New Program Will Train Health Educators to Address Behavioral Issues
La Crosse, Wisconsin - If someday a health educator asks you about your use of alcohol and drugs, depression and exercise, you may be benefiting from a training program beginning this month at the University of Wisconsin-La Crosse.
UW-La Crosse faculty members are learning how to train students in their nationally recognized program in health education and health promotion.
In the fall of 2012, a cohort of up to 25 community health education majors will begin intensive instruction and skill development in behavioral screening and intervention (BSI) - a set of services that are increasingly expected to be delivered in health care settings.
The upcoming training sessions for faculty focus on motivational interviewing (MI), a key part of the BSI model for effecting behavior change.
Behavioral screening and intervention involves regularly asking all patients about behavioral issues that frequently affect health, and delivering research-based interventions to reduce risk, prevent many health problems and decrease health care costs. These issues include:
- Tobacco use
- Excessive drinking
- Drug use
They cause more than 40 percent of all deaths, most chronic illness and most disability in the United States.
Because the services improve health and decrease health care costs, they are recommended by many national and Wisconsin-based organizations, including the Centers for Disease Control and Prevention, the National Institutes of Health, the U.S. Preventive Services Task Force, Wisconsin Manufacturers and Commerce and the Wisconsin Medical Society.
Program Will Develop New Health Professionals
But a significant question remains about how to bring behavioral screening and intervention to scale. Who will actually deliver BSI to millions of Americans in thousands of health care settings across the United States? Most current providers and their staff lack the time and training to do so.
The problem is particularly thorny, as most Americans have at least one risk, and many have several. In Wisconsin, 30 percent of adult patients drink too much, 27 percent are obese, 20 percent smoke, eight percent use illicit drugs, and eight percent are depressed.
This new project involving two UW campuses may bring an answer. The certified health educators will be trained through the Department of Health Education and Health Promotion at UW-La Crosse.
Patients respond to initial questions that quantify their risks and identify problems early, when treatment is more effective, easier, and less expensive. Those who might have serious conditions - such as alcoholism, addiction or depression - are referred for specialty care. Those with mild-to-moderate risk receive services within general health care settings to help them change their behaviors and reduce their risk.
A challenge in delivering these services is that no single profession is trained to help patients with all seven behavioral issues. In this new project, UW-La Crosse students working toward a bachelor's degree in community health education will learn the skills necessary to mitigate risk for all seven behaviors and conditions.
The project will be administered by the Wisconsin Initiative to Promote Healthy Lifestyles (WIPHL) of the University of Wisconsin School of Medicine and Public Health.
Based in the Department of Family Medicine, WIPHL has already helped dozens of Wisconsin health care settings deliver behavioral screening and intervention. More than 100,000 patients have been screened, and more than 25,000 have received interventions. Results include a 20 percent decline in binge drinking, a 48 percent reduction in regular marijuana use, and a 55 percent reduction in depressive symptoms.
The Wisconsin Initiative to Promote Healthy Lifestyles is working on a national grant to recruit and train a limited number of primary care sites throughout Wisconsin to deliver behavioral screening and intervention services.
"Federal health care reform pushes for these behavioral services because of their effectiveness and efficiency," says Dr. Richard L. Brown, WIPHL director and professor of family medicine. "Clearly, if BSI is to fulfill its potential to improve health and decrease health care costs, our nation will need a new army of rigorously trained health care professionals with these special skills."
Motivational Interviewing Will Complement Program
Social worker Laura A. Saunders, of the Wisconsin Initiative to Promote Healthy Lifestyles, will take the lead in training UW-La Crosse health education faculty in motivational interviewing as part of the BSI process. Saunders is a member of the MINT, an international group of trainers in MI.
Saunders describes this application of motivational interviewing as "a partnering, respectful style of communication to help people resolve their natural ambivalence about change and explore the possibility of changing behaviors that may have a negative impact on their overall health."
Dr. Gary D. Gilmore, who directs the graduate community health programs at UW-La Crosse, believes motivational interviewing skills will complement the assessment, planning, evaluation and communication skills already addressed in the nationally accredited Bachelor of Science in Community Health Education program.
"While our graduates already work successfully in health care organizations, as well as in other community-based settings, this behavioral screening and intervention approach will add to the health educator skill set and value as a member of the health care team."
Brown adds, "Many experts have for years been calling for more of a team approach to health care. That need is amplified by the growing shortage of primary care providers. Having a new workforce of health educators available to systematically address behavioral issues in health care settings will personalize care, improve health, and reduce the need for more costly health care services."
Wisconsin Partnership Supports Project
The Wisconsin Partnership Program of the UW School of Medicine and Public Health is funding the new project. The Partnership Education and Research Committee awarded a $300,000 grant in September to the project as one of its three Collaborative Health Sciences grants. The new program becomes available to students in fall of 2012.
The Wisconsin Partnership has a commitment to improve the health and well-being of Wisconsin residents through investments in research, education, prevention practices, interventions, and policy development. Its funds come from the conversion of Blue Cross & Blue Shield United of Wisconsin to a for-profit corporation.
Date Published: 11/30/2011