Kathryn R. Puskar, DrPH, RN, and Ann M. Mitchell, PhD, RN, University of Pittsburgh School of Nursing, Pittsburgh, Pennsylvania, USA, shared results from an online interprofessional project demonstrating the effectiveness of interprofessional collaborative practice (IPCP) and its impact on substance use health care in rural areas.

According to Dr Puskar, substance abuse represents an enormous public health problem, and its comorbidity with mental disorders is well recognized. Early screening by health care personnel has been associated with reductions in health care utilization and in criminal and other societal costs [Cuijpers P et al. Addiction. 2004; Wells-Parker E, Williams M. J Stud Alcohol. 2002; Gentilello LM et al. Ann Surg. 1999]. Nevertheless, she noted that many people need specialty treatment for substance abuse problems but do not receive it.

To address this issue in rural areas, Dr Puskar and colleagues aimed to create an easily accessible, 100% online education intervention for the health care workforce. They established a nurse-led interprofessional collaboration to enhance substance use treatment capacity in rural areas. This ongoing project aims to prepare all health professionals to collaborate, with the common goal of building a better, safer patient-centered and community- or population-oriented health care system in the United States. Its approach reemphasizes the importance of teamwork and communication within and among teams.

More than 230 rural providers are currently enrolled in the project. This involves public health professionals, nurses, and behavioral health professionals in a variety of community-based organizations, predominantly in Pennsylvania, Ohio, and West Virginia.

This interprofessional practice process comprises 7 steps, 1 of which involves online educational modules. Within 1 module, providers learn the reliable, evidence-based Screening, Brief Intervention, and Referral to Treatment (SBIRT) approach. The screening component comprises a short set of questions that can be used within a health visit to identify risky or hazardous substance abuse or dependence. Other modules cover issues such as the continuum of substance use, motivational interviewing strategies, and practicing IPCP. Providers also have access to online case study examples and interprofessional dialogue sessions. Pre- and posttest questionnaires are performed online to determine the effect of the education. These include the Alcohol and Alcohol Problems Perception Questionnaire (AAPPQ) and the Drug and Drug Problems Perception Questionnaire (DDPPQ) [Watson H et al. Addiction. 2007].

Dr Puskar shared data obtained to date, showing changes in the questionnaires' subscale scores from baseline to the postonline module and postinterprofessional dialogue steps. Significant (P < .05) score increases were seen in the subscales of role adequacy, role legitimacy, and role support in the AAPPQ (Figure 1) and role adequacy and role support in the DDPPQ (Figure 2).

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Figure 1.

Alcohol and Alcohol Problems Perception Questionnaire Results

Reproduced with permission from KR Puskar, DrPH, RN.

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Figure 2.

Drug and Drug Problems Perception Questionnaire Results

Reproduced with permission from KR Puskar, DrPH, RN.

The Interdisciplinary Education Perception Scale [Luecht RM et al. J Allied Health. 1990], an IPCP questionnaire, was also used to measure providers' perceptions of the interprofessional collaborative project and its importance. According to Dr Puskar, changes in scores from baseline to postdialogue showed that providers' perceptions of competence and autonomy improved as a result of the collaborative practice project, as did their perceptions of actual cooperation and their understanding of the value of others.

The Readiness for Interprofessional Learning Scale [Reid R et al. Medical Education. 2006] was also used, focusing on providers' attitudes to interprofessional learning with respect to teamwork, professional identity, and patient centeredness. Although scores on this questionnaire also improved from baseline to postdialogue, Dr Puskar indicated that the increases were not statistically significant.

Interprofessional education and practice therefore represent an effective way to strengthen substance use treatment capacity in rural areas. In her concluding remarks, Dr Puskar encouraged nurses to improve interprofessional communication, communicate with clients using SBIRT, communicate with team members, and suggest referrals when necessary.