Introducing integrative primary health care to an interprofessional audience: Feasibility and impact of an asynchronous online course

Audrey J. Brooks, Mei Kuang Chen, Elizabeth Goldblatt, Maryanna Klatt, Benjamin Kligler, Mary S. Koithan, Mary Jo Kreitzer, Jeannie K. Lee, Ana Marie Lopez, Victoria Maizes, Irene Sandvold, Douglas Taren, Patricia Lebensohn

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

Background: Although there is mounting clinical and cost-effectiveness evidence supporting integrative healthcare (IH), a significant knowledge gap hinders widespread adoption by primary care professionals. Intervention: Based on IH competencies developed by an interprofessional team and a needs assessment, a 32-h online interprofessional IH course, Foundations in Integrative Health, was developed. Trainees learn to conduct an IH assessment and how patients are assessed and treated from the diverse professions in integrative primary care. Methods: The course was pilot-tested with educational program trainees, faculty and clinical staff at graduate level primary care training programs (primary care residencies, nursing, pharmacy, public health, behavioral health, and licensed complementary and IH programs). Outcome measures: Prior to and following the course, participants completed an IH knowledge test, an IH efficacy self-assessment, and validated measures of IH attitudes, interprofessional learning, provider empathy, patient involvement, resiliency, self-care, wellness behaviors, and wellbeing. Evaluation surveys were administered following each unit and the course. Results: Almost one-half (n = 461/982, 47%) completed the course. Pre/post course improvements in IH knowledge, IH self-efficacy, IH attitudes, interprofessional learning, provider empathy, resiliency, self-care, several wellness behaviors, and wellbeing were observed. The course was positively evaluated with most (93%) indicating interest in applying IH principles and that the course enhanced their educational experience (92%). Conclusion: This study demonstrates the feasibility and effectiveness of a multi-site, online curriculum for introducing IH to a diverse group of primary care professionals. Primary care training programs have the ability to offer an interprofessional, IH curriculum with limited on-site faculty expertise.

Original languageEnglish (US)
Pages (from-to)392-400
Number of pages9
JournalExplore
Volume16
Issue number6
DOIs
StatePublished - Nov 1 2020

Bibliographical note

Funding Information:
The National Center for Integrative Primary Healthcare (NCIPH) was funded by the Health Resources and Services Administration (HRSA) to transform primary care health professional education by emphasizing an integrative approach to patient care utilizing an interprofessional collaborative team (https://nciph.org/). The NCIPH was formed as a cooperative agreement with HRSA, the University of Arizona Andrew Weil Center for Integrative Medicine (AWCIM), and the Academic Consortium for Integrative Health and Medicine (Consortium). Recognizing that primary care serves as the public's point of entry to the healthcare system, members of the NCIPH proposed that primary care should focus on methods to promote health and wellbeing, support health literacy, and reduce the risk of illness and disability of populations in a cost effective manner that improves the experience of care for the individuals as well as improves the experience of care, wellbeing, and resilience of the health care professional.9 It is of critical importance that providers be healthy themselves in order to provide the level of care patients deserve. In 2008, The Institute of Healthcare Improvement outlined the ?triple aim? of healthcare to be improving the health of populations, enhancing patient experience of care, and reducing the cost of healthcare, but in 2014, this was expanded to include the health of providers. The ?quadruple aim? focuses on the necessity of ensuring the wellbeing of the provider in order to provide quality patient care. The thought is that the quadruple aim enables the triple aim, and emphasizes the value of wellbeing initiatives, linking provider wellbeing with quality of patient care. Attention to provider wellbeing has been called for at both the local and national levels.9 The Accreditation Council for Graduate Medical Education (ACGME) now requires residency and fellowship programs to attend to trainee wellbeing and provide the structure, environment and resources to evaluate and address burnout in order to develop caring and resilient physicians. 10,11 Nursing's core competencies and standards of practice and essentials include recognition of the relationship between self-care and delivering quality patient care. 12,13 The American Nurses Association launched a national movement in 2017 to transform the nation's health by improving the health and wellbeing of nurses.14 As such, a re-imagined and re-vitalized primary health care system would support improving health outcomes across populations (patients and providers) while reducing barriers to care such as low health literacy, cost and access, particularly among the medically underserved. 15-18 The authors would like to thank the site leaders and participants at the pilot sites for supporting and collaborating on this project. We would also like to thank Irene Sandvold, DrPH, FACNM, FAAN, our HRSA project officer for her support and guidance on this project, Paula Cook for project coordination and data management assistance, Robert Rhode, PhD for contributions to the curriculum content and Integrative Health competencies development process, the Andrew Weil Center for Integrative Medicine web team for programming and delivering the online content and providing technical support, and Janice Curtis for assistance with manuscript preparation. This project is/was supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under Grant Number UE1HP27710 National Coordinating Center for Integrative Medicine for $2,029,411. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.The authors would like to thank the site leaders and participants at the pilot sites for supporting and collaborating on this project. We would also like to thank Irene Sandvold, DrPH, FACNM, FAAN, our HRSA project officer for her support and guidance on this project, Paula Cook for project coordination and data management assistance, Robert Rhode, PhD for contributions to the curriculum content and Integrative Health competencies development process, the Andrew Weil Center for Integrative Medicine web team for programming and delivering the online content and providing technical support, and Janice Curtis for assistance with manuscript preparation. This project is/was supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under Grant Number UE1HP27710 National Coordinating Center for Integrative Medicine for, 029,411. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.

Funding Information:
This project is/was supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under Grant Number UE1HP27710 National Coordinating Center for Integrative Medicine for $2,029,411. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.

Keywords

  • Integrative health
  • Interprofessional education
  • Online education, healthcare provider wellbeing

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