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Strategic Prevention Framework/ State Incentive Grant

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Strategic Prevention Framework/ State Incentive Grant

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  1. <?xml version="1.0"?><AllQuestions /> <?xml version="1.0"?><Settings><answerBulletFormat>Numeric</answerBulletFormat><answerNowAutoInsert>No</answerNowAutoInsert><answerNowStyle>Explosion</answerNowStyle><answerNowText>Answer Now</answerNowText><chartColors>Use PowerPoint Color Scheme</chartColors><chartType>Horizontal</chartType><correctAnswerIndicator>Checkmark</correctAnswerIndicator><countdownAutoInsert>No</countdownAutoInsert><countdownSeconds>10</countdownSeconds><countdownSound>TicToc.wav</countdownSound><countdownStyle>Box</countdownStyle><gridAutoInsert>No</gridAutoInsert><gridFillStyle>Answered</gridFillStyle><gridFillColor>0,0,0</gridFillColor><gridOpacity>100%</gridOpacity><gridTextStyle>Keypad #</gridTextStyle><inputSource>Response Devices</inputSource><multipleResponseDivisor># of Responses</multipleResponseDivisor><participantsLeaderBoard>5</participantsLeaderBoard><percentageDecimalPlaces>0</percentageDecimalPlaces><responseCounterAutoInsert>No</responseCounterAutoInsert><responseCounterStyle>Oval</responseCounterStyle><responseCounterDisplayValue># of Votes Received</responseCounterDisplayValue><insertObjectUsingColor>Blue</insertObjectUsingColor><showResults>Yes</showResults><teamColors>User Defined</teamColors><teamIdentificationType>None</teamIdentificationType><teamScoringType>Voting pads only</teamScoringType><teamScoringDecimalPlaces>1</teamScoringDecimalPlaces><teamIdentificationItem></teamIdentificationItem><teamsLeaderBoard>5</teamsLeaderBoard><teamName1></teamName1><teamName2></teamName2><teamName3></teamName3><teamName4></teamName4><teamName5></teamName5><teamName6></teamName6><teamName7></teamName7><teamName8></teamName8><teamName9></teamName9><teamName10></teamName10><showControlBar>Slides with Get Feedback Objects</showControlBar><defaultCorrectPointValue>100</defaultCorrectPointValue><defaultIncorrectPointValue>0</defaultIncorrectPointValue><chartColor1>187,224,227</chartColor1><chartColor2>51,51,153</chartColor2><chartColor3>0,153,153</chartColor3><chartColor4>153,204,0</chartColor4><chartColor5>128,128,128</chartColor5><chartColor6>0,0,0</chartColor6><chartColor7>0,102,204</chartColor7><chartColor8>204,204,255</chartColor8><chartColor9>255,0,0</chartColor9><chartColor10>255,255,0</chartColor10><teamColor1>187,224,227</teamColor1><teamColor2>51,51,153</teamColor2><teamColor3>0,153,153</teamColor3><teamColor4>153,204,0</teamColor4><teamColor5>128,128,128</teamColor5><teamColor6>0,0,0</teamColor6><teamColor7>0,102,204</teamColor7><teamColor8>204,204,255</teamColor8><teamColor9>255,0,0</teamColor9><teamColor10>255,255,0</teamColor10><displayAnswerImagesDuringVote>Yes</displayAnswerImagesDuringVote><displayAnswerImagesWithResponses>Yes</displayAnswerImagesWithResponses><displayAnswerTextDuringVote>Yes</displayAnswerTextDuringVote><displayAnswerTextWithResponses>Yes</displayAnswerTextWithResponses><questionSlideID></questionSlideID><controlBarState>Expanded</controlBarState><isGridColorKnownColor>True</isGridColorKnownColor><gridColorName>Yellow</gridColorName><AutoRec></AutoRec><AutoRecTimeIntrvl></AutoRecTimeIntrvl><chartVotesView>Percentage</chartVotesView><chartLabelsColor>0,0,0</chartLabelsColor><isChartLabelColorKnownColor>True</isChartLabelColorKnownColor><chartLabelColorName>Black</chartLabelColorName><chartXAxisLabelType>Full Text</chartXAxisLabelType></Settings> <?xml version="1.0"?><AllAnswers /> Strategic Prevention Framework/State Incentive Grant 2007Physician Survey: Findings and Recommendations Facilitated by Hurley Research Dept. Kristie R. Schmiege, MPH, CCS, CADC, CPC-M Director of Substance Abuse Services Genesee County Community Mental Health

  2. On-going Needs Assessment is important to our work as the Substance Abuse Coordinating Agency Two major study objectives: 1) Review existing data on consumption patterns and consequences of substance use problems; & 2) Collect new information to better define intervening variables, contributing factors, and readiness for change. BACKGROUND This data is used to maximize our efforts to reduce substance use and abuse in Genesee County

  3. BACKGROUND continued For collecting new information—the following key sectors in the community have been targeted: Government → Law Enforcement Education → Teaching Faculty Young Adults → College Students Medical → Physicians

  4. PHYSICIAN SURVEY • Conducted a review of published literature on physicians’ views of substance use/abuse and barriers to treatment • Identified key barriers to physician ‘aid’ • Developed a companion underage drinking survey • Subcommittee met and revised surveys

  5. PHYSICIAN SURVEY continued • Mailed survey in November 2007 with ‘strong’ cover letter signed by Dr. Allen Ebert, Addiction Specialist, plus a return incentive • Targeted all area physicians (survey mailed to 1115 area practitioners) • Sought those interested in Focus Group participation

  6. Demographics We received a total of 101 responses. Number of years in practice: 32.6% < 10 Years 29.5% 10 – 19 Years 25.3% 20 – 29 Years 12.6% > 30 Years Type of practitioner: • 57.9% MD • 25.3% DO • 4.2% PA • 2.1% NP • 1.1% PsyD • 9.4% Other

  7. 2007 Physician Survey Findings

  8. Training / Education • Most physicians do not feel: competent to treat alcohol- and drug-related disorders. 70.4% Agreed or Strongly Agreed • Or, that there is adequate curriculum time devoted to substance abuse disorders during residency training. 28.1% Neutral 56.3% Disagreed or Strongly Disagreed

  9. Professional Satisfaction • Professional satisfaction caring for patients with substance problems is lower than that for other illnesses. 72.2% Agreed or Strongly Agreed 14.4 % Neutral • Many physicians are skeptical about the probability of influencing or improving outcomes for this group of patients. 77.3% Agreed or Strongly Agreed 14.4% Neutral

  10. Appropriateness • Physicians generally approach addiction as a treatable medical illness. 38.7% Agreed or Strongly Agreed 23.6% Neutral 39.7% Disagreed or Strongly Disagreed • The diagnosis and treatment of alcohol- and drug-related disorders are generally considered peripheral to or outside medical matters. 41.9% Agreed or Strongly Agreed 10.2% Neutral 47.9% Disagreed or Strongly Disagreed

  11. Legal System • Information learned about patient illegal drug use by physicians should not be used for prosecution, so that drug users will be more likely to seek help. 68.4% Agreed or Strongly Agreed 17.3% Neutral • Involvement of the legal/justice system in dealing with alcohol and drug use serves to threaten the communication and trust with a patient. 58.2% Agreed or Strongly Agreed 19.4% Neutral 22.4% Disagreed

  12. Patient Population • It is important that physicians have an open, nonjudgmental attitude about patients who struggle with addiction. 89.8% Agreed or Strongly Agreed 10.2% Neutral • Patients who present with problems related to illegal drug use generally generate a significant workload. 83.7% Agreed or Strongly Agreed

  13. Community Resources • Many physicians experience a ‘learned feeling of helplessness’ in working with substance abuse patients because there are inadequate services available to meet their patient’s needs. 77.6% Agreed or Strongly Agreed 17.3% Neutral • A lack of insurance coverage prevents many patients from seeking treatment for addiction. 74.5% Agreed or Strongly Agreed 17.3% Neutral

  14. Screening / Recognition • Few physicians routinely screen and counsel patients about prevention of substance abuse and alcoholism. 58.2% Agreed or Strongly Agreed 21.4% Neutral 20.4% Disagree or Strongly Disagree • Lack of time prevents physicians from intervening in a patient’s substance abuse problems. 71.9% Agreed or Strongly Agreed 14.6% Neutral • I routinely ask patients about . . . . Use of tobacco: 98.9% Use of alcohol: 96.8% Use of other drugs: 90.5% If there is a family history of addiction: 34.7%

  15. Impact on System • Patients with substance use disorders are prevalent in most hospitals and emergency departments. 90.6% Agreed or Strongly Agreed • Alcohol, tobacco, and other drug abuse undermine the physical and psychological wellbeing of patients, contributing to many illnesses that result in admission to acute care settings. 98.9% Agreed or Strongly Agreed

  16. Useful Tools • What tools might help you in your practice with substance abuse prevention and treatment? Referral Information: 71.6% Brochures: 50.5% Kits: 32.6% Website: 29.5% Other: 6.3%

  17. BARRIERS: SUMMARY • TRAINING: Not adequately prepared; low feelings of competency to treat. • PROFESSIONAL SATISFACTION: Low satisfaction; high skepticism. • APPROPRIATENESS: Not approached as a treatable medical illness; seen as peripheral to medical management.

  18. BARRIERS SUMMARY continued • LEGAL SYSTEM: Separate ‘systems’ (patient data should not be used for prosecution); threatens trust of patients. • PATIENT POPULATION: Champions nonjudgmental approach, but view patients as generating significant workload. • COMMUNITY RESOURCES: Inadequate services; inadequate insurance coverage.

  19. BARRIERS SUMMARY continued • SCREENING/RECOGNITION: Low routine screening/counseling about prevention (lack of time plays a role); but they do ask about use of alcohol, tobacco and other drugs. • IMPACT ON SYSTEM: Patients prevalent in emergency rooms; use seen as contributor to many illnesses.

  20. UNDERAGE DRINKING SUMMARY • ATTITUDES: High recognition of problem; high interest to help. • KNOWLEDGE: Low confidence in recognition of red flags; low understanding of referral options.

  21. UNDERAGE DRINKING SUMMARY continued • CONTRIBUTING FACTORS: Lack of parental supervision and peer pressure rated highest. • INTERVENING: Create gathering places; educate teens about the dangers.

  22. UPDATED PHYSICIAN SURVEY Today’s survey includes: • Previous survey questions for trending and evaluation of our efforts • New questions regarding prescription drug misuse Please complete the survey • Survey is confidential • Results will help us prioritize problems, identify gaps & maximize efforts & resources

  23. Thank You • The updated, 2-sided surveys are light blue and on your tables • Please complete a survey and leave it on your table or at the registration desk, when you leave • Your assistance is greatly appreciated!  • Data available upon request

  24. UNDERAGE DRINKING

  25. Attitudes / Knowledge • There is a significant problem in this community with underage drinking and driving. 78.6% Agreed or Strongly Agreed 18.4% Neutral • There would be interest among area physicians to aid community efforts to reduce underage drinking and driving. 72.4% Agreed or Strongly Agreed 19.4% Neutral • I feel confident in my knowledge of ‘red flags’ that might signal a young patient is experiencing problems with alcohol or drugs. 57.1% Agreed or Strongly Agreed 26.5% Neutral • Do you know where to make referrals for young patients who are struggling with alcohol or drugs? 57.9% No

  26. Very Important Risk-taking/impulsive behavior (64%) Early exposure to alcohol (62%) Lack of parental supervision (79%) Peer pressure (73%) Important Personality characteristics (51%) Hereditary or genetic factors (53%) Low perceived risks (54%) Increased stress (54%) Negative influence of media (51%) Easy retail access (58%) Factors That Play A Role in Underage Drinking

  27. Very Likely Hangover (73%) Poor judgment (76%) Future drinking problems (64%) Likely Suicide (57%) Homicide (52%) Results of Underage Drinking

  28. Interventions as a Community • Educate young people about the dangers of underage drinking. (n=103) • Create friendly, alcohol-free places where teens can gather (n=109) • Create programs, including volunteer opportunities, where young people can grow and succeed. (n=86) • Stiffen penalties for those adults who provide alcohol to minors. (n=58) • Support programs that help teens already involved with drinking. (n=67) Numbers greater than 57 represent an area that the majority (>50%) of respondents identified as an optimal strategy to reduce underage drinking.

  29. Useful Tools • What tools might help you in your practice with substance abuse prevention and treatment? Website 32.3% Kits 35.5% Brochures 52.7% Referral Information 69.9% Other 3.3%

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