DETECT of Mississippi: Evaluation Jo hn Ba rtko wski, Ph.D. Ba rtko wski & Asso c ia te s Re se a rc h T e a m, L L C No ve mbe r 8, 2016—Jac kso n, MS
DETECT and Its Mandate De ve lopme ntal E valuation, T r aining and • E duc ational Consultative T e am of Mississippi T itle I I o f the Ame ric a ns with Disa b ilitie s Ac t re q uire s • a ll sta te s to pla c e q ua lifie d individua ls with I DD in c o mmunity se tting s ra the r tha n institutio ns DE T E CT suppo rts he a lthc a re pro vide rs a nd pa tie nts • in Mississippi a s the sta te tra nsitio ns to c o mmunity- b a se d he a lthc a re fo r pe o ple with I DD Rig o ro us e va lua tio n o f DE T E CT ’ s o utre a c h a nd • e duc a tio na l e ffo rts Re se a rc h te a m a lso re vie ws me dic a l pe rio dic a ls to • a ssist in info rma tio n disse mina tio n
IDD in the US: The Big Picture Ame ric a ns with a n I DD-re la te d c o nditio n • 1.5%-3.0% o f a ll c itize ns o T hus, 5-9 millio n Ame ric a ns a re a ffe c te d o Re duc e d life e xpe c ta nc y fo r se ve re I DD • 20% fe we r ye a rs o f life o
Prevalence of IDD in MS: The Need for DETECT Mississippi a mo ng sta te s ha ving hig he st pro po rtio n • o f c ivilia ns with I DD living in c o mmunity se tting s An e stima te d 14.5%-20.2% o f Mississippia ns with I DD a re living in o c o mmunity se tting s MS se lf-c a re a nd visio n disa b ilitie s a lso ve ry hig h o
IDD Health Risks in Mississippi: DETECT’s Challenge Gre a tly e le va te d he a lth a nd so c ia l risks a mo ng • Mississippia ns with a disa b ility Whe n c o mpa re d to pe o ple with I DD in o the r sta te s, • Mississippia ns with I DD ha ve … Hig he r ra te s o f o b e sity a nd smo king o L o we r ra te s o f e xe rc ise o L o we r ra te s o f e mplo yme nt o Diminishe d e a rning s o
Medical Services: IDD in MS vs. US Source: NCI 2012-2013 30% Had a hearing exam in the past year 56% 44% Had an eye exam in the past year 57% MS US 62% Had a dental exam in the past year 80% 63% Had a physical exam in the past year 89% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
Equipping Medical Providers: DETECT Infrastructure Gains Cre a tio n o f re fe rra l ne two rk a mo ng MS c linic ia ns • Ove r 200 c linic ia ns, mo re tha n 40 de ntists o Pro vide rs lo c a te d thro ug ho ut the sta te fo r b ro a d g e o g ra phic a l re a c h o MS me dic a l sc ho o l c urric ula re vise d to a ddre ss I DD • UMMC a nd Willia m Ca re y Co lle g e o f Me dic ine o Ma jo r a c hie ve me nt: Alte rs me dic a l pipe line , e duc a te s ne xt g e ne ra tio n o T ra ining me dic a l stude nts thro ug h DE T E CT site visits • K no wle dg e g a ins c o uple d with o b se rva tio n, mo de ling o f c a re de live ry o De ve lo pme nt & disse mina tio n o f c linic ia n re so urc e s • Se ve ra l I DD fa c t she e ts & a nno ta te d b ib lio g ra phie s c irc ula te d sta te wid e o Ba se d o n syste ma tic re vie w o f hundre ds o f pub lishe d me dic a l studie s o DE T E CT pro mo tio na l e ffo rts a nd visib ility: Ove r… • 404,000 we b hits with impre ssive c lic k-thro ug h ra te s; 12,600 F B like s o 13,500 po st c a rds; 4,700 le tte rs; ma g a zine a nd ne wsle tte r a ds o
Equipping Medical Providers: DETECT Educational Seminars Bro a d re a c h o f e duc a tio na l se mina rs • Ove r 1,700 se mina r a tte nd e e s thro ug h mo re tha n 20 se mina rs o Ma jo rity a re c linic ia ns: Physic ia ns, nurse pra c titio ne rs, a nd RNs o Othe rs se rve d : Be ha vio ra l he a lth pro vid e rs, inte re ste d c itize ns (pa re nts) o E d uc a tio na l se mina rs o ffe re d sta te wid e o MS a s le a de r in I DD-re la te d physic ia n e duc a tio n • Se mina rs pro vid e d to he a lth a d ministra to rs, physic ia ns, a nd o the rs in No rth o Ca ro lina , F lo rid a , Ge o rg ia , Ca lifo rnia DE T E CT vie we d a s mo d e l fo r o the r sta te s o MS a s string e nt te st o f me d ic a l e d uc a tio n e ffe c tive ne ss o He a lth d ispa ritie s, physic ia n sho rta g e , po pula tio n d ispe rsio n • Se mina rs a s pro mo tio na l c o nduit a mo ng c linic ia ns • 82% una wa re o f DE T E CT prio r to se mina r; 86% una wa re o f missio n b e fo re ha nd o Only 22% o f c linic ia n a tte nde e s se lf-ra te d a s ve ry • kno wle dg e a b le a b o ut I DD b e fo re se mina rs
Mississippi Medical Provider Educational Needs MS DETECT Seminar Attendees Survey Medical providers would benefit from more IDD 88% expertise Degree provided any expertise in treating patients 38% w/IDD Current clinic previously treated patient(s) with IDD 93% Medical provider previously treated patient(s) with 93% IDD Willing to receive additional training on IDD 77% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
Effective Medical Provider Education: Attendee Appraisals DETECT Seminar Impact 98% Presenter responsive to questions 95% Will change treatment 100% Seminar increased IDD awareness 98% Would recommend seminar to colleague 97% Educational seminar was effective 98% Satisfied with educational seminar 92% 93% 94% 95% 96% 97% 98% 99% 100%
Objective Knowledge Gains: DETECT Educational Seminars Co mpa riso ns o f a tte nde e kno wle dg e b e fo re a nd • a fte r e duc a tio na l se mina rs re ve a l sig nific a nt kno wle dg e g a ins Pre te st/ po st-te st me tho do lo g y: Co mpa re sc o re s a c ro ss se ve ra l surve y o ite ms to disc e rn kno wle dg e a c q uisitio n fro m se mina r Ca lc ula te sta tistic a l sig nific a nc e : Ma g nitude o f pre / po st c ha ng e o Sta tistic a lly sig nific a nt kno wle dg e g a ins inc lude … • K no wle dg e o f fe de ra l la w g o ve rning living a rra ng e me nt o ptio ns fo r o pe o ple with I DD K no wle dg e o f the fa ta l fo ur he a lth c o nditio ns tha t thre a te n the we ll-b e ing o o f pe o ple with I DD K no wle dg e o f de nta l issue s tha t a re c o mmo nly fa c e d b y pe o ple with I DD o K no wle dg e o f the lo c a tio ns o f the thre e DE T E CT c linic s in Mississippi o
Self-Assessment Before & After: DETECT Educational Seminars Me dic a l pro vide rs sc o re d the mse lve s o n a 100-po int • sc a le fo r e ffe c tive ly tre a ting pa tie nts with I DD Ave ra g e se lf-a sse ssme nt sc o re b e fo re e duc a tio na l se mina rs: 56 o Ave ra g e se lf-a sse ssme nt sc o re a fte r e duc a tio na l se mina rs: 72 o Pro po rtio na l g a in in sc o re due to se mina r c o mple tio n (b e fo re vs. a fte r): o 29% improve me nt ove r ba se line I ndic a to r sug g e sts g re a te r c linic ia n pro fic ie nc y in unde rsta nding I DD a nd o a wa re ne ss o f e ffe c tive tre a tme nt o ptio ns fo llo wing se mina r
Summing Up… DE T E CT o f Mississippi ha s suc c e ssfully a c hie ve d, • e ve n e xc e e de d, its g o a ls sinc e its inc e ptio n I nfra struc ture e nha nc e me nt (e .g ., re fe rra l ne two rk • e sta b lishme nt, c urric ula r inte g ra tio n) pursue d in ta nde m with physic ia n e duc a tio n K no wle dg e disse mina te d thro ug h va rio us c o nduits • Se mina rs, fa c t she e ts, a nno ta te d b ib lio g ra phie s, ne w me dia a nd o c o nve ntio na l me dia DE T E CT ha s b e c o me a na tio na l mo de l o f c linic ia n • e duc a tio n fo r the tre a tme nt o f pa tie nts with I DD Pro g ra ms a im to a lte r I DD-re la te d he a lth dispa ritie s • Pla n to a dd se ve ra l ite ms to Na tio na l Co re I ndic a to rs in MS fo r 2017 o
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