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The opioid epidemic remains a U.S. public health emergency and a complex social problem. Social workers and other behavioral health professionals with the expertise to provide prevention, treatment, and recovery services for opioid use disorders (OUD) remain urgently needed, particularly in Southern states with large rural populations, a high percentage of medically underserved communities, and a history of healthcare inequities. To help address this workforce gap, an innovative three-year HRSA-funded traineeship program was implemented to prepare social work and nursing graduate students to work interprofessionally to assess and treat opioid use disorders (OUD) emphasizing medically underserved communities in the Deep South.
Methods
The program was designed and implemented by an interdisciplinary university team with oversight from a community advisory board of OUD experts. The yearlong traineeship was identical for social work and nursing students and included specialized coursework on evidenced-based practice in addictions, interprofessional telemedicine and simulation training, and multi-semester field practica in substance use treatment settings. Baseline and post-training surveys assessed knowledge, attitudes, and skills related to OUD and interprofessional practice for the three student cohorts. Key program outcomes were analyzed using paired t-Tests and Wilcoxon Signed-Rank tests; analysis of sub-group differences used Wilcoxon Rank-sum and Chi-squared tests.
Results
The sample (n=54) was predominantly female (92.6%) and White (61.1%). Trainees ranged in age from 22.7 to 62.1 years (=32.4) and were enrolled in the MSW (55.6%), Psychiatric/Mental Health NP (38.9%), and DNP (5.6%) programs. At baseline, trainees reported relatively little previous OUD training from previous classes (29.6%), work/practicum (27.8%), or a continuing education training (14.8%). Rates of personal exposure to OUDs were higher, including or exposure through a friend (38.9%), family member (46.3%), social settings (27.8%), some other type of exposure (16.7%), or the student themselves (7.4%). Nursing students reported significantly more OUD training through work than did social work students (c2=4.15, p=.04), but there were no differences observed on personal OUD exposure. Results indicated significant increases from baseline to post-test on trainees’ knowledge (i.e., SUD [Z=-4.86, p<.001], interprofessional roles [Z=-4.77, p<.001]), attitudes (i.e., benefits of interprofessional approaches for client outcomes [Z=-4.04, p<.001] and SUD treatment [Z=-4.35, p<.001]), and perceived skills (i.e., OUD diagnosis [Z=-4.83, p<.001], OUD treatment [Z=-4.87, p<.001]; interprofessional collaboration to improve client engagement [Z=-4.69, p<.001] and assessment [Z=-4.76, p<.001]). Compared to nursing students, social work trainees reported a greater increased ability to use interprofessional collaboration to improve client engagement (t[52]=2.45,p=.02); there were no other sub-group differences observed.
Conclusions
Findings suggest that a year-long interprofessional training program can help to prepare both social work and nursing graduate students to collaboratively serve clients with OUD in medically underserved communities. While this study has limitations, including sample size and narrow geographic focus, it represents an important step toward identifying effective training mechanisms for social workers and nurses who can collaborate to improve OUD treatment and recovery. Application and testing of this promising training model at other institutions and in other settings may help to address critical behavioral health workforce gaps and combat the opioid crisis.