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Olivia Halle, Public Health Intern, NaRCAD Tags: Harm Reduction, Health Disparities, Stigma, Substance Use  What do we owe to people who have been stigmatized due to circumstances beyond their control? The people of the historically redlined neighborhood of Kensington, Philadelphia come to mind, having been stigmatized for too many reasons: their race, their socioeconomic status, and an increased access to drugs in their neighborhood. As drugs become more potent, such as the synthetic opioid, fentanyl, and the sedative, xylazine, more people have been severely affected by opioid use disorder, and the people of Kensington are no different. But where this neighborhood’s circumstances differ is that they have been victimized by city officials who have capitalized on the stigma of drug use in order for financial benefit. City officials owe it to the people of Kensington to allocate the necessary resources and funds to help reclaim their neighborhood. The city government gentrified Kensington by pushing the people with chronic substance use disorders who are experiencing home insecurity onto Kensington Avenue. This engendered an open air drug market with hundreds of people actively using drugs such as fentanyl and xylazine, better known as “tranq”. The redlining of Kensington has led to low owner occupancy, the lowering of property value, increased segregation, and an overall lack of financial resources injected into the community. The dehumanization of the people that are experiencing unstable housing, a portion of those due to the chronic use of substances, has resulted in this gross and condoned mistreatment by city officials, who capitalized on this situation in order to reduce surrounding property values. It is those same officials who sought to capitalize on vulnerable people that must be the ones to find compassion and recognize that the people of Kensington Avenue are their neighbors too.  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.  The people of Kensington gathering to support increased funding in their neighborhood. ©Co-Creating Kensington https://www.kensingtonplan.org/ 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. 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. 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
 MAKING THE CASE TO LEADERSHIP & FUNDERS
 IMPACT & VALUE OF EVALUATION Key Insights from Melissa Christopher, PharmD & Mark Bounthavong, PharmD, MPH, VA Pharmacy Benefits Management Academic Detailing Services
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
Host: Anna Morgan-Barsamian, MPH, RN, PMP, Senior Manager, Training & Education, NaRCAD
A conversation with Ryan Anderson, Academic Detailer, DISH-AZ, Arizona DHS Tag: Podcast Series, Gender-Affirming Care How can we ensure that every patient feels respected throughout their healthcare journey? Learn about the crucial importance of gender-affirming care and how AD can promote respectful, patient-centered healthcare for gender-expansive individuals. Listen to Ryan’s impactful personal story and vision for the future of gender-affirming care. (Click here for the audio transcription.) 
Ryan Anderson serves as an Academic Detailer 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 the Arizona Department of Health and Human Services. Ryan worked as a microbiologist for 9 years in manufacturing settings and has quality assurance experience in clinical settings. In addition to professional experience, Ryan has 14 years of experience volunteering with organizations that serve the LGBTQ+ community. Ryan is passionate about improving health outcomes for those in the LGBTQ+ community.
Additional Materials from DISH-AZ: MSM Syphilis Toolkit Gender Expansive Care Toolkit Congenital Syphilis Toolkit
Moderated By: Bevin K. Amira, Deputy Director, NaRCAD
A live interview from the 2024 AD Virtual Summit with Carla Foster, MPH, Epidemiologist at NYC Department of Health and Mental Hygiene (NYC DOHMH) and Sarah Popish, PharmD, BCPP, Clinical Program Manager at the VA Pharmacy Benefits Management Academic Detailing Services. Tag: Podcast Series In this episode, join us for our "Leadership Spotlight" at the AD Summit where Bevin Amira moderates a session featuring experts Carla Foster and Sarah Popish. They discuss the barriers to health equity, the importance of patient trust in healthcare, and the power of inclusive practices. Hear their insights on the importance of examining language, racialization, and individual biases in order to commit to authentic and effective anti-racist efforts. You don’t want to miss this thought-provoking session! Click here for the audio transcription. 
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By: Anna Morgan-Barsamian, MPH, RN, PMP, Senior Manager, Training & Education, NaRCAD
A conversation with Emmeline Paintsil, PharmD, MSLD, BCPS, Director of Professional Affairs, Iowa Pharmacy Association Tag: Podcast Series Harm reduction is an impactful approach to empower people who use drugs (and their families) to live self-directed and healthy lives. In this episode, we speak with pharmacist Emmeline Paintsil, who delves into her team's innovative academic detailing project focused on harm reduction. Join us as we explore the impact of providing nonjudgmental care, building trust with patients, and advocating for harm reduction strategies. Click here for the audio transcription. 
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Curated by: Aanchal Gupta, Program Coordinator, NaRCAD Tags: ADvice, Harm Reduction Harm reduction has gained significant traction, especially as an area of focus in AD, with campaigns encouraging clinicians to provide preventive care, discuss harm reduction services with their patients, and connect their patients to related community initiatives. In this edition of AD-vice, we explore the evidence supporting harm reduction strategies, the broader approach that shifts the narrative from stigmatization to inclusivity, and the crucial role of clinician-patient communication.  EVIDENCE & IMPACT OF HARM REDUCTION STRATEGIES
 HARM REDUCTION APPROACH
 CLINICIAN-PATIENT SUPPORT & COMMUNICATION
We hope these insights inspire you to consider harm reduction approaches in your detailing work. If you’re interested in learning more, join us at our 2nd annual AD Virtual Summit where we will dive into these areas further!
Best, The NaRCAD Team
By: Anna Morgan-Barsamian, MPH, RN, PMP, Senior Manager, Training & Education, NaRCAD
A conversation with Bevin Amira, Deputy Director, NaRCAD. Tag: Podcast Series
How can we change the minds of clinicians? Tune in for an insightful conversation with our NaRCAD team members Anna Morgan-Barsamian and Bevin Amira as they discuss the impact of public health detailing programs across the country. Get the inside scoop on what we do here at NaRCAD and how the AD field continues to evolve, with campaigns focusing more and more on harm reduction and collaborative, community-wide initiatives! Click here for the audio transcription.
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By: Anna Morgan-Barsamian, MPH, RN, PMP, Senior Manager, Training & Education, NaRCAD
A conversation with Julia Bareham BSP, MSc, Pharmacist, RxFiles Academic Detailing Service Tag: Podcast Series
How does teaching others encourage us to evolve as health educators? Today we're chatting with expert trainer Julia Bareham as she reflects on providing structure and a personalized approach to training new detailers, resulting in her own professional and personal evolution. Click here for the audio transcription.
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By: Anna Morgan-Barsamian, MPH, RN, PMP, Senior Manager, Training & Education, NaRCAD
Tag: Podcast Series
Introducing the Changing Minds podcast! Dive into conversations with experts and thought leaders from around the world as you join our growing community of listeners committed to advancing the field. Each episode is packed with insights and actionable tips to inspire you on your AD journey!
Listen to Episode 1 to hear from two of our expert detailers, Jess Alward & Chirag Rathod, as they share about the impact of improv. We'll discuss how it can be used to shift communication and how detailers can incorporate these skills into their work. Click here for the audio transcription.
Resources on Medical Improv:
Want more? Check out our Podcast Series page!
 Critical topics our community is working on. (NaRCAD's Annual Community Survey.) Bevin Amira, Deputy Director, NaRCAD To say that health disparities are rampant is not new information to any of us in the field of improving patient outcomes. Our community of educators have much to think about as we prepare to meet with clinicians who care for patients across a spectrum of care needs, patients whose care access correlates directly to their socioeconomic status, the diseases and conditions they're dealing with, and whether or not they feel able to trust that their care providers really DO care about their needs. Can patients afford the prescriptions we're encouraging clinicians to offer? Are the patients who need cancer screenings most able to find transportation to a clinic? Will patients fear being shamed or unheard about their experiences and needs? "Health disparities" and "social determinants of health" aren't just trendy phrases that we should be conversational in--they're lenses through which we MUST consider every key message we deliver within every detailing intervention we implement. How do we do this and do it well, especially when things feel more urgent than ever? It may seem counterintuitive, but our first piece of advice is to hit the PAUSE button. That's right--at NaRCAD, we're urging clinical educators to pause, zoom out from clinical care, and make sure you're looking at these three key areas: -THE PATIENT VOICE: What do patients in my community want and need? (How will I know?) -MY COMMUNITY'S IDENTITY & STRENGTHS: What is the community already doing around this issue? -BEING A STRONG COMMUNITY PARTNER: How can I connect my detailing work to other community initiatives to maximize impact and forge community bonds?  These questions must be considered before you detail if you want to have a sustainable, positive impact. While our field is a niche area, quality improvement cannot happen in a bubble. Our work is only as strong as our ability to think about the entire chain of relationships that exist, all the way down to the patient who is receiving the care the evidence says they should be receiving.
As we move into the year ahead, we're more dedicated than ever to helping you all ask these nuanced questions and recognize that even programs with low resources can find ways to incorporate patient reflections and community buy-in into their campaigns. We're here to teach you how to navigate these areas with care, curiosity, and passion--because each one of us became invested in healthcare improvement out of a sense of dedication to patients receiving the best care possible. Join us, and keep telling us what you want and need. We'll be hosting more community conversations, strategy sessions, check-ins, one-to-one role plays, trainings, convenings, and connections to other experts in the field, inviting you all to share what you've experienced as you work creatively to improve care.  Jerry Avorn, M.D. Co-Founder & Special Adviser, NaRCAD Tags: Evidence Based Medicine, Jerry Avorn Following the astonishing debut of AI applications like ChatGPT a year ago, “knowledge workers” (that’s us) have been forced to ponder how much of what we do could be replaced by a very smart set of computer programs. Such applications can already pass medical licensing exams better than many graduates and have gotten remarkably good at reading X-rays and pathology specimens. How soon will AI systems become adept at reviewing the clinical literature and preparing concise, user-friendly summaries, complete with prescribing recommendations? Not yet, but likely before long.  Try it yourself at home: log onto OpenAI.com (it’s free) and ask ChatGPT for advice about medications for diabetes or hypertension or HIV or anything else. Just be careful about its “hallucinations” – the fact that sometimes AI just makes up wrong stuff. (I prefer the term “confabulation,” also used to describe this well-known phenomenon.) That can be whimsical if you’re a N.Y. Times reporter and ChatGPT advises you to leave your spouse, and it can be very problematic if you’re a lawyer who relies on case law that ChatGPT simply fabricated. (Both actually happened.) But it can be lethal if it involves incorrect clinical recommendations. Yet that said, AI is getting smarter every day. If programmed well in the coming years, large language models like ChatGPT or its growing number of competitors could eventually also learn how to gauge prescribers’ current knowledge, attitudes, and practices, and then ask just the right questions to find out why they’re doing what they’re doing, what their concerns are, and what it would take to get them to change.  Once things mature a bit further, will large health care systems interested in academic detailing and in cost-cutting simply replace humans with AI-AD-bots? After all, they could work 18-hour days, don’t need health care benefits, and can disseminate any message their employer wants. It will be easy replace a recommendation like “SGLT-2 inhibitors in diabetes can reduce cardiovascular and renal disease as well as lower glucose” with: “SGLT-2 inhibitors are extremely expensive and increase our drug budget. Use metformin or sulfonylureas whenever possible.  So if we have a few years to prove that actual people still have a vital role to play in helping practitioners make better decisions, what can we do?
Those are values that endure and can distinguish our work from a sophisticated set of algorithms. Best of all, they can’t be changed if whoever is in charge overwrites a few lines of code to maximize some other agenda, or if the algorithms just make stuff up. Biography.
Jerry Avorn, MD, 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.  What was once "the future" is here...but "the past" is still present. Believe it or not, it was 1838 when 3D technology was born. We've clearly made it a long way since; being able to have The Jetsons-style video calls is something that was once so futuristic that Saturday morning cartoons blew our minds with the very concept. What's most compelling about all of the constantly-expanding technology is that it doesn't do the trick when we want to have good old-fashioned water cooler talk, the kind of talk those of us who ran the 9-5 office gauntlet once took for granted. There's nothing like the quality of an in-person laugh over one that is cut up by static and the repeated query, "Can you guys hear me?", the response to which is so often, "Nope, you're on mute."  Join us for Coffee Tawk @ NaRCAD2023. That's why we're so excited to be hanging around having Coffee Talk in Boston next month. We'd love to be able to talk about advances in the field, but we're more excited to be able to have the option of shaking your hand (after hand sanitizing, of course) and give you some of our killer new swag, something we haven't had the chance to design in 4 years. And while we know time together is much more valuable than swag itself, there's nothing like packing your suitcase with some shiny things in tandem with the best practices you'll apply to your program as you fly back to your home base and build on the important work you do to help clinicians, and by proxy, their patients.  So please do come on out! And if you can't make it, please join us via LiveStream, whether you can only attend one session or the whole she-bang. Register on our Conference Series page and come spend time with us--it's a rare treat these days, and maybe that's one benefit to having had in-person time be scarce these past few years. But that's part of the NaRCAD Team's tendency to look at opportunity over setbacks.
We'd love to share that energy with you in just a few weeks. With excitement, Bevin Amira, Deputy Director  We're never going to stop telling you, our creative, dedicated, and talented community of clinical education professionals, how much we appreciate you. You've spent the past 3 years with us fully online, including our at our trainings, our annual summit, and our conferences. It's been lively and exceeded our wildest expectations of how truly connected and dynamic a virtual conference could be.
This year, we're finally back onstage in person at the Copley Fairmont Hotel in Boston. We couldn't be more excited to kick off a return to the kind of connections that only arise in a face-to-face setting. (For those of you who want to join us virtually again, we'll be having an interactive livestream option--learn more on our Conference Series Page!) To say thank you and stoke the 'in-person' excitement, we're having a FLASH GIVEAWAY: for the next 24 hours, the first 10 people to share 1 thing they're most excited about @ #NaRCAD2023 in the comments below will receive a code for free in-person registration. You'll be contacted by our team within the next day with your code! (*This offer is only for new registrants for this specific promotion.) See you in a few weeks! -The NaRCAD Team Sound off in the comments: What're you looking forward to most in person @ NaRCAD2023? Curated by: Aanchal Gupta, Program Coordinator, NaRCAD Tags: ADvice, Rural AD Programs Academic detailing programs face unique challenges in both rural and urban communities. Rural communities often encounter barriers with both clinicians and their patients having limited access to resources, as well as the difficulty they both face in navigating geographic barriers. In the latest edition of the AD-vice blog, we’ll explore past conversations with public health and healthcare professionals working to close the gaps for patients in rural populations.  CAPACITY-BUILDING & RESOURCE SUPPORT
 COLLABORATION AND COMMUNITY SUPPORT
 ADDRESSING STIGMA AND HEALTHCARE ACCESS
We hope the insights shared in this edition of AD-vice will inspire implementation of strategies on community support, access, and more in your AD programs. Check out our updated Program Planning Hub for examples and guides on how to build and sustain detailing programs as well as resources to support frontline clinicians!
Best, The NaRCAD Team Have thoughts on our DETAILS Blog posts? You can head on over to our Discussion Forum to continue the conversation! Anna Morgan-Barsamian, MPH, RN, PMP, Senior Manager, Training & Education, NaRCAD Tags: Stigma, Evidence-Based Medicine, Health Disparities, Conference Missed our event? Check out the AD Summit videos and materials on our Summit Hub.  We’re fresh off of the excitement of hosting our Academic Detailing Virtual Summit, “A Deeper Understanding of Our Impact on Patient Care.” In prioritizing patient-informed care more than ever before, we explored patient narratives through live interviews, workshops, and special panels, all within a virtual space. Innovations included AD for criminal justice involvement, care delivery redesign for veterans, affirming care for transgender and nonbinary people, and patient-informed communication on sex positivity in HIV prevention. Take a peek at some of the highlights from our event below! AD Fireside Chat: A New Spin on a “Keynote Address” We opened our AD Summit with a real-time interview featuring the originator and co-founder of NaRCAD, Dr. Jerry Avorn, and the National Director of the Veterans Affairs Pharmacy Benefits Management Academic Detailing Service, Melissa Christopher. Audience members were excited to throw ideas around and ask questions about:
Program Development Workshops: Attendees Led the Charge! Our revamped course catalog of workshops invited attendees to be in the director’s seat, as well as behind the scenes as co-creators in small groups. Participants created resources that we’ve published on our website and social media channels, sharing creativity and expertise with the larger AD community. Our workshops covered a wide range of topics including:
 The Pleasure Project Special Panel: Understanding Critical Care Needed for Formerly Incarcerated Patients The outstanding team from New York City Department of Health and Mental Hygiene (NYCDOHMH) shared their groundbreaking detailing campaign, “Public Health Detailing for Criminal Justice Involvement”, with an audience that was hungry for innovation around inclusivity. The NYCDOHMH team shared NYC clinicians’ understanding of formerly incarcerated patients’ care, including clinicians who met the campaign with stigma, and those who were grateful to see such a campaign being implemented. Best Practices Spotlight: Prioritizing the Patient Experience For the first time in NaRCAD’s history, we highlighted leaders in the field who’ve been prioritizing the patient experience. The San Francisco team created space for conversation and discussion about gender-affirming care and ways to encourage safe clinical environments for transgender and nonbinary individuals through language, storytelling, and community outreach. We also heard from the Arizona team about the importance of pleasure being part of a patient’s sexual health history and the role of a detailer in supporting these conversations between clinicians and patients.  Inclusivity Roundtable: Real-time Script Creation
We wrapped up our AD Summit with a roundtable session where attendees co-created a scripting resource to empower detailers to combat stigma during visits. We asked attendees to come up with responses to the stigmatizing comments below. A five-page resource was created in 60 minutes! 1. “I can’t believe patients keep coming back without having lost weight. They’re clearly not trying hard enough, and not making healthy food choices.” 2. “I don’t want those patients at my practice. They’re so difficult to handle and are really just looking for another opioid prescription. Treatment won’t work for them.” 3. “I’m so tired of keeping up with all these different pronouns. You’re either a man or a woman. It gets in the way of providing care.” 4. “I don’t need to use an assessment tool. I can always tell when someone’s at high risk of contracting HIV.” We want to continue these conversations, hear about your team’s innovations, and share resources in person this fall at our annual conference in Boston, MA. We hope to see you there! -The NaRCAD Team A special thank you to all of our AD Summit attendees and presenters as well as our partners at the Agency for Healthcare Research and Quality. For more information on our presenters, you can view the AD Summit Program Book. Have thoughts on our DETAILS Blog posts? You can head on over to our Discussion Forum to continue the conversation! By Anna Morgan-Barsamian, MPH, RN, PMP, Senior Manager, Training & Education, NaRCAD An interview with Adriane Apicelli, MSW, Project Manager, Harm Reduction Projects, University of New Hampshire, College of Health and Human Services. Tags: Harm Reduction, Detailing Visits, Evidence-Based Medicine  Anna: Hi, Adriane. Harm reduction is deeply meaningful to many individuals – can you share why harm reduction is meaningful to you? Adriane: The core principles of harm reduction, such as self-determination, mutualism, and self-advocacy, resonate with my personal and professional values. I firmly believe that individuals are the experts in their own lives, and it’s essential that people have access to the necessary resources, materials, and support systems to ensure their safety and well-being. Harm reduction also offers a powerful framework that facilitates a shift within communities that moves away from moralization and stigmatization of individuals who use drugs. It’s easy to blame individuals for their behavior, but it’s far more challenging to critically reflect on how systems and decisions put people in those circumstances in the first place. Anna: By embracing harm reduction principles, people within our communities can foster empathy and understanding for those facing challenges with substance use. Everyone deserves the same dignity, respect, and access to necessary resources. Can you tell me about the harm reduction detailing project you’ve been working on in collaboration with the National Association of County and City Health Officials (NACCHO)? Adriane: We’re currently focused on detailing elected officials in the State of New Hampshire, including city counselors, mayors, and senators. The opinions and decisions of elected officials shape the harm reduction service landscape – they make decisions that either enable or constrain available resources. Anna: Recognizing the influential role of elected officials is crucial when working on public health initiatives, including harm reduction. What is the overall goal of your current detailing project?  Adriane: We want to empower elected officials to make informed decisions that increase capacity of harm reduction services based on the needs of their communities. We’re currently encouraging elected officials to establish direct connections with individuals who use drugs so they can integrate the expertise from those with lived and living experience into decision-making processes regarding laws, policies, and resource allocation. Anna: Actively listening to those with lived and living experience helps to better understand how to support specific populations. How did your team decide to focus on encouraging elected officials to directly connect with people who use drugs? Adriane: During the development of our detailing project, we consulted with local syringe service program (SSP) participants and asked them how they think elected officials can better understand substance use and harm reduction. The overwhelming response was for direct communication between individuals who use drugs and elected officials, or having elected officials spend the day with them to understand their experiences firsthand. We’re trying to figure out how we can facilitate these approaches to ensure the safety and ethical treatment of SSP participants. We’ve also been exploring the possibility of forming advisory committees to incorporate the perspectives of individuals who use drugs in the decision-making process in a safe and supportive environment.  Anna: Advisory committees certainly help to ensure that voices and perspectives are heard and valued. Let’s transition to thinking about all of your detailing work to date – what makes you most proud to be a harm reduction detailer? Adriane: The people I detail. We shouldn’t underestimate how hard it is to change our minds, our attitudes, or our behaviors. It takes so much humility and effort to receive and integrate new information, especially when it counters your social values and beliefs. It’s an honor to work through that learning process with those that I detail. Anna: Do you have a specific example of that learning process that you can share? Adriane: I detailed someone who was initially hesitant to publicly announce that she prescribes buprenorphine because she was worried how that information would affect her patient panel. We ended up having a conversation about substance use stigma and its implications. We discussed that openly sharing that she prescribes buprenorphine serves as a powerful signal to patients, assuring them that she provides a safe environment to seek treatment. It also sends a message to other clinicians about the importance of prescribing this medication to patients who need it.  Anna: Having those types of honest conversations with people you detail is imperative to changing behaviors and reducing stigma at the individual and community level. Is there anything else you’d like to add before we wrap up today? Adriane: Remember that it’s much easier to build harm reduction capacity in collaboration with others. Last year, I collaborated with individuals from the public health department, a local hospital, the New Hampshire Harm Reduction Coalition (NHHRC), and a community volunteer to address a concern raised by a business owner regarding improperly discarded sharps on their property. We formed an informal work group and created a proposal aimed at piloting an anonymous syringe disposal project, installing two disposal units in the community. The disposal units were proposed to be on city property, so we needed buy-in from City Council to be able to do this. We recognized the power of engaging elected officials and presented our proposal to the City Council. Our proposal received unanimous support and it’s currently being piloted in the community. Collaborative advocacy and engagement with members of the community and elected officials can bring about positive change and enhance the health of all. Anna: We often have more power than we think when we collaborate with others who have similar goals. Detailing is an effective approach for encouraging collaboration and connection with experts in the community, including experts with lived and living experience. Thanks for joining us today, Adriane! We look forward to continuing to hear about your inspiring harm reduction work in New Hampshire. Have thoughts on our DETAILS Blog posts? You can head on over to our Discussion Forum to continue the conversation!  Biography. Since 2020, Adriane Apicelli has served as the Project Manager and primary academic detailer of the University of New Hampshire (UNH), Department of Nursing’s Harm Reduction Education and Technical Assistance (HRETA) project. She holds a Master of Social Work (MSW) from Boston College, where she also earned a Certificate in Management. In addition to her role with the HRETA project, Adriane serves as a nonprofit strategic planning consultant and has previously served as an adjunct professor for the Department of Social Work at UNH.
Anna Morgan-Barsamian, MPH, RN, PMP, Senior Manager, Training & Education, NaRCAD Tags: Conference, Health Disparities We have exciting news at NaRCAD! We’re hosting our first-ever Academic Detailing Virtual Summit on June 22 & 23 from 12-5 pm ET. We’ve listened to what you’ve asked for, so we’re prioritizing hands-on skill-building, program development workshops, roundtables, and live interviews, with an emphasis on high interactivity and networking opportunities!  How is this different than our annual conference? It's unique in three ways: more creativity, more patient voices, and more in-depth workshops. Our Summit invites our community to build real-time resources with one another – it's a chance to create as much as to learn. Our lens will focus more on patient-informed care as we move closer to examining patient narratives. Each day, you’ll choose a workshop track where you’ll connect with experts and community members on topics that matter most to you. Here’s a sneak peek of our program development workshops (to view the entire agenda, visit our AD Summit webpage): Day 1 Program Development Workshops:
Day 2 Program Development Workshops:
Join us! Registration is NOW OPEN. You can access all the presentations and one workshop per day for a fixed rate of $89. As a special promotion, the first 10 people who comment on this blog will receive free registration for the event. Hurry – you don’t want to miss this!
We look forward to learning from all of you. See you there! -The NaRCAD Team Can't join our event? Join us at our annual conference in November in Boston, MA! Anna Morgan-Barsamian, MPH, RN, PMP, Senior Manager, Training & Education, NaRCAD Tags: Opioid Safety, Harm Reduction  The NaRCAD team is back on the road! We had the privilege of attending the 2023 Rx and Illicit Drug Summit in Atlanta, Georgia, where we joined a diverse learning community of over 3,000 participants. We heard about best practices in prevention, treatment, and recovery for those affected by the opioid epidemic and engaged with experts from various fields who have developed innovative strategies to combat the crisis. We attended presentations, poster sessions, and booths from a wide range of professionals, including clinicians, law enforcement personnel, public health officials, lawmakers, attorneys, families, and individuals in recovery. It’s clear that we need to continue to work together across disciplines to reduce opioid use disorder and opioid overdoses within our communities.  While we were in Atlanta, we saw folks from our AD community who are working on opioid-specific academic detailing projects, including our colleagues at Alosa Health! If we didn’t catch you while we were there, please reach out to us at [email protected] and tell us about your experience in Atlanta! NaRCAD also had the opportunity to present with our colleagues from Comagine Health to share about our own collaborations and findings from a recent project, a 15-month clinic-based intervention called Improving Pain and Opioid Management in Primary Care (PINPOINT). The PINPOINT intervention was implemented in 36 clinics in Oregon and combined the Six Building Blocks, academic detailing, and practice facilitation approaches to improve pain management, opioid prescribing practices, and treatment of opioid use disorder in primary care settings.  A baseline survey of clinical staff and prescribers was conducted to assess knowledge, attitudes, and behaviors regarding opioids. The survey results suggested differences between clinical staff and prescribers in behaviors and attitudes about opioid therapy for treatment of chronic pain, familiarity with opioid prescribing best practices, and opioid-related policies and procedures. The participants who attended the conference session were eager to learn about how they could implement academic detailing programs in their own communities. We’re excited to share about the importance of academic detailing at future conferences and continue to learn and grow alongside all of you. Interested in submitting a proposal with the NaRCAD team at a future conference? Email us at [email protected]! Have thoughts on our DETAILS Blog posts? You can head on over to our Discussion Forum to continue the conversation! Curated By: Aanchal Gupta, Program Coordinator, NaRCAD Tags: ADvice, Program Management, Training Academic detailing program managers oversee and coordinate all aspects of an AD program to ensure its success, impact, and strengthen the detailing team. They have a crucial role in achieving team goals. In this edition of AD-vice, we’ll look into how program management in AD contributes to team and program success.  Team Building and Support:
 Recruitment and Training:
 Interprofessional Collaboration:
Effective program management plays a crucial role in the success and support of academic detailing programs. We hope the insights shared in this edition of AD-vice will help in navigating and implementing strategies of team building, recruitment, training, and more. As always, our NaRCAD team is here to support you and your detailing programs! Best, The NaRCAD Team Have thoughts on our DETAILS Blog posts?
You can head on over to our Discussion Forum to continue the conversation! By Anna Morgan-Barsamian, MPH, RN, PMP, Senior Manager, Training & Education, NaRCAD An interview with Rocko Cook, Public Health Detailer and Public Health Detailing Program Manager, Detailing Improved Sexual Health (DISH), Arizona State University. Tags: Detailing Visits, Evidence-Based Medicine, HIV/AIDS  Anna: Hi, Rocko – thanks for joining DETAILS today! HIV prevention work is critical and often deeply meaningful to those working in the field. Can you tell me why this work speaks to you? Rocko: I found out I was positive for HIV and syphilis in 2002. I encountered firsthand the stigma and shame associated with these diagnoses. It was devastating, but it’s made me feel even more connected to the work I’m currently involved in. I’ve worked in various roles in the field of HIV prevention and care since 1994, just two years before medication was widely available. In the 90s, there was little support for people who tested positive for HIV from a care perspective, financial perspective, and housing perspective. We now have the medications and tools to prevent, treat, and support people with HIV. Despite this, there’s an urgent need to continue educating clinicians, staff, case managers, community health workers, and other people who are on the frontlines about these tools and resources. Academic detailing helps to close that gap and gives me the opportunity to live my passion of educating others about HIV.  Anna: Thank you for your openness in sharing your personal and professional experiences. Your passion for HIV prevention and care is evident. What’s the number one thing you want clinicians and staff in your community to do differently when it comes to HIV? Rocko: I’d love for them to change the culture of the entire clinic space and create a more welcoming environment for patients. There needs to be a focus on consistent communication coming from every professional a patient meets with when receiving care. 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. It’s difficult to have these conversations. I've been doing this for a long time and I’m not perfect at it either, but once we practice and start getting comfortable with ourselves, then it gets a lot easier to be comfortable with patients. Anna: Modeling this type of communication during a detailing visit is key. It can help clinicians and staff feel more comfortable having the same conversations with patients. Can you share a story from the field about a positive response or reaction from someone you detailed? Rocko: There was an agency we worked with that hired a new physician, testers, and medical assistants for their mobile medical and HIV testing unit. They had never worked with this patient population, so our team did several trainings and 1:1 detailing sessions where we role played conversations with patients. We needed to bring them up to speed on how to have gender inclusive conversations and communicate with sex positivity. We had a lot of fun together. The team ended up going to Phoenix Pride to do a big testing event. We were delighted with their success in providing testing to the community and creating a welcoming and safe environment for people interested in being tested.  Anna: That’s a large event for the mobile unit team to tackle, while also succeeding in creating a safe space for all! Let’s talk a little bit more about the impact on patients. Can you share any data on the impact of your detailing work? Rocko: We have anecdotal evidence that folks are benefiting from our services. My colleague and I are closely involved in the gay community and people often tell us about their care experiences. We’re in an enviable position because we know a lot of people and hear things in passing. It helps us do a better job targeting our services; we can work directly with clinics that we’ve heard would benefit from detailing. I also recently connected with someone of trans experience who was tested at Phoenix Pride. They’ve had poor encounters in the past where clinicians and staff assumed the body parts they have. They shared that they had a positive experience with the mobile unit and felt comfortable throughout the visit. Being able to see our impact firsthand has been really motivating for me; it makes my heart sing. Anna: It’s rare to be so closely connected to the community that’s being impacted by your detailing work. It’s clearly been beneficial for your detailing efforts and getting your program up and running. Let’s wrap up with a final question - what has made you most proud of this project so far?  Rocko: I’m so proud of the way our team has come together and engaged with partners across the state. We’ve been able to leverage partnerships and community relationships to enhance program development, implementation, and dissemination. I’m also proud of our creativity in choosing our program’s name, DISH AZ (Detailing Improved Sexual Health). We send out a Weekly Special 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, while using food as our motivator! Anna: That’s an innovative way to keep your network engaged! We’re looking forward to hearing about your program as your team continues to expand its network and positively impact more people in the community. Thanks for chatting with us today and sharing your experiences, Rocko! Your passion for this work is palpable. Have thoughts on our DETAILS Blog posts? You can head on over to our Discussion Forum to continue the conversation!  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.
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