title: Evaluation of American Indian Health Service Training in Pain Management and Opioid Substance Use Disorder.
abstract: We examined the benefits of a collaboration between the Indian Health Service and an academic medical center to address the high rates of unintentional drug overdose in American Indians/Alaska Natives. In January 2015, the Indian Health Service became the first federal agency to mandate training in pain and opioid substance use disorder for all prescribing clinicians. More than 1300 Indian Health Service clinicians were trained in 7 possible 5-hour courses specific to pain and addiction. We noted positive changes in pre- and postcourse knowledge, self-efficacy, and attitudes as well as thematic responses showing the trainings to be comprehensive, interactive, and convenient.
authors.affiliation: Joanna G. Katzman is with the Department of Neurosurgery, University of New Mexico (UNM) School of Medicine, Albuquerque. Christopher Fore is with the Indian Health Service (IHS), Telebehavioral Health Center of Excellence, Albuquerque, NM. Snehal Bhatt and Julie Griffin Salvador are with the Department of Psychiatry, UNM School of Medicine. Nina Greenberg is with the Mathematics and Statistics Department, UNM. George C. Comerci and Lisa Marr are with the Department of Internal Medicine, UNM School of Medicine. Christopher Camarata is with the Department of Family Medicine, UNM School of Medicine. Rebecca Monette, Sanjeev Arora, and Andrea Bradford are with Project ECHO (Extension for Community Healthcare Outcomes), UNM School of Medicine. Denise Taylor is with the Department of Pediatrics, UNM School of Medicine. Jenny Dillow is with the Department of Anesthesia, UNM School of Medicine. Susan Karol is with IHS, US Health and Human Services, Rockville, MD.
authors.forename: Joanna G
authors.initials: JG
authors.lastname: Katzman
authors.affiliation: Joanna G. Katzman is with the Department of Neurosurgery, University of New Mexico (UNM) School of Medicine, Albuquerque. Christopher Fore is with the Indian Health Service (IHS), Telebehavioral Health Center of Excellence, Albuquerque, NM. Snehal Bhatt and Julie Griffin Salvador are with the Department of Psychiatry, UNM School of Medicine. Nina Greenberg is with the Mathematics and Statistics Department, UNM. George C. Comerci and Lisa Marr are with the Department of Internal Medicine, UNM School of Medicine. Christopher Camarata is with the Department of Family Medicine, UNM School of Medicine. Rebecca Monette, Sanjeev Arora, and Andrea Bradford are with Project ECHO (Extension for Community Healthcare Outcomes), UNM School of Medicine. Denise Taylor is with the Department of Pediatrics, UNM School of Medicine. Jenny Dillow is with the Department of Anesthesia, UNM School of Medicine. Susan Karol is with IHS, US Health and Human Services, Rockville, MD.
authors.forename: Chris
authors.initials: C
authors.lastname: Fore
authors.affiliation: Joanna G. Katzman is with the Department of Neurosurgery, University of New Mexico (UNM) School of Medicine, Albuquerque. Christopher Fore is with the Indian Health Service (IHS), Telebehavioral Health Center of Excellence, Albuquerque, NM. Snehal Bhatt and Julie Griffin Salvador are with the Department of Psychiatry, UNM School of Medicine. Nina Greenberg is with the Mathematics and Statistics Department, UNM. George C. Comerci and Lisa Marr are with the Department of Internal Medicine, UNM School of Medicine. Christopher Camarata is with the Department of Family Medicine, UNM School of Medicine. Rebecca Monette, Sanjeev Arora, and Andrea Bradford are with Project ECHO (Extension for Community Healthcare Outcomes), UNM School of Medicine. Denise Taylor is with the Department of Pediatrics, UNM School of Medicine. Jenny Dillow is with the Department of Anesthesia, UNM School of Medicine. Susan Karol is with IHS, US Health and Human Services, Rockville, MD.
authors.forename: Snehal
authors.initials: S
authors.lastname: Bhatt
authors.affiliation: Joanna G. Katzman is with the Department of Neurosurgery, University of New Mexico (UNM) School of Medicine, Albuquerque. Christopher Fore is with the Indian Health Service (IHS), Telebehavioral Health Center of Excellence, Albuquerque, NM. Snehal Bhatt and Julie Griffin Salvador are with the Department of Psychiatry, UNM School of Medicine. Nina Greenberg is with the Mathematics and Statistics Department, UNM. George C. Comerci and Lisa Marr are with the Department of Internal Medicine, UNM School of Medicine. Christopher Camarata is with the Department of Family Medicine, UNM School of Medicine. Rebecca Monette, Sanjeev Arora, and Andrea Bradford are with Project ECHO (Extension for Community Healthcare Outcomes), UNM School of Medicine. Denise Taylor is with the Department of Pediatrics, UNM School of Medicine. Jenny Dillow is with the Department of Anesthesia, UNM School of Medicine. Susan Karol is with IHS, US Health and Human Services, Rockville, MD.
authors.forename: Nina
authors.initials: N
authors.lastname: Greenberg
authors.affiliation: Joanna G. Katzman is with the Department of Neurosurgery, University of New Mexico (UNM) School of Medicine, Albuquerque. Christopher Fore is with the Indian Health Service (IHS), Telebehavioral Health Center of Excellence, Albuquerque, NM. Snehal Bhatt and Julie Griffin Salvador are with the Department of Psychiatry, UNM School of Medicine. Nina Greenberg is with the Mathematics and Statistics Department, UNM. George C. Comerci and Lisa Marr are with the Department of Internal Medicine, UNM School of Medicine. Christopher Camarata is with the Department of Family Medicine, UNM School of Medicine. Rebecca Monette, Sanjeev Arora, and Andrea Bradford are with Project ECHO (Extension for Community Healthcare Outcomes), UNM School of Medicine. Denise Taylor is with the Department of Pediatrics, UNM School of Medicine. Jenny Dillow is with the Department of Anesthesia, UNM School of Medicine. Susan Karol is with IHS, US Health and Human Services, Rockville, MD.
authors.forename: Julie
authors.initials: J
authors.lastname: Griffin Salvador
authors.affiliation: Joanna G. Katzman is with the Department of Neurosurgery, University of New Mexico (UNM) School of Medicine, Albuquerque. Christopher Fore is with the Indian Health Service (IHS), Telebehavioral Health Center of Excellence, Albuquerque, NM. Snehal Bhatt and Julie Griffin Salvador are with the Department of Psychiatry, UNM School of Medicine. Nina Greenberg is with the Mathematics and Statistics Department, UNM. George C. Comerci and Lisa Marr are with the Department of Internal Medicine, UNM School of Medicine. Christopher Camarata is with the Department of Family Medicine, UNM School of Medicine. Rebecca Monette, Sanjeev Arora, and Andrea Bradford are with Project ECHO (Extension for Community Healthcare Outcomes), UNM School of Medicine. Denise Taylor is with the Department of Pediatrics, UNM School of Medicine. Jenny Dillow is with the Department of Anesthesia, UNM School of Medicine. Susan Karol is with IHS, US Health and Human Services, Rockville, MD.
authors.forename: George C
authors.initials: GC
authors.lastname: Comerci
authors.affiliation: Joanna G. Katzman is with the Department of Neurosurgery, University of New Mexico (UNM) School of Medicine, Albuquerque. Christopher Fore is with the Indian Health Service (IHS), Telebehavioral Health Center of Excellence, Albuquerque, NM. Snehal Bhatt and Julie Griffin Salvador are with the Department of Psychiatry, UNM School of Medicine. Nina Greenberg is with the Mathematics and Statistics Department, UNM. George C. Comerci and Lisa Marr are with the Department of Internal Medicine, UNM School of Medicine. Christopher Camarata is with the Department of Family Medicine, UNM School of Medicine. Rebecca Monette, Sanjeev Arora, and Andrea Bradford are with Project ECHO (Extension for Community Healthcare Outcomes), UNM School of Medicine. Denise Taylor is with the Department of Pediatrics, UNM School of Medicine. Jenny Dillow is with the Department of Anesthesia, UNM School of Medicine. Susan Karol is with IHS, US Health and Human Services, Rockville, MD.
authors.forename: Christopher
authors.initials: C
authors.lastname: Camarata
authors.affiliation: Joanna G. Katzman is with the Department of Neurosurgery, University of New Mexico (UNM) School of Medicine, Albuquerque. Christopher Fore is with the Indian Health Service (IHS), Telebehavioral Health Center of Excellence, Albuquerque, NM. Snehal Bhatt and Julie Griffin Salvador are with the Department of Psychiatry, UNM School of Medicine. Nina Greenberg is with the Mathematics and Statistics Department, UNM. George C. Comerci and Lisa Marr are with the Department of Internal Medicine, UNM School of Medicine. Christopher Camarata is with the Department of Family Medicine, UNM School of Medicine. Rebecca Monette, Sanjeev Arora, and Andrea Bradford are with Project ECHO (Extension for Community Healthcare Outcomes), UNM School of Medicine. Denise Taylor is with the Department of Pediatrics, UNM School of Medicine. Jenny Dillow is with the Department of Anesthesia, UNM School of Medicine. Susan Karol is with IHS, US Health and Human Services, Rockville, MD.
authors.forename: Lisa
authors.initials: L
authors.lastname: Marr
authors.affiliation: Joanna G. Katzman is with the Department of Neurosurgery, University of New Mexico (UNM) School of Medicine, Albuquerque. Christopher Fore is with the Indian Health Service (IHS), Telebehavioral Health Center of Excellence, Albuquerque, NM. Snehal Bhatt and Julie Griffin Salvador are with the Department of Psychiatry, UNM School of Medicine. Nina Greenberg is with the Mathematics and Statistics Department, UNM. George C. Comerci and Lisa Marr are with the Department of Internal Medicine, UNM School of Medicine. Christopher Camarata is with the Department of Family Medicine, UNM School of Medicine. Rebecca Monette, Sanjeev Arora, and Andrea Bradford are with Project ECHO (Extension for Community Healthcare Outcomes), UNM School of Medicine. Denise Taylor is with the Department of Pediatrics, UNM School of Medicine. Jenny Dillow is with the Department of Anesthesia, UNM School of Medicine. Susan Karol is with IHS, US Health and Human Services, Rockville, MD.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Monette
authors.affiliation: Joanna G. Katzman is with the Department of Neurosurgery, University of New Mexico (UNM) School of Medicine, Albuquerque. Christopher Fore is with the Indian Health Service (IHS), Telebehavioral Health Center of Excellence, Albuquerque, NM. Snehal Bhatt and Julie Griffin Salvador are with the Department of Psychiatry, UNM School of Medicine. Nina Greenberg is with the Mathematics and Statistics Department, UNM. George C. Comerci and Lisa Marr are with the Department of Internal Medicine, UNM School of Medicine. Christopher Camarata is with the Department of Family Medicine, UNM School of Medicine. Rebecca Monette, Sanjeev Arora, and Andrea Bradford are with Project ECHO (Extension for Community Healthcare Outcomes), UNM School of Medicine. Denise Taylor is with the Department of Pediatrics, UNM School of Medicine. Jenny Dillow is with the Department of Anesthesia, UNM School of Medicine. Susan Karol is with IHS, US Health and Human Services, Rockville, MD.
authors.forename: Sanjeev
authors.initials: S
authors.lastname: Arora
authors.affiliation: Joanna G. Katzman is with the Department of Neurosurgery, University of New Mexico (UNM) School of Medicine, Albuquerque. Christopher Fore is with the Indian Health Service (IHS), Telebehavioral Health Center of Excellence, Albuquerque, NM. Snehal Bhatt and Julie Griffin Salvador are with the Department of Psychiatry, UNM School of Medicine. Nina Greenberg is with the Mathematics and Statistics Department, UNM. George C. Comerci and Lisa Marr are with the Department of Internal Medicine, UNM School of Medicine. Christopher Camarata is with the Department of Family Medicine, UNM School of Medicine. Rebecca Monette, Sanjeev Arora, and Andrea Bradford are with Project ECHO (Extension for Community Healthcare Outcomes), UNM School of Medicine. Denise Taylor is with the Department of Pediatrics, UNM School of Medicine. Jenny Dillow is with the Department of Anesthesia, UNM School of Medicine. Susan Karol is with IHS, US Health and Human Services, Rockville, MD.
authors.forename: Andrea
authors.initials: A
authors.lastname: Bradford
authors.affiliation: Joanna G. Katzman is with the Department of Neurosurgery, University of New Mexico (UNM) School of Medicine, Albuquerque. Christopher Fore is with the Indian Health Service (IHS), Telebehavioral Health Center of Excellence, Albuquerque, NM. Snehal Bhatt and Julie Griffin Salvador are with the Department of Psychiatry, UNM School of Medicine. Nina Greenberg is with the Mathematics and Statistics Department, UNM. George C. Comerci and Lisa Marr are with the Department of Internal Medicine, UNM School of Medicine. Christopher Camarata is with the Department of Family Medicine, UNM School of Medicine. Rebecca Monette, Sanjeev Arora, and Andrea Bradford are with Project ECHO (Extension for Community Healthcare Outcomes), UNM School of Medicine. Denise Taylor is with the Department of Pediatrics, UNM School of Medicine. Jenny Dillow is with the Department of Anesthesia, UNM School of Medicine. Susan Karol is with IHS, US Health and Human Services, Rockville, MD.
authors.forename: Denise
authors.initials: D
authors.lastname: Taylor
authors.affiliation: Joanna G. Katzman is with the Department of Neurosurgery, University of New Mexico (UNM) School of Medicine, Albuquerque. Christopher Fore is with the Indian Health Service (IHS), Telebehavioral Health Center of Excellence, Albuquerque, NM. Snehal Bhatt and Julie Griffin Salvador are with the Department of Psychiatry, UNM School of Medicine. Nina Greenberg is with the Mathematics and Statistics Department, UNM. George C. Comerci and Lisa Marr are with the Department of Internal Medicine, UNM School of Medicine. Christopher Camarata is with the Department of Family Medicine, UNM School of Medicine. Rebecca Monette, Sanjeev Arora, and Andrea Bradford are with Project ECHO (Extension for Community Healthcare Outcomes), UNM School of Medicine. Denise Taylor is with the Department of Pediatrics, UNM School of Medicine. Jenny Dillow is with the Department of Anesthesia, UNM School of Medicine. Susan Karol is with IHS, US Health and Human Services, Rockville, MD.
authors.forename: Jenny
authors.initials: J
authors.lastname: Dillow
authors.affiliation: Joanna G. Katzman is with the Department of Neurosurgery, University of New Mexico (UNM) School of Medicine, Albuquerque. Christopher Fore is with the Indian Health Service (IHS), Telebehavioral Health Center of Excellence, Albuquerque, NM. Snehal Bhatt and Julie Griffin Salvador are with the Department of Psychiatry, UNM School of Medicine. Nina Greenberg is with the Mathematics and Statistics Department, UNM. George C. Comerci and Lisa Marr are with the Department of Internal Medicine, UNM School of Medicine. Christopher Camarata is with the Department of Family Medicine, UNM School of Medicine. Rebecca Monette, Sanjeev Arora, and Andrea Bradford are with Project ECHO (Extension for Community Healthcare Outcomes), UNM School of Medicine. Denise Taylor is with the Department of Pediatrics, UNM School of Medicine. Jenny Dillow is with the Department of Anesthesia, UNM School of Medicine. Susan Karol is with IHS, US Health and Human Services, Rockville, MD.
authors.forename: Susan
authors.initials: S
authors.lastname: Karol
mesh_terms: D000046:Academic Medical Centers / Q000458:organization & administration; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D001291:Attitude of Health Personnel; D003194:Computer-Assisted Instruction / Q000379:methods; D003299:Cooperative Behavior; D004502:Education, Medical, Continuing / Q000458:organization & administration*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007198:Indians, North American; D004930:Inuit; D009293:Opioid-Related Disorders / Q000175:diagnosis / Q000208:ethnology* / Q000517:prevention & control; D059408:Pain Management / Q000379:methods*; D010818:Practice Patterns, Physicians'; D020377:Self Efficacy; D014481:United States; D016549:United States Indian Health Service / Q000458:organization & administration*
chemical_list: D000701:Analgesics, Opioid