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Outreach Education led by Osteopathic Medical Students on Substance Use Prevention for Sustainable Health Literacy in Underserved Youth Communities
Garg, E. [1]
Gogineni, K. [1]
Mahimkar, S. [1]
Jambunathan, V. [2]
Jamal, L. [1]
Nazaroff, C. [1]
Restini, C. [3]

Journal: Journal of Osteopathic Medicine Date: 2024/12, 124(12):Pages: A123-A125. doi: Subito , type of study: cross sectional study

Full text    (https://www.degruyter.com/document/doi/10.1515/jom-2024-2000/html)

Keywords:

cross sectional study [824]
e-cigarettes [1]
health literacy [5]
medical students [629]
opioids [38]
osteopathic medicine [1994]
prevention [38]
substance abuse [9]
underserved communities [4]
USA [1598]
youth communities [1]

Abstract:

Context: Substance abuse, especially due to opioids, marijuana, and e-cigarette usage in high schools is correlated with a lack of knowledge and spread of misinformation in the cohort, as well as a lack of communication from healthcare professionals [1]. Thus, there is a need to improve education and prevention efforts in this vulnerable population [2]. In 2019, the Substance Use Prevention (SUP) Task Force was formed at Michigan State University College of Osteopathic Medicine (MSUCOM) and was later restructured as a committee under the Student Osteopathic Medical Association (SOMA) chapter of MSUCOM. Inspired by the Opioid Prevention Task Force created by the National SOMA [3], the SUP initiative aims to merge primary prevention strategies with osteopathic principles. This program seeks to empower high school students in the greater Detroit area, a historically underserved community, to make informed decisions about substance use. Objective: To demonstrate the protocol development process for a community service initiative led by Osteopathic Medical Students (OMS) and to evaluate the effectiveness of educational interventions designed by OMS in enhancing high school students’ understanding of substance use. Methods: As incorporated under SOMA, co-chairs and committee member positions were created, and volunteer positions were open to all OMS candidates in MSUCOM. Committee members and faculty established lines of communication with high school leadership, securing necessary permissions from principals, parents, and relevant faculty. Committee members organized presentations and coordinated the requests of the schools in terms of the substances presented and time constraints with volunteers, working to create a flexible presentation that met the needs of the individual school. The project was submitted to the IRB, including data collection and obtaining informed consent from the principals, parents/guardians, children, and instructors. Pre-clerkship students were actively recruited through the MSUCOM SOMA chapter. Interested OMS joined the program after being informed of the purpose and expectations of SUP and its outreach activities, undergoing ethical training and fulfilling the institutional obligations required to interact with minors. SUP Committee leaders created educational materials after consulting current research about substance abuse, relevant national and state legislation, and information from the MSUCOM curriculum. Faculty advisors networked with community leaders/high school representatives, and also provided permanence to a program characterized by the transience of medical students. The educational materials included interactive activities such as question banks, physical games like bingo and a spinning wheel, and technology tools inspired by the MSUCOM pre-clerkship curriculum. Presentation content was modified to meet needs identified by the school and often focused on opioid overdose and e-cigarette/vaping, as community needs differed by school district (IRB-approved study MSU ID: 8018). High school students completed a survey administered by the Qualtrics application before and after the topic discussion to assess student learning and the impact of OMS didactic interactions. Questions on the anonymous survey pertained to assessing substance identification, overdose reversal, and health consequences. Surveys featured both subjective scales (i.e., measures of confidence) and objective questions (concepts touched on in the presentation such as substance identification, overdose reversal, health consequences, and socioeconomic burden). Data were collected from 100 high schoolers who met the inclusion criteria of attending the interactions and completing both surveys. Answers were collected electronically. Data are expressed as % (N). T-test was applied to statistical analyses (Prism GraphPad, 10.2). Significance considered p<0.05 (CI, 95%). Results: After the approval of SUP as a committee in 2022, and the subsequent successful recruitment of pre-clerkship students as members, the SUP member roster saw a 400% increase in OMS participation. From there, we were able to find results from our dynamic interactions. We dissected student knowledge gain in two ways: subjectively and objectively. Subjects ranked their confidence in the expertise of the substance use presented before and after didactic interactions. Amongst all the schools, there was an increase of 33% (p<0.05) of students reporting being “a lot more” or “a great deal” confident in their knowledge of e-cigarettes/vaping and an increase of 44% (p<0.001) reporting “a lot more” or “a great deal” confident for opioids. Additionally, 55.2% (p<0.01) learned the similarities and differences between e-cigarettes and tobacco, 53.7% of students learned about the use of naloxone, and 66.9% of students understood how opioid overdose occurred. Learning was demonstrated by correctly answering post-survey questions compared to pre-survey ones. Conclusion: OMS successfully communicated and educated teenagers about e-cigarettes and opioids, improving proficiency, and increasing confidence among the students. Such positive results are due to the high schoolers’ engagement and the incorporation of active learning techniques during the presentations. Due to its design as a cross-sectional study, data were collected before and immediately after the presentation. This creates a limitation intrinsic to the study, namely that the long-term retention of the material by students is unknown. This limitation can be overcome with a prospective study that would reassess student knowledge after a given period, providing insight into the long-term retention of material from OMS-lead SUP presentations. Overall, self-confidence is key for health literacy, which may empower the youth to utilize their newfound knowledge about substance abuse to make informed decisions. The sustainability of this project is substantiated by its continuation into its third year, demonstrating its potential for statewide and national implementation.

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