition, we describe a computer-assisted, interactive minimal intervention, titled Healthy Habits, used in three different controlled studies and its effects. This minimal intervention produced modest to sizable health behavior and psychosocial improvements, depending on the intensity of personal contacts, producing larger effects at longer-term assessments. MINC comparison conditions could help to advance both health care and health research, especially comparative effectiveness research. Policy and funding implications of requiring an intervention to be demonstrated more effective than a simpler, less costly MINC alternative are discussed
  • Culturally-Relevant Online Education Improves Health Workers' Capacity and Intent to Address Cancer

    Cueva, Katie; Dignan, Mark; Revels, Laura; Cueva, Melanie (Springer, 2018-01-24)
  • Baseline Opioid Survey: Access, Consumption, Consequences, and Perceptions among Young Adults in Alaska

    Barnett, Jodi (Center for Behavioral Health Research & Services, University of Alaska Anchorage, 2017-05-01)
  • Baseline Assessment: Alaska's Capacity and Infrastructure for Prescription Opioid Misuse Prevention

    Elkins, Amanda (Center for Behavioral Health Research & Services, University of Alaska Anchorage, 2017-08-01)
  • What patients want: Relevant health information technology for diabetes self-management.

    King, Diane (Springer, 2015-03-05)
    Health information technology has great potential to promote efficiency in patient care and increase patient-provider communication, and patient engagement in their treatment. This paper explored qualitatively what patients with type 2 diabetes want from electronic resources that are designed to support their diabetes self-management. Data were collected via interviews and focus groups from managed care patients who had completed participation in either a web-based (MyPath) or in-person group-based (¡Viva Bien!) longitudinal diabetes self-management study. Content analysis identified common themes that highlighted participant interest in virtual and electronic programs to support diabetes self-management goals, and their desired content and features. Eighteen ¡Viva Bien! participants completed telephone interviews and 30 MyPath participants attended seven focus groups in 2010-2011. All participants expressed a preference for face-to-face contact; however, most participants were also interested in using technology as a tool to support daily diabetes self-management decisions and to receive tailored information. Choice of technology, personalized instruction on how to use program features, and the ability to exchange information with their healthcare team were desired by all participants. Participants were divided on whether virtual social support networks should be closed to friends and family, should include other program members (peers), or should be open to anyone with diabetes. Participants aged 65 and older stressed the desire for technical support. What patients wanted from technology is real-time assistance with daily behavioral decision-making, ability to share information with their healthcare team, connections with others for support, and choice.
  • Statute and implementation: How phantom policies affect tenure value and support

    Defeo, Dayna; Hirshberg, Diane; Berman, Matthew (Center for Alaska Education Policy Research, University of Alaska Anchorage, 5/10/2018)
    Using survey responses from public school teachers and principals in Alaska, this article describes their understanding of tenure statute, and how that understanding affected support, perceived effectiveness, and valuation of tenure. Teachers and principals who inflated tenure protections were more likely to support it; the more teachers inflated tenure protections, the higher dollar value they placed on it. The article discusses the fiscal and policy implications of tenure inflation, noting that this garners the most criticism from education reformers, but concomitantly constitutes cost savings for taxpayers.
  • The Feasibility of Adopting an Evidence-Informed Tailored Exercise Program within Adult Day Services: The Enhance Mobility Program.

    King, Diane; Faulkner, S.A.; Hanson, Bridget (Taylor & Francis Group, 11/29/2017)
    This article uses the RE-AIM framework to evaluate the feasibility of implementing Enhance Mobility (EM), a tailored, evidence-informed group exercise and walking program for older adults with dementia, into an adult day services center. Participant physical performance outcomes were measured at baseline and 8 months. Program staff were interviewed to understand implementation challenges. Participant outcomes did not change significantly, though gait speed improved from limited to community ambulation levels. Implementation challenges included space reallocation and adequate staffing. Adopting EM in adult day services is feasible, and has potential to reach older adults who could benefit from tailored exercise.
  • An environmental scan of the role of nurses in preventing fetal alcohol spectrum disorders.

    King, Diane; Hanson, Bridget; Porter, Rebecca; Edwards, Alexandra (PubMed, 1/25/2018)
    Nurses are in an ideal position to talk to their patients of reproductive age about alcohol use and encourage the prevention of alcohol-exposed pregnancies. Effective conversations can be efficiently included in the clinical encounter to identify alcohol misuse and offer appropriate follow-up. This report presents results of an environmental scan of resources relevant to nursing professionals and nurses' role in addressing alcohol misuse. Gaps in nursing education and practice guidelines with regard to defining the nursing role in preventing alcohol-exposed pregnancies were revealed. Findings identified a need to promote adoption among nurses of evidence-based preventive practices to prevent alcohol misuse.
  • Examining the sustainability potential of a multisite pilot to integrate alcohol screening and brief intervention within three primary care systems.

    King, Diane; Hanson, Bridget (Oxford Academic, 1/23/2018)
    The U.S. Preventive Services Task Force recommends that clinicians adopt universal alcohol screening and brief intervention as a routine preventive service for adults, and efforts are underway to support its widespread dissemination. The likelihood that healthcare systems will sustain this change, once implemented, is under-reported in the literature. This article identifies factors that were important to post implementation sustainability of an evidence-based practice change to address alcohol misuse that was piloted within three diverse primary care organizations. The Centers for Disease Control and Prevention funded three academic teams to pilot and evaluate implementation of alcohol screening and brief intervention within multi clinic healthcare systems in their respective regions. Following the completion of the pilots, teams used the Program Sustainability Assessment Tool to retrospectively describe and compare differences across eight sustainability domains, identify strengths and potential threats to sustainability, and make recommendations for improvement. Health systems varied across all domains, with greatest differences noted for Program Evaluation, Strategic Planning, and Funding Stability. Lack of funding to sustain practice change, or data monitoring to promote fit and fidelity, was an indication of diminished Organizational Capacity in systems that discontinued the service after the pilot. Early assessment of sustainability factors may identify potential threats that could be addressed prior to, or during implementation to enhance Organizational Capacity. Although this study provides a retrospective assessment conducted by external academic teams, it identifies factors that may be relevant for translating evidence-based behavioral interventions in a way that assures that they are sustained within healthcare systems.

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