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Sprague Martinez L, Araujo Brinkerhoff C, Howard RC, Feldman JA, Kobetz E, White JT, Tumiel Berhalter L, Bilheimer A, Hoffman M, Isasi CR, Killough C, Martinez J, Chesley J, Baig AA, Foy C, Islam N, Petruse A, Rosales C, Kipke MD, Baezconde-Garbanati L, Battaglia TA, Lobb R. Strategies to promote language inclusion at 17 CTSA hubs. J Clin Transl Sci 2024; 8:e67. [PMID: 38690228 PMCID: PMC11058578 DOI: 10.1017/cts.2024.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 12/30/2023] [Accepted: 01/12/2024] [Indexed: 05/02/2024] Open
Abstract
The prioritization of English language in clinical research is a barrier to translational science. We explored promising practices to advance the inclusion of people who speak languages other than English in research conducted within and supported by NIH Clinical Translational Science Award (CTSA) hubs. Key informant interviews were conducted with representatives (n = 24) from CTSA hubs (n = 17). Purposive sampling was used to identify CTSA hubs focused on language inclusion. Hubs electing to participate were interviewed via Zoom. Thematic analysis was performed to analyze interview transcripts. We report on strategies employed by hubs to advance linguistic inclusion and influence institutional change that were identified. Strategies ranged from translations, development of culturally relevant materials and consultations to policies and procedural changes and workforce initiatives. An existing framework was adapted to conceptualize hub strategies. Language justice is paramount to bringing more effective treatments to all people more quickly. Inclusion will require institutional transformation and CTSA hubs are well positioned to catalyze change.
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Affiliation(s)
- Linda Sprague Martinez
- Boston University School of Social Work, Boston, MA, USA
- Boston University Clinical and Translational Science Institute, Boston, MA, USA
| | - Cristina Araujo Brinkerhoff
- Boston University School of Social Work, Boston, MA, USA
- Boston University Clinical and Translational Science Institute, Boston, MA, USA
| | - Riana C. Howard
- Boston University School of Social Work, Boston, MA, USA
- Boston University Clinical and Translational Science Institute, Boston, MA, USA
| | - James A. Feldman
- Boston University Clinical and Translational Science Institute, Boston, MA, USA
- Boston Medical Center Health System, Boston, MA, USA
| | - Erin Kobetz
- University of Miami Clinical and Translational Science Institute, Miami, FL, USA
| | - J. Tommy White
- North Carolina Translational and Clinical Sciences (NC TraCS) Institute, University of North Carolina, Chapel Hill, NC, USA
| | - Laurene Tumiel Berhalter
- Dept of Family Medicine, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
- University at Buffalo Clinical and Translational Science Institute, Buffalo, NY, USA
| | - Alicia Bilheimer
- North Carolina Translational and Clinical Sciences (NC TraCS) Institute, University of North Carolina, Chapel Hill, NC, USA
| | - Megan Hoffman
- University of Minnesota Clinical and Translational Science Institute, Minneapolis, MN, USA
| | - Carmen R. Isasi
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, New York, NY, USA
- The Harold and Muriel Block Institute for Clinical and Translational Research (ICTR), New York, NY, USA
| | - Cynthia Killough
- Clinical and Translational Science Center, University of New Mexico Health Sciences Center, Albuquerque, NM, USA
| | - Julia Martinez
- Clinical and Translational Science Center, University of New Mexico Health Sciences Center, Albuquerque, NM, USA
| | | | - Arshiya A. Baig
- Department of Medicine, University of Chicago Center for Institute for Clinical and Translational Science, University of Chicago, Chicago, IL, USA
| | - Capri Foy
- Wake Forrest University School of Medicine Clinical and Translational Science Institute, Winston-Salem, NC, USA
| | - Nadia Islam
- New York Langone University Clinical and Translational Science Institute, New York, NY, USA
| | - Antonia Petruse
- Clinical and Translational Science Institute Office of Clinical Research, University of California Los Angeles, Los Angeles, CA, USA
| | - Carolina Rosales
- University of Florida Clinical and Translational Science Institute, Gainesville, FL, USA
| | - Michele D. Kipke
- Southern California Clinical and Translational Science Institute (SC CTSI), Los Angeles, CA, USA
| | | | - Tracy A. Battaglia
- Boston University Clinical and Translational Science Institute, Boston, MA, USA
- Boston Medical Center Health System, Boston, MA, USA
| | - Rebecca Lobb
- Boston University Clinical and Translational Science Institute, Boston, MA, USA
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Killough C, Ortegon ER, Vasireddy R, Kincaid T, Silverblatt H, Crisanti A, Page K. Training Psychiatrists in New Mexico: Reflections from Psychiatry Residents Who Participated in a Rural Track Versus a Traditional Program Alone over the Past Decade. Acad Psychiatry 2022; 46:470-474. [PMID: 34988922 PMCID: PMC8731206 DOI: 10.1007/s40596-021-01572-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 11/22/2021] [Indexed: 06/14/2023]
Abstract
OBJECTIVE With over 60% of rural Americans living in mental health professional shortage areas, there is a need for providing psychiatry residents training experiences in rural communities with the goal of increasing the likelihood that they will end up practicing in those same communities following graduation. The purpose of this study was to survey previous and current psychiatry residents, with the goal of describing the impact of the program on rural track residents compared to those in the traditional residency track. METHODS Psychiatry residents 2010-2020 completed an online survey. For those who participated in the rural residency track, the survey asked additional questions regarding barriers experienced practicing in rural areas (e.g., professional isolation) and whether the goals of the rural track were met. RESULTS Seventy-four residents completed surveys, with 26% in the "Rural Track Group" (RTG) and 74% in the "Non-rural Track Group" (NTG). More RTG reported they were more likely to practice in rural, frontier, or underserved areas after residency compared to NTG (74% versus 60%). Most RTG (72%) strongly agreed the rural program helped meet goals. Distance from family was a top barrier for current RTG (63%), followed by concerns about local schools, social isolation, and reduced career opportunities for partners (45%). CONCLUSIONS Residents of the RTG were more likely to consider a career in a rural area than those of the traditional program alone. Psychiatry residency requirements should be reviewed to address top rural training barriers to promote retention in rural areas.
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Crisanti AS, Murray-Krezan C, Reno J, Killough C. Effectiveness of Peer-Delivered Trauma Treatment in a Rural Community: A Randomized Non-inferiority Trial. Community Ment Health J 2019; 55:1125-1134. [PMID: 31338716 PMCID: PMC6744517 DOI: 10.1007/s10597-019-00443-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Accepted: 06/25/2019] [Indexed: 11/26/2022]
Abstract
This randomized controlled non-inferiority trial explored the effectiveness of Seeking Safety (SS) delivered by peer providers compared to its delivery by licensed behavioral health clinicians. The study enrolled 291 adults with PTSD and/or substance use disorders. Data were collected at 3 and 6-months post start of treatment. With respect to long-term outcomes, at 6 months PTSD symptoms decreased by 5.1 points [95% CI (- 9.0, - 1.1)] and by 4.9 points [95% CI (- 8.6, - 1.1)] and coping skills increased by 5.5 points [95% CI (0.4, 10.6)] and by 5.6 points [95% CI (0.8, 10.4)], in the peer- and clinician-led groups, respectively. This study demonstrated non-inferiority of peer-delivered SS compared to clinician-delivered SS for reducing PTSD symptoms and similar outcomes for both groups with respect to coping skills. A confirmatory study on the effectiveness of peer-delivered trauma-specific services is warranted, especially given the potential for increasing access to such treatment in underserved rural communities.
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Affiliation(s)
- Annette S Crisanti
- Department of Psychiatry and Behavioral Sciences, University of New Mexico, MSC 09 5030, Albuquerque, NM, 87131, USA.
| | | | - Jessica Reno
- Department of Psychiatry and Behavioral Sciences, University of New Mexico, MSC 09 5030, Albuquerque, NM, 87131, USA
| | - Cynthia Killough
- Department of Psychiatry and Behavioral Sciences, University of New Mexico, MSC 09 5030, Albuquerque, NM, 87131, USA
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Crisanti AS, Reno J, Salvador JG, Killough C, Greene RN. Perceived helpfulness of peer-delivered trauma specific treatment: A randomized controlled trial. Psychol Serv 2018; 16:425-432. [PMID: 30407046 DOI: 10.1037/ser0000281] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Peer providers have been associated with positive outcomes in behavioral health, but little is known about the perceived helpfulness of their services. We used a mixed-methods randomized controlled trial to compare the perceived helpfulness of seeking safety (SS) led by peer providers compared to its delivery by licensed behavioral health clinicians (including both a licensed alcohol and drug abuse counselor and licensed clinical mental health counselor). Participants (N = 278) rated the helpfulness of 12 SS topics at the end of every session. A subset (n = 245) of participants also rated the helpfulness of SS overall and its treatment components; 3 and 6 months following their first SS group. We also collected qualitative data to inform our understanding of the ways perceived helpfulness varied among participants in peer-led (PL) and clinician-led (CL) groups. Ratings of overall and topic-specific helpfulness were high among both groups, and while ratings were slightly higher among participants in PL groups, the difference was not significant. Participants in PL-SS rated certain treatment components significantly more helpful compared to participants in CL-SS, including the focus on learning coping skills (81.6% PL vs. 64.9% CL, p = .020) and safety as a priority of treatment (81.6% PL vs. 61.5% CL, p = .006). Because of the homogeneity of helpfulness ratings, the relationship between perceived helpfulness and treatment retention and outcomes could not be examined. Future research on this association is warranted. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Affiliation(s)
- Annette S Crisanti
- Division of Community Behavioral Health, Department of Psychiatry and Behavioral Sciences, University of New Mexico
| | - Jessica Reno
- Division of Community Behavioral Health, Department of Psychiatry and Behavioral Sciences, University of New Mexico
| | - Julie G Salvador
- Division of Community Behavioral Health, Department of Psychiatry and Behavioral Sciences, University of New Mexico
| | - Cynthia Killough
- Division of Community Behavioral Health, Department of Psychiatry and Behavioral Sciences, University of New Mexico
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