An interview with Mike Fischer, MD, MS, Director & Founder, NaRCAD

When our community comes together, we get back to the essence of why we do the work we do: building trust with clinicians and their patients.

Join us as we chat about the magic of our annual international conference, with this year's 13th annual just around the corner.

You'll hear from our director and founder, Mike Fischer, about the importance of this annual event, a sneak peek of what's on the menu, and what the bottom line of good detailing and relationship-building is all about: trust. Stay tuned 'til the end for an opportunity to get free registration at this year's event.



"We have people from all different parts of the country [...] from city health departments, state health departments, private healthcare systems, nonprofit organizations that promote health topics, rural health departments...each of them is going to have a unique story to tell about how they do academic detailing." 

​Click here for the audio transcription.

When I was younger, I used to think "provenance" referred to a lovely part of southern France, or maybe to a divine presence that was watching over us all the time. Then I learned it actually means the source of something: a work of art, a book, perhaps an idea. And that such provenance has two key dimensions: how rigorous is the information on which it’s based, and who is trying to purvey that art or idea to a potentially unsuspecting customer.
 
For decades, my colleagues and I – at NaRCAD, Alosa, and throughout the global academic detailing community – have obsessed over issues of provenance in trying to develop the very best messages we could about the benefits and risks of medications: Where was that study published? Who did the work?  And by far the most important: How rigorous was its methodology?

Like-minded evidence synthesizers around the world would focus on confidence intervals, effect sizes, control groups, and clinical implications, trying to boil down these complex and often delicate ideas to help busy clinicians do the best job they could in making therapeutic decisions for and with their patients.

Then came 2025, and the nation went through the looking glass.  Legally constituted laws were overridden, constitutional rights were no longer sacrosanct, official budgets turned out to not really be budgets after all. In our world, some of the most basic principles of medical science describing the effectiveness and harms of medical products got tossed aside at the highest levels of government. In statements that would have seemed familiar to George Orwell, in discussing topics from vaccines to mifepristone federal and state officials could in fact declare that 2 + 2 = 5. We should have seen this coming years ago, when a presidential spokesperson introduced the toxic concept of “alternative facts,” or the nation’s most widely-watched news channel got caught repeatedly lying about imaginary plots to rig voting machines.
 
Truth just isn’t what it used to be.  For our community of academic detailers, that’s a problem, and an opportunity.

As we’ve seen, autism has become a focal point for medical product disinformation. Citing a very thin evidence base that none of us would consider reliable, senior administration officials recently declared leucovorin to be a promising treatment for this challenging condition. And the chief of the nation’s health apparatus, with no training at all in science, continued to claim that vaccines cause that condition, while the President himself blamed it on a mother’s use of acetaminophen during pregnancy – a contention that was as cruel as it is baseless. This is what medical risk-benefit communication has come to in 2025.

Paradoxically, this loss of respect for rigorous evidence comes as both bad news and good news for evidence-based academic detailing. Bad news, of course, because overworked primary care clinicians now have to spend precious time they don’t have on new conversations like, “No, Mrs. Jones, little Jimmy’s autism is not your fault,” and explaining that mifepsristone is an effective way to terminate a pregnancy, and vaccines are among the safest and most effective treatments we have to offer, even if the Surgeon General of one state (Florida) is now moving to abolish mandates for their use in children.

​The situation at present is much healthier in countries where evidence-based medicine and unbiased educational outreach aren’t at risk of being mowed down by demagoguery and autocracy-defined science. But even our international colleagues shouldn’t become too complacent; a year ago I never would have expected these grotesque distortions to have become entrenched so quickly here, either.

So where’s the good news? The current chaos makes what we do even more vital, and even more precious. Just as sources of nutritious food and clean water are most needed when people are hungry and surrounded by contaminated slop, a pure source of information untainted by ideology or junk science is even more valuable when people are getting constantly spammed by medical untruths. If it ever were to happen that randomized double-blind trials (an increasingly quaint concept) do one day show that leucovorin cures autism, I know our academic detailing community would be out there educating people about its proper use. And if there is solid epidemiologic evidence that perhaps healthy young people don’t all need constant Covid boosters (which may well be true), we’ll be out there saying that too. 

Unlike our leaders in Washington, our academic detailing programs will continue to encourage evidence-based medical policies, not policy-based medical evidence. As NaRCAD has been saying for years, we’re just ambassadors of the best data, wherever that leads. And at a time of rampant disinformation, that will be more important than ever.

Read more of Jerry's recent media pieces here:
​
"Corporate support cannot make up for threats to the NIH budget: Pharmaceutical money comes with strings"  Stat10 | October 22, 2025
 
WBUR's OnPoint Podcast: Will TrumpRx Actually Lower Drug Prices? On Point with Meghna Chakrabarti, featuring Jerry Avorn, MD | October 16, 2025

A conversation with Vishal Kinkhabwala, MD, MPH, Training Consultant & Expert Facilitator

Being a successful detailer is about so much more than conveying good evidence, or reaching the most clinicians. 

Come and chat with Vishal Kinkhabwala, MD, MPH, a Training Consultant and Expert Facilitator at NaRCAD, as he drops wisdom nuggets about the importance of camaraderie, deep listening, being of service, building rapport, and approaching clinicians as "just a new friend I haven't met yet."  Vishal shares his experiences as a detailer in the area of infectious disease prevention, his tips for building relationships, and the importance of true presence, not "acting like you're listening."

A great episode to tune into for new and veteran detailers alike, and anyone who wants to learn more about the impact of 1:1 clinical outreach education visits in clinicians' own frontline environments.

​Click here for the audio transcription.

Biography: Learn more about Vishal on the Our Team Page.

A conversation with Paul Fanikos, RPh, MPA/HA, COO, Alosa Health, hosted by Bevin Amira, Deputy Director, NaRCAD

Making sure older adults receive a holistic, evidence-based approach to care: learning from Alosa Health.

On our August 2025 episode, we chat with Alosa Health's COO, Paul Fanikos, RPh, MPA/HA, about all things detailing, with a focus on Alosa's recent campaign to support older adults, their providers, and their caregivers in managing the challenges of dementia and Alzheimer's with care, compassion, and connection to the best evidence, resources, and community supports.

Paul shares his insights into the importance of caring for older patients with such complex needs by recognizing that their clinicians and caregivers have equally complex challenges.

Tune in for a conversation that highlights a critical detailing campaign that expertly bridges the best guidelines for care with the humanity, patience, and kindness that must be present when supporting older patients who need memory care.

​"And then what we DID notice, most importantly, were the caregiver resources for patients and also aligning them to local resources that are inexpensive or low cost. And that was something that was incredibly valuable to prescribers and their offices and others, and obviously families. It's a tough disease. It progresses. And to do that in a way that's with dignity for older adults."
-Paul Fanikos, COO, Alosa Health

​Click here for the audio transcription. ​

Host: Bevin Amira, Deputy Director, NaRCAD

A conversation with Zack Jenio, Program Manager, Mile High Behavioral Health/"Dr." Zacharina Jenny-hoe, Drag Queen

Join us for the tea on how to interweave public health initiatives into artistic spaces where community members feel safe, seen, and understood. Zack Jenio, Program Manager of Mile High Behavioral Health in Denver, Colorado, who also hails as Drag Queen Dr. Zacharina Jenny-hoe, discusses the impact of meeting patient needs by bringing harm reduction, including HIV prevention tools and naloxone, to performance spaces.

We also discuss challenges queer patients face in primary care clinics where trust can be unintentionally eroded by stigma; the allure of drag as a celebration of femininity and glamour; and the ways that clinicians can start thinking creatively about patient needs, identity, and access to care--OUTSIDE of the traditional healthcare space. 

​
Click here for the audio transcription.

"It liberates you as a person to be able to learn more and be open to learning more.
​And I think that's the first part. The second part is, and it's something that I always talk about with harm reduction principles: providing resources and care in a non-judgmental, noncoercive way is what's so important."
​
-Zack Jenio/Zacharina Jenny-hoe
Mile High Behavioral Health

Biography.
F. Zack Jenio (any pronouns)
Program Manager, Mile High Behavioral Healthcare
Zack Jenio is the Program Manager for Bee the Vibe, a harm reduction program of Mile High Behavioral Healthcare in Denver, CO. His work in harm reduction lies at the intersection of safer-sex/safer-drug use and Queer communities, ensuring that LGBTQ+ people have access to resources and education to live safer lives. Zack also works as a local drag queen in Denver as Dr. Zackarina Jenny-hoe (not a doctor) in order to bring his harm reduction advocacy into the LGBTQ+ community through the camp and glamour of drag. She organizes and hosts drag events where audiences can get naloxone or STI testing and watch a fun show. She also trains other local Colorado drag artists in prevention principles to create a health advocate network of Queer harm reductionists!

Host: Bevin Amira, Deputy Director, NaRCAD

A conversation with Rocko Cook, Public Health Detailers & Program Manager, Detailing Improved Sexual Health (DISH), Arizona State University 

​Tag: Podcast Series, Evidence Based Medicine

We can't talk about HIV without talking about sex and drugs.

 In this episode, we connect with Rocko Cook, whose over 30 years in the field of HIV prevention, care, and community-building give us insights into the best ways to the best ways to communicate with patients and clinicians alike. Rocko shares their story of learning about their own HIV+ status; unique projects that meet people "where they're at", including HIV testing in bathhouses; and the importance of partnering with clinicians as a consultant, partner, and advocate of patients.

Learn more about DISH-AZ and the work they do.

​
Click here for the audio transcription.

Biography. Rocko Cook serves as the Program Manager for DISH-AZ (Detailing for Improved Sexual Health in Arizona), a program of the Office of Evaluation and Partner Contracts for the Southwest Interdisciplinary Research Center (SIRC) at Arizona State University in partnership with Arizona Department of Health and Human Services. Rocko began working in the field of HIV in 1994 and is a community leader with over 15 years of experience implementing prevention and care programs in Arizona, Ohio, and Kentucky. In addition to his duties as a program manager, Rocko has served as a public speaker, presenter at local and national conferences, and as a consultant and leader for HIV community planning groups. Rocko has been living with HIV since 2002 and is passionate about improving sexual health for all communities.

Host: Bevin Amira, Deputy Director, NaRCAD

A conversation with Jerry Avorn, MD, Co-Founder and Special Adviser, NaRCAD

​Tag: Podcast Series, Evidence Based Medicine

How do we stay the course and stay rooted in facts amidst a major disruption impacting the healthcare landscape?

"Godfather" and originator of academic detailing Jerry Avorn joins the show to share his reflections on the current state of healthcare; the history of treatment and medications prior to rigorous study; his new book, Rethinking Medications; the critical importance of treating evidence, facts, and science as our collective North Star; and where we can look to a future where there is hope of correcting our course back towards the kind of evidence-based clinical care and health policy that we need, now more than ever!

Visit rethinkmeds.info to connect with other Rethinking Medications readers, listeners, and thinkers, and check out the 2025 academic detailing systematic review mentioned in this episode, along with one from 2007.

(Click here for the audio transcription.)

"I'm hoping [...] that we will at some point, when we look back maybe a year from now, at the havoc that is being created on a daily basis in terms of our healthcare system, in terms of sowing doubt about treatments that work, about taking away coverage for things that are actually helping people, particularly disadvantaged populations." 

-Jerry Avorn, MD

​Jerry Avorn, MD (he/him)
Co-Founder & Special Adviser, NaRCAD
​Dr. Avorn is Professor of Medicine at Harvard Medical School and Chief Emeritus of the Division of Pharmacoepidemiology and Pharmacoeconomics (DoPE) at Brigham & Women's Hospital. A general internist, geriatrician, and drug epidemiologist,  he pioneered the concept of academic detailing and is recognized internationally as a leading expert on this topic and on optimal medication use, particularly in the elderly. Read more.


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Host: Anna Morgan-Barsamian, MPH, RN, PMP, Senior Manager, Training & Education, NaRCAD

A conversation with Bevin Amira, Deputy Director, NaRCAD
​
​Tag: Podcast Series, Evidence Based Medicine

How can public health professionals stay resilient and connected
​when the landscape is shifting beneath their feet?

In this episode, Anna Morgan-Barsamian passes the mic to Bevin Amira, NaRCAD’s Deputy Director and interim host, for a conversation on navigating devastating public health funding cuts and the rising spread of misinformation. Together, they explore how detailers can stay grounded in evidence, sustain meaningful relationships with clinicians, and lean into the power of community during challenging times.

*Stay tuned until the end for a special discount to NaRCAD’s upcoming AD Virtual Summit!

(Click here for the audio transcription.) 

Bevin directs NaRCAD’s communications and strategic partnerships, building collaborations with public health leaders at the national and federal level. With career experience in building learning communities to increase engagement and sustainability, Bevin has expertise in creating interactive, interdisciplinary training curricula at healthcare-based non-profits. In collaboration with the dynamic NaRCAD team, Bevin facilitates NaRCAD's virtual and in-person learning sessions to encourage hands-on skill development and best practices sharing amongst peer programs. Read more.

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Host: Anna Morgan-Barsamian, MPH, RN, PMP, Senior Manager, Training & Education, NaRCAD

A conversation with Maggie Kaufmann, MPH, MA, Director of Harm Reduction Programs, University of Illinois Chicago
​
​Tag: Podcast Series, Evidence Based Medicine, ​Harm Reduction

How can harm reduction strategies not only save lives but also challenge stigma and transform communities?

In this episode, Maggie Kaufmann, Director of Harm Reduction Programs at the University of Illinois Chicago dives deep into harm reduction strategies, exploring how these evidence-based approaches save lives, combat stigma, and integrate with academic detailing projects. Maggie shares insights on transformative and creative harm reduction initiatives, including drug checking, mobile medications for opioid use disorder (MOUD) services, overdose prevention sites, and community-based education in local theaters. Tune in for a compelling conversation on the evolving landscape of harm reduction and its impact on public health. 

​If you have any questions about integrating harm reduction into academic detailing projects, please contact Maggie at [email protected].

(Click here for the audio transcription.) 

Maggie has been with the Community Outreach Intervention Projects (COIP) at University of Illinois Chicago for almost ten years in several roles including overseeing both research studies and service provision for People Who Use Drugs (PWUD). She brings with her expertise in harm reduction, hepatitis C prevention interventions, case management/recovery support and clinical capacity building. She earned her Master of Public Health and Master of Arts in Anthropology from University of Illinois Chicago (UIC), in 2014. Prior to her work with COIP she taught courses in anthropology at the undergraduate level with a focus on the effects of racism and other modes of discrimination on healthcare access and quality. Currently, she is the Harm Reduction Services Coordinator for COIP, Project Director for a NIDA-funded study evaluating an intervention to reduce opioid overdoses among those with criminal legal system involvement in Illinois, and Director of the NACCHO-funded, Harm Reduction Academic Detailing Project at UIC. She also has experience with provider education and clinical capacity building and regularly speaks to diverse groups in the health sciences around harm reduction and how to integrate these principles and practices into clinical settings. She is passionate about improving the health and wellbeing of PWUD and reducing stigma around substance use to increase access to nonjudgmental, person-centered care and supportive services.  

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Host: Anna Morgan-Barsamian, MPH, RN, PMP, Senior Manager, Training & Education, NaRCAD

A conversation with Tahirih McAleer, BSP, Academic Detailer, RxFiles Academic Detailing Program and Loren Regier, BA, BSP, Consultant Pharmacist, RxFiles Academic Detailing Program
​
​Tag: Podcast Series, Evidence Based Medicine

How do we navigate uncertainty in our conversations?

 Join us as we hear from our colleagues at RxFiles Academic Detailing Program as they share strategies for handling uncertainty. From balancing preparation with the inevitable "I don't knows" to practicing presence in both professional and personal settings, this episode offers insights into how detailers can make deeper connections and have more meaningful discussions. Tune in to learn how embracing discomfort can lead to growth and confidence.

(Click here for the audio transcription.) 

Loren is a Pharmacist and Consultant Editor with RxFiles Academic Detailing Service in Saskatoon, SK, Canada. Loren has guided the development of this provincial academic detailing service since the first “ground breaking” pilot project began in 1997. Loren is active as a member of the Canadian Academic Detailing Collaboration and provides training and consultation to various programs and initiatives. Loren’s interests cover the practical application of evidence to practice and the ongoing development of multifaceted interventions that support academic detailing. Additionally, Loren serves as a faculty facilitator for NaRCAD’s Academic Detailing Techniques trainings. Read more.

Tahirih graduated from the College of Pharmacy and Nutrition at the University of
Saskatchewan in 2015. Since then, she has been working in community pharmacies
in rural settings. She joined RxFiles as an academic detailer in 2018 where she
primarily visits rural health care providers. Tahirih is passionate about improving
accessibility to primary care practices. Outside of healthcare practices, Tahirih
and her husband run a mixed animal veterinary clinic alongside their 2 young
boys.​

​
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To state the obvious: it's a particularly challenging time to be working in evidence-based medicine. While rapid change is nothing new in clinical outreach education, we're facing a lot of wild unknowns as we head into 2025. When it's hard to see straight, or find the right motivation to forge ahead, a sense of community is critical support that can make what seems insurmountable a bit less daunting.

​At NaRCAD, we're particularly lucky--this community is especially empathetic, attuned, whipsmart, creative, and supportive. When one of us is struggling, we're right there with one another, sharing care, compassion, and perhaps the most vital ingredient of all: a sense of humor. (Yep, this community is hilarious.) So, how do we harness this energy as we commit to our work this year?

Host: Anna Morgan-Barsamian, MPH, RN, PMP, Senior Manager, Training & Education, NaRCAD

A conversation with Dr. Mike Fischer, Founder & Director, NaRCAD

​Tag: Podcast Series, Evidence Based Medicine

How can innovation and adaptation drive the field of academic detailing forward?

In this episode, Founder and Director Mike Fischer shares the importance of adapting the AD model to meet diverse needs and tackle emerging public health challenges. We discuss the uncertainty of the landscape that lies ahead, meeting it with hope that we can continue to explore new opportunities to improve clinical care. Join us as we discuss the growth of the NaRCAD community, highlighting its role in shaping the future of clinical outreach education.

 (Click here for the audio transcription.) 

Dr. Fischer is a general internist, epidemiologist, and health services researcher. He is Chief of the Section of General Internal Medicine at Boston Medical Center (BMC) and a Professor of Medicine at Boston University Chobanian & Avedisian School of Medicine. He practices primary care internal medicine at BMC’s safety-net clinic and supervises residents in both the outpatient and inpatient settings. With extensive experience in designing and evaluating interventions to improve medication use, he has conducted numerous studies demonstrating the potential gains from improved prescribing. In 2010 he and Dr. Jerry Avorn co-founded NaRCAD and since then he has led its growth and has published on the principles of academic detailing and its application to a range of clinical areas. Read more.

​
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Host: Anna Morgan-Barsamian, MPH, RN, PMP, Senior Manager, Training & Education, NaRCAD
A conversation with Mary Hightower, Regional Health Specialist
​Iowa Department of Health and Human Services

Tag: Podcast Series, HIV/AIDS

How can patient voices be incorporated into AD work to affect change?

Join us as we discuss how Iowa’s detailing program is addressing health disparities and combatting stigma in rural communities. Whether you work in public health, healthcare, or community advocacy, this episode provides practical strategies to elevate patient perspectives and inspire meaningful change.

 (Click here for the audio transcription.) 

Mary Hightower is a Regional Health Specialist with the Iowa Department of Health and Human Services, Bureau of HIV, STI, and Hepatitis. Her role involves building relationships with healthcare providers and community stakeholders to promote STI testing, treatment, and education. For the last eight years, she has connected stakeholders to resources for HIV, linkage to care, and encouraged PrEP uptake (Pre-exposure prophylaxis) while addressing stigma in rural Iowa. Before this position, Mary managed grants for the Southeast Iowa Adolescent Pregnancy Prevention Coalition and worked as a Health Educator at Planned Parenthood of the Heartland for eight years. She has 16 years of experience in infection prevention education and is pursuing a Master of Public Health, expected to be completed in August 2025.

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Host: Anna Morgan-Barsamian, MPH, RN, PMP, Senior Manager, Training & Education, NaRCAD

A conversation with Alexandria Stevenson, MPH, Academic Detailer, Florida Department of Health in Broward County.

​Tag: Podcast Series, Harm Reduction, ​Opioid Safety

​How can meaningful conversations impact the opioid crisis?

Academic Detailer Alexandria Stevenson from the Florida Department of Health in Broward County discusses her team’s important work on opioid safety and overdose prevention. Funded by the CDC's Overdose Data to Action Local Grant, Alexandria shares how her team collaborates with clinicians and community partners to promote harm reduction, distribute free naloxone kits, and educate the community.​

​(Click here for the audio transcription.) 

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​Alexandria M. Stevenson serves as the Lead Academic Detailer and Health Educator for the Overdose Data to Action (OD2A) LOCAL grant at the Florida Department of Health in Broward County. Since joining the Department in 2015, she has worked in various programs, including the AIDS Drug Assistance Program (ADAP) and Women, Infants, and Children (WIC), in Broward and Brevard counties. She also has interned at Office of Health Promotion and Education in Seminole County. Alexandria has been with Broward County’s OD2A-L initiative since 2020, where she has excelled as an academic detailer for the past two years. She holds a bachelor’s degree in anthropology from the University of South Florida and a master’s degree in public health from Rollins College.

It's no exaggeration to say that our annual conference is our team's favorite time of the year. The chance to connect with everyone who makes our community so uniquely vibrant creates a consistently infectious renewal of enthusiasm every year, without fail. "NaRCAD 2024: Envisioning Our Future: Growth and Innovation in AD” will be no different, and we hope you'll be with us as we celebrate!

This year's event takes creative AD approaches to the next level. AD programs from across the globe will share their important work on myriad topics, from opioid use disorder to gender-affirming care; from preventing detailer panic to encouraging clinician use of person-first language in support of patients who deal with highly-stigmatized conditions. You can take a peek at our agenda here and see what we've got planned for you!

​Presenters will lead you through key strategies for AD success such as smart data tracking, EMR alignment, and increasing your program's visibility through better marketing. And of course, AD originator and NaRCAD Co-founder Dr. Jerry Avorn will deliver his Annual AD Talk, bringing you his reliable brand of insights from the year in healthcare and his visions for the future of AD. 

We'll also be exploring key adaptations to the model itself. Successful programs will share their innovations in delivering detailing sessions to alternative target audiences, branching out beyond frontline clinicians to community-based organizations who also play a key role in supporting patient safety. Want to move around during your breakout? You'll get a chance to try medical improv with seasoned detailers who are also experts in the world of theatre! And our Global Perspectives session will feature successes and diverse approaches to AD from our colleagues in Japan, Norway, and Canada.

​We're so eager to spend two days with you. Whether you're with us in Boston this year, or joining us virtually, we're here to listen to your ideas, think about ways to put them into action, share your successes and challenges, and connect you with the brightest and most creative folks in our field. 

And we'll be leading the charge in keeping the energy of excitement alive as we all prepare for the year ahead--2025 will be packed with opportunities to learn new approaches to clinical outreach education, train your team in the nuances of persuasive communication, and build new relationships with clinicians who need your expertise to provide the best evidence-based care to the patients who trust them. 

See you in six weeks!
Bevin K. Amira
​Deputy Director, NaRCAD

*Be the first 15 blog commenters below and win a free registration to the in-person event!*

Host: Anna Morgan-Barsamian, MPH, RN, PMP, Senior Manager, Training & Education, NaRCAD

A conversation with Debra Rowett, PSM, BPharm, Adv Prac Pharm, FPS, Advanced Practice Pharmacist, Drug and Therapeutics Information Service 

​Tag: Podcast Series

​What lessons can three decades of AD teach us about adapting to change? 

Hear from Debra Rowett, an advanced practice pharmacist and academic detailing leader in Australia for over 30 years. Deb shares the origins of AD in Australia and how it has evolved to support health professionals across various therapeutic areas. She discusses the importance of building trusted relationships with clinicians, particularly in rural areas, and how her team has adapted to challenges through the years. Deb also highlights the future of AD, emphasizing co-design, collaboration, and the role of technology. Don’t miss her insights on how AD continues to evolve and make a meaningful impact on patient care.


​(Click here for the audio transcription.) 

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Debra Rowett PSM, BPharm, Adv Prac Pharm, FPS, has led an academic detailing team for over 20 years and is a member of the team which designed, developed and delivered the “Best Practice in Educational Visiting” training for academic detailers in Australia and has provided consultancies to international academic detailing programmes. Debra is an experienced academic detailer with expertise in designing, developing, training, implementing and evaluating academic detailing programmes. Debra has served as the President of the Australian Pharmacy Council and President of the Council of Pharmacy Schools. Debra has worked extensively in the area of quality use of medicines, inter-professional practice, policy and health workforce development in Australia. Debra is a member of the national Drug Utilisation Sub-Committee of the Australian Pharmaceutical Benefits Advisory Committee (PBAC).

Curated by: Aanchal Gupta, Program Coordinator, NaRCAD

Tags: ADvice, HIV/AIDS, Sexual Health, Gender-Affirming Care
 
In this edition of our AD-vice series, we delve into the critical role of community partnerships, approaches to address stigma, and evidence-based practices in HIV prevention and sexual health, empowering clinicians and patients to work together to make informed health decisions.

BUILDING RELATIONSHIPS & PARTNERSHIPS

• “We send out a Weekly Special [newsletter] with a buffet of options on new evidence and information related to HIV prevention and care. We’re creating an active and robust network of professionals!” – Rocko Cook, DISH-AZ

 

• “It’s important to build a relationship with your state’s health department leadership and obtain an official endorsement letter from the state supporting your activities. Establishing a relationship not only positively impacts your program’s visibility and ability to gain access to clinicians, but it also helps to make sure you're aware of other outreach initiatives.” – Ashley Allison, Oregon AIDS Education and Training Center

 

• “When I'm talking to providers, one of the things I hear most is, ‘I wish I had other providers to talk to about gender-affirming care.’ A big part of what we do with academic detailing is connect other providers together.” – Ryan Anderson, DISH-AZ

ADDRESSING STIGMA

• “Whenever I address something uncomfortable with a provider, stigma or otherwise, I try to create an environment where we can work collaboratively on the issue and the provider feels as though I am a resource for them.”  – Jess Alward, MS, State of NH

 

• “In order to talk about PrEP, you first have to talk about risks for HIV, which often means talking about sex. I think there can be discomfort on both the patient and provider side, and sex is often still a stigmatized topic. There are also overarching resource barriers, including the fact that clinicians are extremely busy and have to address competing health needs in the primary care setting.” – Alyson Decker, NP, MPH, San Francisco Department of Public Health

 

• “All clinicians and staff need to be able to communicate with patients in a sex-positive way and in a way that connects with patients’ specific experiences, identities, and needs. They need to be comfortable communicating about sexual behavior, testing, and PrEP.” – Rocko Cook, DISH-AZ

 

• “Racial and ethnic minorities continue to be underrepresented in PrEP utilization and overrepresented in new HIV diagnoses, and I want my work to contribute to correcting this. I think PrEP can be a tool for health justice and being part of that is valuable to me.” – Mary Nagy, MPH, RN/BSN, Michigan Department of Health and Human Services

BEST PRACTICES, FLEXIBILITY & ADAPTABILITY

• “Providers were asked which supports would best help them to incorporate PrEP into their practice, and ‘education’ was by far the most frequent answer. In addition to the research I’ve seen indicating detailing is an effective intervention to change provider behavior, it's clear that the providers themselves agree that education is important.” – Mary Nagy, MPH, RN/BSN, Michigan Department of Health and Human Services

 

• “There are many places where 1:1 visits aren’t feasible due to clinic structure or culture. If I’m able to detail to a small group, it can be a way to meet with a few providers and gain insight about how PrEP might be incorporated or enhanced in their setting.” – Alyson Decker, NP, MPH, San Francisco Department of Public Health

The insights shared by experts highlight the power of partnerships, approaches to address stigma, and evidence-based practices in creating meaningful change and positively impacting patient outcomes. Explore our revamped HIV Prevention Toolkit for more tools and resources.
 
Best,
The NaRCAD Team

Host: Anna Morgan-Barsamian, MPH, RN, PMP, Senior Manager, Training & Education, NaRCAD

A conversation with Jacki Travers, PharmD, Clinical Pharmacist, Pharmacy Management Consultants

​Tag: Podcast Series, Cardiovascular Health, ​Diabetes

​How can we ensure that community partnerships are front-and-center in improving patient health? Pharmacist, detailer, and trainer Jacki Travers shares insights into a five-year collaboration with the Oklahoma State Department of Health aimed at reducing health disparities related to diabetes and cardiovascular disease. This project empowers local populations by partnering with safe spaces at the heart of communities, inviting libraries, faith-based organizations, and community health workers to work in harmony with detailing to reduce health disparities and increase patient access to care, resources, and support.

​(Click here for the audio transcription.) ​

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Jacki Travers is a clinical pharmacist with Pharmacy Management Consultants (PMC), a division of the University of Oklahoma College of Pharmacy. Since 2015, she has led the PMC academic detailing program. Her AD efforts are primarily in service to Oklahoma Medicaid providers, who in turn care for some of the state’s most vulnerable population. She has served as a training facilitator for the NaRCAD Academic Detailing Techniques trainings since 2019.

Since earning her Pharm.D. degree from the University of Oklahoma, she has served in the practice settings of independent, hospital, and clinical pharmacy. She currently develops detailing materials, delivers detailing services, and analyzes program results for multiple topics as part of a statewide plan. Her program efforts focus on bridging the gap between information and application in order to provide quality health care in a fiscally responsible manner.

Olivia Halle, Public Health Intern, NaRCAD

Tags: Harm Reduction, Health Disparities, Stigma, Substance Use

How do we begin to repair these complex harms? Harm reduction is an effective direct response to the rise of drug use and seeks to well equip people who use drugs with life-saving tools and information, and the emergency medical setting can be an access point to those services. Emergency clinicians are often the main point of care for people who use drugs or experience housing instability. By using a strategy like academic detailing (AD) within the emergency medical setting, trained public health educators can encourage emergency medical staff to integrate harm reduction as a critical tool to increase safety for people who use drugs. 

Detailing would raise awareness and give hope to people with OUD by providing destigmatized access to care, leading to fewer overdoses. AD can also provide the necessary education in equipping emergency clinicians with person-first language. When many people who use drugs have little trust in the healthcare system, it is vital for emergency clinicians to lead with compassion when caring for people who use substances.

Connecting people who use substances to harm reduction services not only ensure safe practices in the person seeking out harm reduction services, but enable a sense of agency that often fades when experiencing housing instability. Increased referrals from emergency clinicians to harm reduction services would support people who use drugs in living safer lives, increasing community connection, trust in the healthcare system, and a greater sense of dignity. ​

Funding these relatively inexpensive interventions is critical. In 2023, the city of Philadelphia announced that $7.5 million dollars from national opioid settlement funds would be directly funneled into Kensington’s schools, parks, foreclosure prevention, and rental assistance. These services, which can be accessed through Co-Creating Kensington, in conjunction with harm reduction services such as Prevention Point Philadelphia on Kensington Avenue, would help to destigmatize home insecurity and drug use when paired with AD. While $7.5 million dollars will barely scratch the surface of what is owed to the Kensington community, it will begin to mobilize reparations. 
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The people of Kensington, Philadelphia deserve better. They deserve access to harm reduction services and OUD treatment with the full support of the city behind them. By continuing to fund community-directed services, along with academic detailing and harm reduction, city officials can take these first steps to begin to repair harm and restore agency, security, and hope to the people of Kensington. 

Biography. Olivia is a summer intern helping the NaRCAD team through providing feedback and support on usability of NaRCAD’s online materials and training sessions. She also aids the NaRCAD team through conducting literature reviews along with organizing and collecting data for online toolkits covering critical academic detailing areas.

Olivia is an incoming sophomore at the University of Washington studying public health gaining exposure to the field through her summer internship at NaRCAD. Olivia provides insight into how academic detailing and other evidence-based public health research can be more digestible to a greater audience. Olivia enjoys reading and practicing yoga in her spare time.

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Curated by: Aanchal Gupta, Program Coordinator, NaRCAD

Tags: ADvice, Evaluation, Data
 
In this edition of our AD-vice series, we explore the importance of data collection, program evaluation, and leadership buy-in for AD programs. Gathering and analyzing data not only helps in understanding the challenges faced by clinicians, but also in driving meaningful change by demonstrating the impact of your detailing efforts. Read insights from experts in the field on planning and executing your AD program evaluations.

PRACTICE TOOLS & STRATEGIES FOR DATA COLLECTION

• "For a resource-constrained department, having that one-page Word document that allows detailers to chart their interactions is more than enough data. Charting for just five minutes after a detailing visit about everything that took place becomes a wealth of information. You can also use an Excel document to input data from provider surveys." -Kristefer Stojanovski, PhD, MPH, San Francisco Department of Public Health

 

• "When I’m detailing on one topic, I’m always thinking about future topics by gathering data from providers so that I can better understand their challenges. I ask providers their biggest concerns and I’ve been really surprised at how ready they are to share gaps in resources and information."

            -Jacki Travers, PharmD, Pharmacy Management Consultants

• "For every campaign, we conduct an initial and follow-up visit where we assess providers’ practices. This allows us to see if there has been a change in practice from the initial to the follow-up visit. Additionally, we rate what providers intend to adopt in terms of the key recommendations, supporting tools, and resources. We also collect a large amount of qualitative data because it's also critical to gain a more complete picture of the campaign’s success, especially when reporting on barriers, access, and materials." -Michelle Dresser, MPH, New York City Department of Health and Mental Hygiene

MAKING THE CASE TO LEADERSHIP & FUNDERS

• "It’s important to track a mix of quantitative and qualitative data, and the critical components that should be tracked are the outcomes and the process of detailing. Data is absolutely critical for getting leadership buy-in, especially if it can tell a story." -Kristefer Stojanovski, PhD, MPH, San Francisco Department of Public Health

 

• "It’s always been useful for us to evaluate and publish our results, especially when we approach the government for more funding. While we can’t do every campaign as a research project, I’ve been working on evaluating a campaign we did on diabetes and also a study on the impact of group visits vs. 1:1 detailing." -Harald Langaas, MPharm, MPH, KUPP - RELIS

 

• "It would be a strong statement if someone was able to go to leadership with a story about how providers have changed their practices. Using concrete results and showing leadership that detailing is making a change is extremely helpful for buy-in." -Kristefer Stojanovski, PhD, MPH, San Francisco Department of Public Health

IMPACT & VALUE OF EVALUATION 
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Key Insights from Melissa Christopher, PharmD & Mark Bounthavong, PharmD, MPH, VA Pharmacy Benefits Management Academic Detailing Services
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• "Measuring program work builds a case not just for the success of one academic detailing intervention, but for the success of future programs--a case for sustainability. Evaluation measures the quality of a program, analyzing results to look at a program’s impact, and allowing for process improvement adjustments to be made to streamline efforts and strengthen that impact. Evaluation cannot be optional, especially when lives are at stake."

 

• "Leveraging results from well-designed evaluation is essential for academic detailing interventions to illustrate success, share value, and provide stakeholders and community members with a clear ‘Yes!’ in answer to their overarching question: ‘Was the investment worth it?’"

 

• "We encourage other academic detailing programs to prioritize program evaluation as we have at the VHA—no matter the size of your program, if you’re thinking, ‘we can’t afford to do program evaluations,’ we stress that you can’t afford NOT to do them."

For additional information, check out our AD Evaluation Toolkit for guides on planning an evaluation intervention, adaptable surveys, detailing visit tracking sheets, and more!
 
Best,
The NaRCAD Team