XR-NTX may be an effective adjunct in the residential treatment and aftercare of patients with opioid dependence.

Background Given that youth alcohol use is more common in rural communities, such communities can play a key role in preventing alcohol use among adolescents. Guidelines recommend primary care providers incorporate screening, brief intervention, and referral to treatment (SBIRT) into routine care. Objective The aim is to train primary care providers and school nurses within a rural 10-county catchment area in Pennsylvania to use SBIRT and facilitate collaboration with community organizations to better coordinate substance use prevention efforts. Methods To build capacity to address underage drinking and opioid use among youth aged 9-20 years, this project uses telehealth, specifically Project ECHO (Extension for Community Healthcare Outcomes), to train primary care providers and school nurses to address substance use with SBIRT. Our project will provide 120 primary care providers and allied health professionals as well as 20 school nurses with SBIRT training. Community-based providers will participate in weekly virtual ECHO sessions with a multidisciplinary team from Penn State College of Medicine that will provide SBIRT training and facilitate case discussions among participants. Results To date, we have launched one SBIRT ECHO project with school personnel, enrolling 34 participants. ECHO participants are from both rural (n=17) and urban (n=17) counties and include school nurses (n=15), school counselors (n=8), teachers (n=5), administrators (n=3), and social workers (n=3). Before the study began, only 2/13 (15.5%) of schools were screening for alcohol use. Conclusions This project teaches primary care clinics and schools to use SBIRT to prevent the onset and reduce the progression of substance use disorders, reduce problems associated with substance use disorders, and strengthen communities’ prevention capacity. Ours is an innovative model to improve rural adolescent health by reducing alcohol and opioid use. International Registered Report Identifier (IRRID) DERR1-10.2196/21015

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A221what or very much affected their performance at work. In our multivariate logistic regression model examining change in employment status, the number of hours/ week of caregiving, use of support services, a PHQ-2 depression score of 4+, caring for a spouse, younger age and lower income were statistically significant. In our analysis examining change in work performance, the number of hours/week of caregiving, use of support services, PHQ-2 score of 4+, providing assistance with greater number of ADLs and greater number of IADLs, and younger age were significant. ConClusions: Informal caregivers report high levels of change in employment and performance. Caregiver burden and the presence of depressive symptoms were strongly associated with a change in employment status and work performance as a result of caregiving. Efforts aimed at identifying high levels of caregiver burden and depressive symptoms among caregivers may potentially have an impact on employment for some caregivers.

BACKGROUND Given that youth alcohol use is more common in rural communities, such communities can play a key role in preventing alcohol use in adolescents. Guidelines recommend primary care providers incorporate screening, brief intervention, and referral to treatment (SBIRT) into routine care. OBJECTIVE Increase adolescent alcohol and drug screening, brief intervention, and referral to treatment among primary care providers and school nurses. METHODS To build capacity to address underage drinking and opioid use among youth ages 9 to 20, this project uses telehealth, specifically Project ECHO®, to train primary care providers and school nurses to intervene on substance use with SBIRT. Our project will engage 120 primary care providers and allied health professionals, and 20 school nurses to participate in SBIRT training. Community-based providers will participate in weekly virtual ECHO sessions with a multi-disciplinary team from Penn State College of Medicine who will provide SBIRT training and facilitate case discussions by participants. RESULTS To date, we have launched one SBIRT ECHO with school personnel, enrolling 34 participants. ECHO participants are from both rural (n=17) and urban (n=17) counties and include school nurses (n=15), school counselors (n=8), teachers (n=5), administrators (n=3), and social workers (n=3). Before the study began, only 15.5% of schools were screening for alcohol use. CONCLUSIONS This project teaches SBIRT for use in primary care clinics and schools to prevent the onset and reduce the progression of substance use disorders (SUD), reduce SUD-related problems, and strengthen communities’ prevention capacity. Ours is an innovative model to improve rural adolescent health by reducing alcohol and opioid related harms.