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Evaluation of a Level I trauma center provider training in patient-centered alcohol brief interventions using the Behavior Change Counseling Index rated by standardized patients

BACKGROUND: Traumatic injury requiring hospitalization is common in the USA and frequently related to alcohol consumption. The American College of Surgeons requires that Level I and II verified trauma centers implement universal alcohol screening and brief intervention for injured patients. We exami...

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Autores principales: Darnell, Doyanne, Parker, Lea, Engstrom, Allison, Fisher, Dylan, Diteman, Kaylie, Dunn, Christopher
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6937416/
https://www.ncbi.nlm.nih.gov/pubmed/31922018
http://dx.doi.org/10.1136/tsaco-2019-000370
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author Darnell, Doyanne
Parker, Lea
Engstrom, Allison
Fisher, Dylan
Diteman, Kaylie
Dunn, Christopher
author_facet Darnell, Doyanne
Parker, Lea
Engstrom, Allison
Fisher, Dylan
Diteman, Kaylie
Dunn, Christopher
author_sort Darnell, Doyanne
collection PubMed
description BACKGROUND: Traumatic injury requiring hospitalization is common in the USA and frequently related to alcohol consumption. The American College of Surgeons requires that Level I and II verified trauma centers implement universal alcohol screening and brief intervention for injured patients. We examined whether Level I trauma center provider skill in patient-centered alcohol brief interventions improved after training and whether professional role (eg, nursing, social work) and education were associated with these skills. METHODS: We present evaluation data collected as part of training in alcohol brief interventions embedded within a larger clinical trial of a collaborative care intervention targeting posttraumatic stress disorder and related comorbidities. Sixty-five providers from 25 US Level I trauma centers engaged in a 1-day workshop, with 2 hours dedicated to training in patient-centered alcohol brief interventions followed by 6 months of weekly coaching in a collaborative care model. Providers completed standardized patient role-plays prior to and 6 months after the workshop training. The standardized patient actors rated provider quality of alcohol brief interventions immediately after each role-play using the Behavior Change Counseling Index (BECCI), a pragmatic measure designed to assess the quality of behavior change counseling, an adaptation of motivational interviewing suitable for brief healthcare consultations about behavior change. RESULTS: Seventy-two percent of providers completed both standardized patient role-play assessments. A statistically significant improvement in overall BECCI scores (t(41)=−2.53, p=0.02, Cohen’s d=−0.39) was observed among those providers with available pre–post data. Provider professional role was associated with BECCI scores at pre-training (F(3, 58)=11.25, p<0.01) and post-training (F(3, 41)=8.10, p<0.01). DISCUSSION: Findings underscore the need for training in patient-centered alcohol brief interventions and suggest that even a modest training helps providers engage in a more patient-centered way during a role-play assessment. LEVEL OF EVIDENCE: Level V, therapeutic/care management.
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spelling pubmed-69374162020-01-09 Evaluation of a Level I trauma center provider training in patient-centered alcohol brief interventions using the Behavior Change Counseling Index rated by standardized patients Darnell, Doyanne Parker, Lea Engstrom, Allison Fisher, Dylan Diteman, Kaylie Dunn, Christopher Trauma Surg Acute Care Open Original Research BACKGROUND: Traumatic injury requiring hospitalization is common in the USA and frequently related to alcohol consumption. The American College of Surgeons requires that Level I and II verified trauma centers implement universal alcohol screening and brief intervention for injured patients. We examined whether Level I trauma center provider skill in patient-centered alcohol brief interventions improved after training and whether professional role (eg, nursing, social work) and education were associated with these skills. METHODS: We present evaluation data collected as part of training in alcohol brief interventions embedded within a larger clinical trial of a collaborative care intervention targeting posttraumatic stress disorder and related comorbidities. Sixty-five providers from 25 US Level I trauma centers engaged in a 1-day workshop, with 2 hours dedicated to training in patient-centered alcohol brief interventions followed by 6 months of weekly coaching in a collaborative care model. Providers completed standardized patient role-plays prior to and 6 months after the workshop training. The standardized patient actors rated provider quality of alcohol brief interventions immediately after each role-play using the Behavior Change Counseling Index (BECCI), a pragmatic measure designed to assess the quality of behavior change counseling, an adaptation of motivational interviewing suitable for brief healthcare consultations about behavior change. RESULTS: Seventy-two percent of providers completed both standardized patient role-play assessments. A statistically significant improvement in overall BECCI scores (t(41)=−2.53, p=0.02, Cohen’s d=−0.39) was observed among those providers with available pre–post data. Provider professional role was associated with BECCI scores at pre-training (F(3, 58)=11.25, p<0.01) and post-training (F(3, 41)=8.10, p<0.01). DISCUSSION: Findings underscore the need for training in patient-centered alcohol brief interventions and suggest that even a modest training helps providers engage in a more patient-centered way during a role-play assessment. LEVEL OF EVIDENCE: Level V, therapeutic/care management. BMJ Publishing Group 2019-12-29 /pmc/articles/PMC6937416/ /pubmed/31922018 http://dx.doi.org/10.1136/tsaco-2019-000370 Text en © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.
spellingShingle Original Research
Darnell, Doyanne
Parker, Lea
Engstrom, Allison
Fisher, Dylan
Diteman, Kaylie
Dunn, Christopher
Evaluation of a Level I trauma center provider training in patient-centered alcohol brief interventions using the Behavior Change Counseling Index rated by standardized patients
title Evaluation of a Level I trauma center provider training in patient-centered alcohol brief interventions using the Behavior Change Counseling Index rated by standardized patients
title_full Evaluation of a Level I trauma center provider training in patient-centered alcohol brief interventions using the Behavior Change Counseling Index rated by standardized patients
title_fullStr Evaluation of a Level I trauma center provider training in patient-centered alcohol brief interventions using the Behavior Change Counseling Index rated by standardized patients
title_full_unstemmed Evaluation of a Level I trauma center provider training in patient-centered alcohol brief interventions using the Behavior Change Counseling Index rated by standardized patients
title_short Evaluation of a Level I trauma center provider training in patient-centered alcohol brief interventions using the Behavior Change Counseling Index rated by standardized patients
title_sort evaluation of a level i trauma center provider training in patient-centered alcohol brief interventions using the behavior change counseling index rated by standardized patients
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6937416/
https://www.ncbi.nlm.nih.gov/pubmed/31922018
http://dx.doi.org/10.1136/tsaco-2019-000370
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