all ohio siccs presentation 2017 pdf -...
TRANSCRIPT
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PREPARING STUDENTS TO PROVIDE BEHAVIORAL HEALTH SERVICES IN A PRIMARY CARE SETTING:
THE STUDENT INTEGRATED CARE COMPETENCY SCALE
2017 All Ohio Institute on Community Psychiatry March 25, 2017
Tamara S. Davis, PhD, MSSWAssociate Dean for Academic AffairsProgram Principal Investigator
College of Social Work
Rebecca Reno, PhD, MSW, MAPostdoctoral Researcher,OSU College of Public Health
Additional Co-authors:
Joe Guada, PhD, MSWAssociate Professor
Adriane Peck, MSW, LISW-SMEDTAPP Integrated Care Program Manager
Lauren Haas-Gehres, MA, MSWMEDTAPP Data Analyst
Staci Swenson, MA, MSW, LISW-SIntegrated Care ManagerPrimaryOne Health
Shannon Evans, LPCC-SMEDTAPP Clinical Supervisor
Stacey Saunders-Adams, PhD, MSSA, LISW-SMEDTAPP Senior Research Associate
This program is partially funded by the MEDTAPP Healthcare Access (HCA) Initiative and utilizes federal financial participation funds through the Ohio Department of Medicaid. Views stated in this presentation are those of the researchers only and are not attributed to the study sponsors, the Ohio Department of Medicaid or to the Federal Medicaid Program. MEDTAPP HCA Initiative funding supports teaching and training to improve the delivery of Medicaid services and does not support the delivery of Medicaid eligible services.
Thisworkforcedevelopmentinitiativeisacollaborationamong:
OSUCollegeofSocialWork
PrimaryOne Health
(andoriginatingpartnerMentalHealthAmericaofFranklinCounty)
Acknowledgements
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Introduction to the Integrated and Culturally Relevant Care (ICRC)
Field Education Program
and the
Student Integrated Care Competency Scale (SICCS) &
Student Integrated Care Competency Scale-Supervisor
(SICCS-S)
APPROACH TO INTEGRATED CARE
Peek,C.J.(2013,p.13).Integratedbehavioralhealthandprimarycare:Acommonlanguage.InM.R.TalenandA.BurkeValeras(eds.)IntegratedBehavioralHealthinPrimaryCare.NewYork:Springer.
INTEGRATED PRIMARY CARE OR PRIMARY CARE BEHAVIORAL HEALTH
“Combines medical & BH services for problems patients bring to primary care, including stress-linked physical symptoms, health behaviors, MH or SA disorders. For any problem, they have come to the right place –“no wrong door” … BH professional used as a consultant to PC colleagues” (emphasis added)
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ICRC CURRICULUM COMPONENTS
Specializededucationandareasofcompetency
IntegratedCare
Healthcarebasics
Technology
Screening,assessment&diagnosing
Carecoordination&communication
Culturallyresponsivecare
Evidence-informedapproaches
Documentation
(Davis,T.S.,Guada,J.,Reno,R.,Peck,A.,Evans,S.,MoskowSigal,L.,&Swenson,S.,2015)
• Demand outpacing workforce prepared for integrated behavioral health services àNeed for quality training programs (McCabe & Sullivan, 2015; Rishel, 2015)
• Social workers in integrated health settings do not feel prepared (Horevitz & Manoleas, 2013)
• Social work positioned to lead interdisciplinary training (Taylor, Coffey, & Kashner, 2015)
• CSWE 2015 EPAS (CSWE, 2015)• Curriculum expands generalist competencies• Curriculum includes advanced clinical competencies
• Aligns with SAMHSA and HRSA integrated care competencies for behavioral health clinicians (Hoge, Morris, Laraia, Pomerantz, & Farley, 2014; Stanhope, Videka, Thorning, & McKay, 2015)
ICRC CURRICULUM CURRENCY
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SICCS DESIGN
IntegratedCare
(4Questions)
Healthcarebasics
(4questions)Technology(3questions)
Specializededucationandareasofcompetency
Screening,assessment&diagnosing(4questions)
Carecoordination&communication(4questions)
Culturallyresponsivecare(4questions)
Evidence-informedapproaches
(10questions)
Documentation(4questions)
Pretest Mid-placement Student Final
Self-Evaluation
Supervisor
Evaluation
B E G I NNI NG O F S T U D E NT ’ S E ND O F S T U D E NT ’ S
TIMING OF SICCS & SICCS-S ADMINISTRATION
F I E L D T R A I N I NG F I E L D T R A I N I NG
Orientation
Trainings
Individual & Group Supervision
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SICCS & SICCS-S DEVELOPMENT• CBPR development process for curriculum &
scale development– Incorporated feedback from supervisors,
students, practitioners and community health partners
• Iterative Process– Scale reflects curricular content
– Curriculum & scale shifted to incorporate various populations and evidence-based practices
– Input gathered from focus groups with students and formal and informal engagement with others
Mental Health America of Franklin County(Originating Partner)
SICCS• Administered through Qualtrics
• 37 Item Scale
• Student self-report
• All items scaled 0 to 50 = No opportunity to demonstrate competence
5 = Demonstrates advanced skills
• 185 is the highest possible score
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SICCS-S• Administered through Qualtrics
• 37 Item Scale
• Items scored by Supervisors– Independently (first wave) and Collaboratively (second wave)
• All items scaled 0 to 5 with guiding level of supervision required– Level 0: No opportunity to demonstrate competence
– Level 1: Needs constant supervision/modeling/feedback
– Level 5: Needs minimal supervision/feedback
• 185 is the highest possible score
Competency Scale
Student Evaluation
Program Evaluation
ICRC Evaluation Model: Student Integrated Care Competency Scale (SICCS)
Development,administration,refinementcycle
Administered3xduringthestudent’splacement
Preliminaryfindings
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METHODS
DESIGN & ANALYSIS•Design:
– SICCS: Interrupted Time-Series Design (Pretest, Midterm, Posttest)
– SICCS-S: Posttest only
• Analyses:– Friedman’s Test
– Wilcoxon Sign Rank Test– Student SICCS
– Supervisor (SICCS-S)/Student Post-test (SICCS)
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SAMPLE• Convenience Sample
– 23 MSW ASAP or MSW II students completing the ICRC Training & Field Placement (data include only two-semester placement students)
• Demographics– 3 Male, 20 Female
• Two waves: – 2014-2015 and 2015-2016
2013-2014 Student Team
RESULTS
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STUDENT SICCS TREND
N=23
ü First Administration: First week of Fall Semester
ü Mid-Program: First week of Spring Semester
ü Program Completion: End of Spring Semester1.96
3.70
4.41
0.00
0.50
1.00
1.50
2.00
2.50
3.00
3.50
4.00
4.50
5.00
First Administration Mid-Program Program Completion
Mea
n of
Sco
res
p=.000
STUDENT PERFORMANCE ON SICCS
FRIEDMAN’S TEST
Test Statistics
N 23
Chi-Square 46.000
Df 2
Asymp Sig. .000
Significant difference between Median scores at each SICCS Administration
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WILCOXON SIGN RANK TESTProgram Start
to Mid-Program
Mid-Program to Program
Completion
Program Start to Program
Completion
Z -4.198 -4.198 -4.198
Asymp. Sig. (2-tailed) .000 .000 .000
r -.62 -.62 -.62
A significant (positive) difference between each testing point with a large effect.
WILCOXON SIGN RANK TESTProgram
Completion vs.Supervisor
Score
Z -2.572
Asymp. Sig. (2-tailed) .010
r .38
A significant difference between student ratings and supervisor ratings. In general, students rated themselves higher than their supervisors on the SICCS; 78% of the time, the supervisor rating was lower than the students’ rating.
Mean Median
StudentRating 4.4065 4.378
Supervisor Rating 4.1152 4.054
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SICCS & SICCS-S: RELIABILITY
Chronbach’s alpha:– SICCS (student scale) α=.910
– SICCS-S (supervisor scale) α=.938
CONCLUSIONS &NEXT STEPS
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CONCLUSIONS:• SICCS demonstrates strong reliability across two student
cohorts
• SICCS demonstrates sensitivity to change in three-month administrations
• SICCS demonstrates student gains in competencies over time in the expected direction
• SICCS-S demonstrates strong reliability and utility in triangulating student self-reports of competencies gained
NEXT STEPS:Continue testing SICCS psychometric properties with each cohort of students (currently in year three of instrument implementation)
Additional validity testing with students not receiving ICRC curriculum and field program
Develop online CEU program for licensed behavioral health professionals based on ICRC curriculum
Develop parallel instrument for licensed behavioral health professionals re-tooling to work in integrated healthcare settings
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REFERENCES:CouncilonSocialWorkEducation(2015).EducationalPolicyandAccreditationStandards,forBaccalaureateandMaster’sSocialWork
Programs.Retrievedfrom:http://www.cswe.org/File.aspx?id=81660
Davis,T.S.,Guada,J.,Reno,R.,Peck,A.,Evans,S.,Moskow Sigal,L.,&Swenson,S.(2015online).Integratedandculturallyrelevantcare:Amodeltopreparesocialworkersforprimarycarebehavioralhealthpractice,SocialWorkinHealthCare,54(10),909-938.
Hoge,M.A.,Morris,J.A.,Laraia,M.,Pomerantz,A.,&Farley,T.(2014).CoreCompetenciesforIntegratedBehavioralHealthandPrimaryCare.Washington,DC:SAMHSA-HRSACenterforIntegratedHealthSolutions.Available:http://www.integration.samhsa.gov/workforce/Integration_Competencies_Final.pdf
Horevitz,E.,&Manoleas,P.(2013).Professionalcompetenciesandtrainingneedsofprofessionalsocialworkersinintegratedbehavioralhealthinprimarycare.SocialWorkinHealthCare,52(8),752–787.
McCabe,H.A.,&Sullivan,W.P.(2015).Socialworkexpertise:Anoverlookedopportunityforcutting-edgesystemdesignunderthePatientProtectionandAffordableCareAct.Health&SocialWork,40(3),155-157.
Rishel,C.(2015).Establishingaprevention-focusedintegrativeapproachtosocialworkpractice.FamiliesinSociety:TheJournalofContemporarySocialServces:96(2),125-132.
Stanhope,V.,Videka,L.,Thorning,H.,&McKay,M.(2015).Movingtowardintegratedhealth:Anopportunityforsocialwork.SocialWorkinHealthCare,(54),383-407.
Taylor,L.D.,Coffey,D.S.,&Kashner,T.M.(2015).Interprofessional educationofhealthprofessionals:Socialworkersshouldleadtheway.HealthSocialWork,41(1),5-8.
Forfurtherinformation…
Tamara S. Davis, Ph.D., MSSWAssociate Dean for Academic AffairsPrincipal Investigator, PCBH Workforce Development InitiativeCollege of Social WorkThe Ohio State [email protected]