Mental health issues are prevalent among adolescents and adults in the United States. Many communities, however, face severe shortages of trained mental health providers, which results in primary care providers (PCPs) delivering mental health services. Unfortunately, PCPs are often ill-equipped to provide this specialized care to individuals. Therefore, there is a need to develop and evaluate programs to deliver advanced mental health care training to PCPs, particularly those in geographically isolated areas. A tele-education program, Extension for Community Health care Outcomes (ECHO) Idaho, developed a behavioral health program for PCPs in Idaho-ECHO Idaho Behavioral Health (ECHO Idaho BH). PCPs were recruited from across Idaho to participate in 22 ECHO Idaho BH sessions led by a panel of mental health experts. An evaluation survey was developed to assess overall participant satisfaction, as well as program content, organization, and associated activities. A total of 212 ECHO Idaho BH session evaluation surveys were completed. Overall, participants were highly satisfied with the program and indicated that participation in the program improved their clinical practice. The ECHO Idaho BH series reduced barriers to participation for attendees, enhanced attendee knowledge, and attendees indicated attendance would improve their patient care. Thus, ECHO Idaho BH may be an effective method for increasing the quality of mental health care services available for Idaho residents.

Context The increased emphasis on implementing evidence-based practice has reinforced the need to more accurately assess patient improvement. Psychometrically sound, patient-reported outcome (PRO) measures are essential for evaluating patient care. A PRO instrument that may be useful for clinicians is the Disablement in the Physically Active (DPA) scale. Before adopting this scale, however, researchers must evaluate its psychometric properties, particularly across subpopulations. Objective To evaluate the psychometric properties of the DPA scale in a large sample using confirmatory factor analysis procedures and assess structural invariance of the scale across sex, age, injury status, and athletic status groups. Design Observational study. Setting Twenty-two clinical sites. Participants Of 1445 physically active individuals recruited from multiple athletic training clinical sites, data from 1276 were included in the analysis. Respondents were either healthy or experiencing an acute, subacute, or persistent musculoskeletal injury. Main Outcome Measure(s) A confirmatory factor analysis was performed on the full sample, and multigroup invariance testing was conducted to assess differences across sex, age, injury status, and athletic status. Given the poor model fit, alternate model generation was used to identify a more parsimonious factor structure. Results The DPA scale did not meet contemporary fit index recommendations or the criteria to demonstrate structural invariance. We identified an 8-item model that met the model fit recommendations using alternate model generation. Conclusions The 16-item DPA scale did not meet the model fit recommendations and may not be the most parsimonious or reliable measure for assessing disablement and quality of life. Use of the 16-item DPA scale across subpopulations of interest is not recommended. More examination involving a true cross-validation sample should be completed on the 8-item DPA scale before this scale is adopted in research and practice.

Objective: To develop and evaluate a relevant and readily accessible post-professional opioid use disorder (OUD) education program for a rural and frontier state.Design: Observational study. Setting/participants: Healthcare providers enrolled in Extension for Community Healthcare Outcomes (ECHO) Idaho Opioid, a tele-mentoring education program.Main outcome measure: Participant-level demographics of those that attended the ECHO Idaho Opioid program and post-session and program evaluation surveys.Results: A total of 273 individuals attended at least one ECHO Idaho Opioid session (per session average = 22.8); 183 post-session evaluations (per session average = 6.3) and 42 program evaluations were completed. The program was well received by providers in a rural and frontier state and may be a viable option to enhance patient care for OUD patients in these communities.Conclusion: The Project ECHO model is successful at reaching providers across diverse geographic regions, overcoming barriers associated with attending advanced trainings or developing peer networks to improve patient care. The model can be used to develop educational content and delivery that participants believe is satisfactory, valuable, and applicable to their profession and practice.

Context Instrument-assisted soft tissue mobilization (IASTM) is a popular myofascial intervention used by health care professionals. Objective To document IASTM clinical practice patterns among health care professionals in the United States. Design Cross-sectional study. Setting Online survey. Patients or Other Participants A total of 853 members of the National Athletic Trainers' Association (n = 249) and the American Physical Therapy Association (n = 604). Main Outcome Measure(s) Responses to a 55-item electronic survey that assessed 4 areas, namely, IASTM training and experience, IASTM application, perception of IASTM in practice, and demographic information. Results Most (n = 705, 83%) of the 853 respondents used IASTM in their practice, and they had an average of 15 years of work experience. Approximately 86% (n = 731) reported completing some type of formal training, and 61% (n = 518) had completed some type of informal training. Respondents used >34 different IASTM tools. Seventy-one percent (n = 606) indicated either not knowing how to quantify the amount of force applied by the tool during treatment or not trying to quantify. Fifteen percent (n = 128) estimated a force ranging from 100 to 500g. The treatment time for a specific lesion and location ranged from 1 to ≤5 minutes, with an average total treatment time of 14.46 ± 14.70 minutes. Respondents used 31 different interventions before or after IASTM. Approximately 66% (n = 564) reported following treatment recommendations, and 19% (n = 162) described rarely or never following recommendations learned during training. A total of 94% (n = 801) recounted using some type of clinical outcome measure to assess their treatment. Cluster analysis identified 3 distinct cluster groupings among professionals, with most (89%, n = 729/818) indicating that IASTM was an effective treatment. Conclusions This survey documented the IASTM practice patterns of health care professionals. Cluster profiles characterized group differences in IASTM training and clinical application. The gaps among research, clinical practice, and training need to be bridged to establish IASTM best practices.