Our Project Framework
RIAC seeks to expand the impact of two projects that will advance the IOM pillars of nursing in Rhode Island and align within RWJF’s Culture of Health framework. More specifically, RIAC aims to focus this project on reducing stigma and increasing clinical- and community-approaches to “whole-person health” to transform Rhode Island’s health system.
RIAC aims to align this with the following Culture of Health Principles:
- Attaining the best health possible is valued by our entire society;
- Healthcare is efficient and equitable; and
- Business, government, individuals, and organizations work together to build healthy communities and lifestyles.
Why this Project is Needed
In Rhode Island, approximately 48,538 adults and 5,315 children statewide suffer from substance use disorders. Approximately 129,836 adults experience the co-occurrence of mental illness and chronic disease statewide. Further, 9,744 adults statewide experience severe mental illness and chronic disease simultaneously. An approximate 11,730 children within the state are diagnosed with serious emotional disturbance concurrently with chronic disease. These numbers necessitate that Rhode Island move towards a health system that embraces the Culture of Health and provide the integrated physical, behavioral (i.e., mental health and substance use), and social care required to address the needs of the whole person. One barrier, both in the clinical and community settings, to doing this is the stigma associated with behavioral health. These statistics are based on data pulled from HealthFacts RI, Rhode Island’s All-Payer Claims Database.
Our Project Intervention Approach
The following intervention approach has been organized to coincide with RIAC’s organizational core values focused on workforce transformation (i.e., strong community advocacy; lifelong professional development; active interprofessional leadership; and exceptional practice).
1) Organize for Strong Community Advocacy: Convene and align a broad stakeholder coalition around stigma reduction, including but not limited to academic institutions, public sector and state government initiatives, professional associations representing various healthcare clinicians, care transformation organizations, local (and national) employers, insurers, and local community agencies such as Rhode Island’s Health Equity Zones and Regional Prevention Coalitions. RIAC focuses on ensuring that nurses actively participate in and advocate for policy, system, and environmental changes within their local communities to improve health equity for all patients. It is also imperative to broaden this scope to include other clinical and community partners to address stigma in Rhode Island.
- Recruitment of Stakeholders and Monthly Partner Convening
- Informed by Governor’s Executive Order on Behavioral Health
- Aligned with Rhode Island’s Opioid Overdose Prevention Task Force
- Intended to Increase Situational Awareness, Information Sharing, and Collaboration
- Aimed at Expanding Role Nurses Can Play in Developing a Stigma-Free Culture of Health
Development of a Comprehensive Stigma-Reduction Communications Plan Incorporating:
- Governor’s “Recovery-Friendly Workplace Initiative”
- National “Campaign to Change Direction on Mental Health”, led locally by HARI
- RIC’s Adapted “We Ask Everyone Campaign”
- IHI’s “Recover Hope Campaign”
- RI’s “Truth Initiative”
2) Develop Opportunities for Professional Development: Develop, promote, and scale educational and training opportunities around stigma-reduction leveraging the cross-sector coalition of organizations. By working to expand and scale the impact of pre-existing programs, we can focus on maximizing their reach, developing more accessible forms of dissemination, and marketing specific trainings offered by partners. RIAC focuses on ensuring nurses embrace a culture of continuous learning. We leverage local educational institutions as pathways for academic progression of health professionals. We use a broad inter-professional approach that serves to benefit all Rhode Islanders.
- Offer Free Screening, Brief Intervention, and Referral to Treatment (SBIRT) Training to Clinicians and Community Partners in partnership with the Rhode Island SBIRT Training and Resource Center at Rhode Island College
- Assist in Developing and Launching Stigma-Reduction Trainings and Webinars with the Rhode Island SBIRT Training and Resource Center and Other Local Partners
- Promote and Expand Trauma-Informed Care Training Opportunities with the Department of Behavioral Health, Developmental Disabilities, and Hospitals
- Assess and Market Applicable IHI Open School Trainings on Recover Hope Resources
- Schedule and Host Arts-Based Performances on Opioid Addiction
- Promote RIDOH/RIAAP Toxic Stress Toolkit to Clinical Providers
3) Champion Interprofessional Commitment and Engagement: Utilizing the RIAC’s network of affiliated organizations, we have the potential to disseminate stigma-reduction awareness among many of the state’s largest and fastest-growing occupations across health. By partnering with our state’s largest employers we will educate, raise awareness, and impact hiring practices for over 286,934 employees. Additionally we will seek to promote and integrate stigma-reduction awareness into community-based projects, contextualized to local issues and with the goal of yielding the greatest genuine engagement of community members and partners.
RIAC believes nurses play an integral role in leading the redesigning of healthcare, in partnership with physicians, other members of the care team, and patients/caregivers. A joint effort for changing the narrative around stigma will yield an even higher return on investment and engage the interprofessional team.
- Host Rhode Island’s First Interprofessional Stigma Reduction Conference
- Set and Work to Achieve Nursing Benchmarks for Youth and Adult Mental Health First Aid Training among RIAC Membership
- Expand Benchmarks for Youth and Adult Mental Health First Aid Training to Other Professions
- Develop Nurses as Youth and Adult Mental Health First Aid Trainers and Work with RI School Nurse Teachers Association and Rhode Island State Nurses Association to Volunteer Time to Provide Parent-Focused Trainings in Community Settings
- Advocate for and Increase Culturally-Competent Medication-Assisted Treatment (MAT) Providers in Rhode Island
4) Promote Exceptional Practice Within and Beyond Rhode Island: Through collaborative engagement of addiction and recovery experts we will develop and distribute resources based on the findings and lessons learned from partners’ educational and training programs, as well as the outcome of our integration and dissemination efforts. This condensed free resource will be shared with partner organizations and national networks to sustain impact in Rhode Island, and serve as a roadmap for other states seeking to integrate stigma-reduction practices. It will include links to resources and best practice partners. For RIAC, nurses must leverage the full extent of their educational training and scope of practice to provide the highest level of quality care, serving as change agents within community and clinical settings. This area of focus applies to all clinical fields and can be broadened based on lessons learned within nursing.
- Launch Nursing-Led, Stigma-Focused Academic Detailing in Medical Institutions, Pharmacies, and Community Settings to Promote the SBIRT Training and Resource Center’s, We Ask Everyone Campaign, and the Institute for Healthcare Improvement’s Recover Hope Change the Narrative Pledge.
- Work with CTC-RI’s “Integrated Behavioral Health and Community Health Team/SBIRT” Projects to Identify Best Practices and Develop Public Information/Toolkits for Dissemination (Including Universal Screening for Anxiety, Depression, Tobacco, and Substance Use).
- Work with Patient-Centered Medical Home (PCMH)-Kids and Similar Initiatives to Expand the Conscious Discipline Training to Practices with High Rates of Potential Child Maltreatment.
- Work with RIDOH and Local Nurses to Recruit Population Health Activators and Expand Compass Assessments of Institutional Portfolios in RI.
- Explore and/or Develop Stigma-Related Curriculum for Local Psychiatric Nurse Practitioner and/or Other Professional Educational Programs as a National Model.
Our Current Project Partners
- The Autism Project
- Blue Cross and Blue Shield of Rhode Island
- Bradley Hospital
- Care Transformation Collaborative of Rhode Island
- CVS MinuteClinic
- Creating Outreach About Addict Support Together (COAAST)
- Community College of Rhode Island
- iHeartRadio/iHeartMedia RI, RI Broadcasters Association
- Lifespan Health System
- The Miriam Hospital
- Mental Health Association of RI
- National Association for Mental Illness RI
- New England Institute of Technology
- Parent Support Network
- Rhode Island Certified School Nurse Teachers Association
- Rhode Island Chapter of American Academy of Pediatrics
- Rhode Island College
- Rhode Island Department of Behavioral Health, Developmental Disabilities, and Hospitals
- Rhode Island Department of Health
- Rhode Island Free Clinic
- Rhode Island Governor’s Office/Governor’s Recovery Friendly Workplace Initiative
- Rhode Island Medical Society
- Rhode Island State Nurses Association
- RI Police Chiefs Association
- RIC School of Nursing
- RIC School of Social Work and SBIRT Resource Center
- Social Enterprise Greenhouse
- Substance Use and Mental Health Leadership Council
For questions or to get involved
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