Substance use workforce training needs during intersecting epidemics: an analysis of events offered by a regional training center from 2017 to 2020 | BMC Public Health

A total of 10,695 participants attended 345 New England ATTC TA events over the three-year period, of which 258 events (75%) were retained for this analysis. Eighty-seven events with a total of 552 attendees were excluded because they were classified as meetings or as coordinated by other ATTCs. The final analytic sample for total attendance included 10,143 attendees (95% of participants). Demographic information was available from 6642 attendees (66% of the analytical sample) who completed GPRA post event forms.

Participant demographics

Table 2 presents socio-demographic data. Of the TA attendees with available data, respondents predominantly identified as female (69.7%), and White (72.6%) with the next largest identification categories being Black (7.7%), Multi-Race (5.5%), and Hispanic (5.5%). Nearly half of participants held a Bachelor’s Degree or lower (47.3%), with the other half holding a Master’s Degree or higher (52.7%%). Attendees represented over 30 professions, with the majority identifying as behavioral health or substance use treatment providers (50.6%).

Table 2 Sociodemographic information for participants who completed post-event forms over a 3-year period (N = 6642)

Over the three-year period, the socio-demographics of the workforce attending TA events shifted with regard to gender, race/ethnicity, participant training/education background, and participant primary profession. Analyses revealed shifts in the attendee composition in terms of gender, race/ethnicity, and training background that were significant but in the trivial range (Cramer’s V < .10), whereas the shift in primary profession was moderate (Cramer’s V = .23). Attendees’ primary professions diversified across the three-year period, with greater representation among peer community support providers, education professionals, and students.

Training participants/regions

Of the 258 TA events analyzed, 69 % of TA events were face-to-face and the remainder were virtual. Over the first 2 years, the New England ATTC provided TA both in-person (68.5% of events) and virtually (31.5% of events). Midway through the third year (March 2020), all TA was transitioned to fully virtual due to the COVID-19 pandemic.

Table 3 presents TA event counts by state and by type. TA occurred across all six New England states, with the majority of trainings offered to the full New England region (31.4%), followed by New Hampshire (16.7%) and Connecticut (14.3%). Notably, regional coverage was fairly stable, with no significant association between fiscal year and TA by state.

Table 3 Coverage and type of Technical Assistance (TA) events over 3-year period

Frequency of TA types offered

Of the 258 events analyzed, most were categorized as targeted TA (76.4%). Intensive (18.6%) and basic TA (5.0%) were offered far less frequently. Over the three-year period, the total number of events decreased by about 10% and the TA types shifted. The proportion of events classified as targeted TA decreased by 28%, whereas the proportion classified as intensive TA increased by 23%. Chi squared analyses revealed significant differences in TA types across the fiscal years, and these changes were moderate in size (Cramer’s V = 0.20; see Table 3).

Most frequently offered and attended training topics

Across all 3 years, the most frequently requested TA topics and the most heavily attended included EBPs (41.5% of events, 30.9% of attendees; see Table 4), Consumer Needs (27.5% of events, 34.8% of attendees), and Health Equity (14.0% of events, 20.6% of attendees). EBPs, Health Equity, and Consumer Needs were most frequently requested as targeted TA (72.0, 77.8, and 81.7% were targeted TA, respectively), though EBP events were also often requested as intensive TA (27.1% intensive). Across TA categories, 21.3% of events were classified as opioid-related, 13.6% were classified as justice related, and 2.3% were classified as COVID-related.

Table 4 Frequency of and attendance at Technical Assistance (TA) events by topic

Within the three most requested event categories, further patterns emerged. Of the EBP events, the most popular interventions were medication for opioid use disorder (29.9%) and motivational interviewing (29.0%). Within the Consumer Needs events, about two-thirds (69.0%) provided general substance use education, with topics such as diagnosing substance use disorders, recognizing co-occurring mental health disorders, and applying general clinical skills (e.g. group counseling delivery). Finally, more than half (52.8%) of the Health Equity events involved training in effectively working with specific underserved populations (e.g. sexual and gender minorities, Hispanic and Latino populations). Other popular Health Equity topics included cultural humility (33.3%) and use of the Culturally and Linguistically Appropriate Services (CLAS) standards (13.9%).

As shown in Figs. 1 and 2, the total number of events declined substantially from Year 1 to Year 2 and then rebounded somewhat in Year 3 (to 90% of the Year 1 level). The number of attendees similarly declined from Year 1 to Year 2, but then jumped up substantially in Year 3 (to 150% of the Year 1 level) as events shifted to virtual delivery during the COVID-19 pandemic.

Fig. 1

New England ATTC events by topic over a 3-year period

Fig. 2
figure 2

Total attendees at New England ATTC training topics across 3 years

Analyses of the relative proportions of events in each year revealed moderate increases in the EBP and Health Equity categories. By contrast, there were decreases in the proportion of events in all other topics (Cramer’s V = 0.22). Similar trends were found in the proportion of attendees; EBP and Health Equity events had increased attendance (3.5 and 14.6% increases, respectively), while all other topics had decreased attendance (see Table 4).

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