Substance Abuse Workforce Training Needs During Intersecting Epidemics: An Analysis of Events Offered by a Regional Training Center from 2017 to 2020 | BMC Public Health
A total of 10,695 participants attended 345 New England ATTC TA events over the three-year period, of which 258 events (75%) were retained for this analysis. Eighty-seven events with a total of 552 attendees were excluded because they were classified as meetings or as coordinated by other ATTCs. The final analytical sample for total attendance included 10,143 participants (95% of participants). Demographic information was available from 6,642 participants (66% of the analytical sample) who completed GPRA forms after the event.
Table 2 presents the socio-demographic data. Among technical assistance participants for whom data is available, respondents primarily identified as female (69.7%) and white (72.6%), with the next identifying categories being black ( 7.7%), multiracial (5.5%) and Hispanic (5.5%). ). Almost half of the participants had a bachelor’s degree or less (47.3%), with the other half holding a master’s degree or higher (52.7%). Participants represented more than 30 professions, with the majority identifying as behavioral health or addiction treatment providers (50.6%).
Over the three-year period, the socio-demographic characteristics of the workforce participating in technical assistance events changed with respect to gender, race/ethnicity, training/education of participants and the main occupation of the participants. Analyzes revealed changes in participant composition in terms of gender, race/ethnicity, and educational background that were significant but within an insignificant range (Cramer’s VV= 0.23). The primary occupations of participants diversified over the three-year period, with greater representation among peer community support providers, education professionals and students.
Of the 258 TA events analyzed, 69% of TA events were face-to-face and the rest were virtual. In the first 2 years, the New England ATTC provided TA both in person (68.5% of events) and virtually (31.5% of events). In the middle of the third year (March 2020), all technical support was completely virtual due to the COVID-19 pandemic.
Table 3 shows the number of TA events by state and type. TA took place in all six New England states, with the majority of training offered to the entire New England region (31.4%), followed by New Hampshire (16.7 %) and Connecticut (14.3%). Notably, regional coverage was fairly stable, with no significant association between fiscal year and technical assistance by state.
Frequency of types of technical support offered
Of the 258 events analyzed, most were classified as targeted AT (76.4%). Intensive (18.6%) and basic (5.0%) technical assistance was offered much less often. Over the three-year period, the total number of events decreased by approximately 10% and the types of AT changed. The proportion of events classified as targeted AT decreased by 28%, while the proportion of events classified as intensive AT increased by 23%. Chi-square analyzes revealed significant differences in AT types across exercises, and these changes were of moderate magnitude (Cramer’s V= 0.20; see table 3).
Training topics most frequently offered and followed
Over the 3 years, the most frequently requested and attended technical assistance topics included EBP (41.5% of events, 30.9% of attendees; see Table 4), consumer needs (27 .5% of events, 34.8% of participants) and health. Equity (14.0% of events, 20.6% of participants). EBPs, health equity, and consumer needs were most frequently requested as targeted TA (72.0, 77.8, and 81.7% were targeted TA, respectively), although events EBP were also often requested as intensive TA (27.1% intensive). Across all AT categories, 21.3% of events were classified as opioid-related, 13.6% were classified as justice-related, and 2.3% were classified as COVID-related.
Within the three categories of most requested events, other models have emerged. Among EBP events, the most popular interventions were medication for opioid use disorder (29.9%) and motivational interviewing (29.0%). As part of consumer needs events, approximately two-thirds (69.0%) provided general education about substance use, with topics such as diagnosing substance use disorders, recognizing co-occurring mental health conditions and the application of general clinical skills (eg group counseling). Finally, more than half (52.8%) of health equity events involved training to work effectively with specific underserved populations (e.g. sexual and gender minorities, Hispanic and Latino populations ). Other popular health equity topics included cultural humility (33.3%) and use of culturally and linguistically appropriate service standards (CLAS) (13.9%).
As shown in Figs. 1 and 2, the total number of events decreased significantly from year 1 to year 2, then rebounded somewhat in year 3 (to 90% of the year 1 level). Attendance also decreased from Year 1 to Year 2, but then increased significantly in Year 3 (to 150% of Year 1 level) as events transitioned to delivery virtual during the COVID-19 pandemic.
Analyzes of the relative proportions of events each year revealed moderate increases in the EBP and Health Equity categories. In contrast, there were decreases in the proportion of events in all other subjects (Cramer’s V= 0.22). Similar trends were found in the proportion of participants; EBP and Health Equity events saw an increase in attendance (increases of 3.5 and 14.6%, respectively), while all other topics saw a decline in attendance (see Table 4).