Progress 09/01/19 to 08/31/22
Outputs
Target Audience:Our target audiences included adult community members from Union, Baker, Tillamook, and Lincoln counties, including county-level decision makers and service providers, community coalition members, partner organizations, and other key stakeholders. Participation in program activities reflected these target audiences. In both regions, Community Conversations participants included elected officials, healthcare service providers, law enforcement, educators, and other key community stakeholders. All but one MHFA training offered in Year 2 recruited community members from the general public (one was scheduled specifically for a local public health agency). Prevention Week activities, radio programs, and dissemination of resource guides targeted local community members. Changes/Problems:Deviations from Program Timeline Ultimately, we accomplished all planned program activities, but a combination of circumstances led to deviations from the planned timeline. During 2020 and 2021, COVID-19, wildfires, and other circumstances limited the bandwidth of both the internal project team and our partners. We also learned how much time is necessary to build and foster relationships when working with partners in rural or frontier counties. In Union and Baker counties especially, we experienced delays for a variety of reasons (e.g., difficulty scheduling, finding the right composition of partners). Changes in Protocol After several attempts to cultivate relationships with media partners in Union and Baker counties to do radio programs, we pivoted to creating PSAs and airing them on a schedule. We feel good about this product because it was a truly collaborative effort, involving both radio partners and local service providers. What opportunities for training and professional development has the project provided?Mental Health First Aid Training has been offered 8 times in the 4 counties over the course of the grant period; a total of 96 individuals participated. At least 35 community leaders and service providers participated in at Community Conversations in either Tillamook or Union counties. These guided conversations involved reaching shared understanding and consensus about local assets and needs for behavioral health, as well as priorities for action. As mentioned in Year 1, the execution of program activities during the pandemic has led to some informal opportunities for professional development. For example, because all Coast to Forest activities continue to be offered/implemented remotely, our program staff have developed expertise in virtual instruction and group facilitation; in fact we have shared our learning about this in multiple conference presentations. Further, our project team has learned a great deal about producing content for radio and for podcasts, working with local media outlets, and producing public service announcements. How have the results been disseminated to communities of interest?The team has disseminated evaluation results and practice findings at two conferences in 2022 (The National Health Outreach Conference and the Oregon Public Health Association Annual Meeting). Community Conversations Reports are also available online, and shared with partners in each of the participating counties. The team is also planning to communicate a project wrap-up report to partners in all four counties early in 2023. What do you plan to do during the next reporting period to accomplish the goals?
Nothing Reported
Impacts
What was accomplished under these goals?
Mental Health First Aid (MHFA) Our evaluation of MHFA indicates participants increased their confidence in assisting a person experiencing a mental health or SUD-related challenge, as well as having an increased awareness of the common signs and symptoms of mental health or SUD-related challenges (Outcome Objective #1 and #3). By conducting an analysis of the pre-training and 30-day post-training survey results, we found a significant increase in participant confidence and awareness relating to mental health and SUD. Between the pre- and 30-day post-training surveys: 77.8% of survey participants reported increased confidence in recognizing the signs that a person may be dealing with a mental health concern or crisis 73.1% of survey participants reported increased confidence in assisting a person who may be dealing with a mental health concern or crisis to connect with community, peer, and personal supports. 77.8% of survey participants reported increased confidence in offering basic information and support about mental health concerns to a person in distress 74.1% of survey participants reported increased awareness of the physical signs like changes in normal patterns or appearance 81.5% of survey participants reported increased awareness of the emotional symptoms like depressed mood, irritability, or excessive anxiety or worry 85.2% of survey participants reported increased awareness of concerning thoughts such as self-blame, racing thoughts, or strange or troubling ideas However, when we evaluated helping behaviors between pre- and 30-day surveys, we did not find a significant increase in helping behaviors except for one of the eleven survey items (Outcome Objective #4). For the lone item, there was a statistically significant increase in assessing whether someone was in crisis. For this question, 42.3% of respondents reported an increased frequency of assessing whether someone was in crisis in the past 6 months. When we analyzed the results of the mental health stigma questions (Outcome Objective #2), we found a significant decrease in mental health related stigma for two of the three questions. Specifically: 40.0% of respondents reported decreased stigma regarding their willingness to accept someone who has received mental health treatment as a close friend. 24.0% of respondents reported decreased stigma regarding thinking less of a person who has received mental health treatment. Generally speaking, participants overwhelmingly reported being satisfied with the training, while also finding it to be useful to the workplace and in their own lives. In the 30-day survey, 84.6% of surveyed participants were "extremely" or "somewhat satisfied" with the training, 80.8% found the training "extremely" or "very useful" to everyday life, and 76.9% found it to be "extremely" or "very useful" to the workplace. Over the two-year grant period, a total of 96 people participated in MHFA training. Among these participants that completed the pre-training survey, 61.9% identified as being White, 9.52% identified as being Hispanic or Latino, 4.76% identified as being Black or African American, and 23.8% identified as Other. Furthermore, 88.5% of survey participants identified as female, 7.69% identified as male, 1.4% identified as Gender non-conforming/Gender queer, 1.4% identified as Gender fluid/not exclusively male or female, 2.9% identified as other, and the remaining did not provide a response. The majority of our survey participants work in industries such as healthcare (28.6%), human and social services (28.6%), education (14.3%), and public health (14.3%). Community Conversations Although we did invite all Community Conversations participants to complete pre and post surveys about their learning and their experience, completion of these surveys was low and probably did not reflect the composition of all participants. In both regions, the team observed more partnerships and resource sharing. For example, as a result of Community Conversations in Union County, our team member Robin Maille was invited to other existing tables/conversations for local planning. Anecdotally, we also heard appreciation from both groups about the process and the final report document. We believe that this experience speaks to some progress in community efficacy (Outcome Objective 6). The completion of the final reports meets Objective 7 as both communities agreed to priorities and action plans. We also know that the communities are using the plans set forth in the reports. Tillamook Commissioner Skaar reports that the report/action plan will be used to help the Mental Health Advisory Committee make a road map for their work and for use by the OUR Tillamook Group (Opioid Use Response Tillamook) to identify priorities for their actions. Union County is using their report/action plan to use Opioid Settlement Funding. Our planning and activities for Prevention Week improved significantly in the past year. Our team embraced tracking capabilities of social media and designed a social media campaign (because our partners were still not ready for in-person activities). According to our tracking, over 1100 users interacted with our posts and materials. The campaign also led to a large increase in use of online resource guides. During this reporting period, we continued our radio presence. Two radio programs aired in the Tillamook/Lincoln area, highlighting MHFA trainings and online resource guides. Our team also worked with Elkhorn Media in Union/Baker to develop, record, and air 9 public service announcements that play on a rotation on multiple radio stations in that region.
Publications
- Type:
Conference Papers and Presentations
Status:
Published
Year Published:
2022
Citation:
Estrada, I., Phibbs, S., Myers, A., Ceraso, M., & Linnell, D. (2022). Coast to Forest: Evaluation of a virtual (online) Adult Mental Health First Aid Training in Oregon. Oral presentation at the annual meeting of the Oregon Public Health Association, Corvallis, OR, October 17-18, 2022.
- Type:
Conference Papers and Presentations
Status:
Published
Year Published:
2022
Citation:
Martin, A., Linnell, D., Maille, R., Phibbs, S., Ceraso, M., & Myers, A.E. (2022). Supporting mental health through Community Conversations: Adapting a best practice curriculum in two rural Oregon counties. Oral presentation at the annual meeting of the Oregon Public Health Association, Corvallis, OR, October 17-18, 2022.
- Type:
Other
Status:
Published
Year Published:
2022
Citation:
Martin, A. (2022). Structural Competencies in Public Health. Invited panel presentation at Oregon Health and Sciences University, Portland, OR, September 14th, 2022.
|
Progress 09/01/20 to 08/31/21
Outputs
Target Audience:Program activities for the first year have consistently reached members of the target audience indicated in the proposal: adult community members in the four counties served by Coast to Forest (Union, Baker, Tillamook, and Union). We also indicated that we would recruit county-level decision makers, health care and social service providers, first responders, community coalition leaders and members, farmers and agricultural sector workers, parents (through the Oregon Parenting Education Collaborative), 4-H volunteers, and other key stakeholders for various activities. Mental Health First Aid Over the past program year, 10 people on the project team became certified to teach MHFA. Across the span of September 2020 and September 2021, 67 people participated in MHFA trainings across Union, Baker, Tillamook, and Lincoln counties. Approximately 50% of training participants identified as being White, 3% identified as Asian, 3% identified as Black or African American, and the remainder identified as Other or did not respond to this question. Our participants were predominantly female (62%) and males constituted 18% of our participants; 21% of participants did not report a gender identity. Over the past year, training participants primarily represented education (25%), healthcare (21%), and human/social services (18%) industries. Community Conversations About Mental Health The first Community Conversations was held in Tillamook County over 4 sessions this fall (9/16/21 - 11/16/21), in Year 2 of the project. Significant planning occurred during the program year; planning partners included the Executive Director of a local counseling center, the Behavioral Health Director of the regional coordinated care organization (Medicaid insurer), and a county commissioner. Prevention Week Over the past program year, Prevention Week activities were implemented across three counties, reaching an estimated 622 people. Demographic information was not collected for these participants, but they do represent residents of Union, Tillamook, and Lincoln counties. Radio Programs Over the past program year, a total of 8 radio segments were delivered across Tillamook and Lincoln Counties. Radio segments ranged between 30-60 minutes and covered a variety of topics including medication assisted treatment, mental health first aid, and mental health and substance use services available from local and state resources. Estimated reach for individual radio programs is not available. Resource Guides Four county-specific resource guides were developed during the program year; resource guides were reviewed by 7 local partners and 1 consortium. Resource guides are made available during Mental Health First Aid trainings. Resource guides have also been posted on the Coast to Forest website (https://extension.oregonstate.edu/coast-forest-mental-health-promotion-rural-oregon). Analytics indicate that there have been at least 101 unique page views of the website in the four counties; the resource guides were downloaded by 7 unique users in the first year. Partner Interactions In an effort to fulfill our commitment to join existing tables/partners, the Coast to Forest team has recorded 72 unique partner interactions, many of which constitute meetings with locally existing coalitions, planning groups, and advisory councils (e.g., the Union County Parenting Coalition, Union County Trauma Informed Coalition, Baker Local Community Advisory Council, Tillamook County Advisory Council, Tillamook Rural Communities Opioid Response Program Committee, Coast to Cascades Community Wellness Network of Lincoln County, and more). Changes/Problems:Significant Deviations from Program Timeline The impact of COVID-19 on our team and on our community partners' capacity to engage with us simply cannot be overstated. As noted previously in this report, we simply have not had the level of engagement we expected from community partners to implement some activities, especially in the Union/Baker region. This has resulted in significant delays in implementing Community Conversations and radio programming. Unexpected Outcomes/Changes in Protocol Our community partners are clearly aching for in-person activities and a return to normalcy. At times, however, OSU policies for COVID response restricted us to remote programming only. Even when we adjusted plans and protocols for in-person activities (e.g., requiring masks, assessing participants and staff for symptoms 24-hours in advance), a Delta surge meant that we went back to a remote-only implementation. What opportunities for training and professional development has the project provided?Mental Health First Aid (MHFA) training has been provided to 67 individuals in the four-county service area, the majority of whom report working in human or social services or education. Each MHFA trainee receives a certificate from the National Council on Behavioral Health indicating their status as a "Mental Health First Aider". In addition, we have enabled 10 professionals (within and external to our team) to become MHFA instructors. The instructor certification takes three days and requires passing a practice training; recertification with the National Council on Behavioral Health is available annually. Some informal opportunities for professional development have been provided by the project. For example, because all Coast to Forest activities continue to be offered/implemented remotely, our program staff have developed expertise in virtual instruction and group facilitation. Further, our project team has learned a great deal about producing content for radio and for podcasts, including the use of audio-editing software. How have the results been disseminated to communities of interest?Results have not yet been disseminated; evaluation team members are preparing a programmatic update to share with community partners which we expect to release in early 2022. What do you plan to do during the next reporting period to accomplish the goals? We will continue offering MHFA remotely. As of 11/28/21, Community Conversations About Mental Health has been completed in Tillamook County. Our team members will continue to work with those participants to finalize their written plan for action. We will continue to actively identify partners in Union/Baker counties who are willing and have the bandwidth to implement Community Conversations in that region. We will confer with community partners about Prevention Week programming for 2022. As COVID restrictions loosen, we have an opportunity to be intentional about supporting in-person events and activities. We will continue to explore opportunities to offer radio programming in Union and Baker counties. The team plans to disseminate resource guides with more organization and intention in early 2022; we have immediately been introducing the website where resource guides exist online to MHFA participants. We will continue to conduct monitoring and evaluation activities, and to share our results with our valued community partners.
Impacts
What was accomplished under these goals?
Our evaluation of MHFA indicates that participants increased their awareness of signs and symptoms of mental health challenges, including signs of emotional distress and suicidality (#1). Results from a comparison of the baseline and 30-day follow-up questionnaire indicates that participants are significantly more confident in identifying the signs of mental health challenges and offering help to those experiencing a mental health challenge (#3). Specifically, the percentage of participants who were fairly/very confident increased on the following skills: Asking someone about thoughts of suicide increased from 58% to 87%. Offering basic information/support to someone in emotional distress increased from 56% to 94%. Assisting someone in accessing professional help increased from 57% to 94%. Furthermore, approximately 95% of respondents reported feeling extremely satisfied with the training and 85% reported that they would recommend the training to others. Similarly, 55% of respondents found the training to be useful in their everyday life, and 40% expected that the training would be useful in the workplace. Personal and public stigma related to mental health challenges were also assessed in the evaluation of MHFA. Our evaluation results indicate that personal or public perceptions of stigma related to mental health challenges did not significantly change after participants completed MHFA (#3). Additionally, evaluation results did not indicate an increase in helping behaviors (#4) like calling a crisis hotline for someone, or assessing whether or not someone was in crisis. We believe that these results were affected by the following. First, only about half of participants completed a 30-day follow-up survey, reducing our ability to detect a change. Second, the professional affiliations of the majority of our MHFA participants (most reported working in human/social services or education) suggest that they may already be attentive to mental health stigma; also, the average personal stigma score at baseline was consistent with a rejection of mental health stigma. Third, with respect to helping behaviors, 30 days may not have provided participants with adequate opportunities to practice their helping skills in the real world. Key informant interviews indicate that MHFA trainings are being promoted through community stakeholder networks, which leverages existing relationships with the local community to fill training seats. Some respondents noted that working through local stakeholders increases the reach of MHFA training activities. Among many key informants there was a shared recognition of the benefits and value of MHFA training, given the rise in mental health and substance use disorder challenges their communities. Additionally, some key informants noted being unaware about MHFA trainings in their community, however to some this was due to being overwhelmed with COVID-19 response activities. Some respondents expressed being vaguely aware of Coast to Forest activities and objectives, but felt out of touch with the progress of the program as a whole. Furthermore, some of the common barriers to participating in the MHFA training included the online format, in addition to the time commitment needed to attend the training. One of the challenges in implementing program activities such as Community Conversations About Mental Health, Prevention Week activities, and dissemination of resource guides were the recurrent disruptions and burden resulting from COVID-19. For example, with prospective attendees and local stakeholders tied up in the local COVID-19 response, the frontier counties such as Union and Baker have been unable to participate in Community Conversations activities. Community conversations planning went well in Tillamook County, according to key informant interviews. Some respondents indicate that they appreciate the facilitation and planning role that Coast to Forest team members have taken on in delivering this activity. In addition, respondents had highlighted the cross-section of participants, with representation from a wide variety of agencies such as healthcare, mental health professionals, law enforcement, and private businesses. Some respondents mentioned that they were unaware of Community Conversations taking place in their communities, however they mentioned it would be a useful activity to bring to their area. All Prevention Week activities had to be delivered virtually or remotely, which key informants felt limited their reach and participation. We expected that key informant interviews would provide feedback about our radio programming, however, all eight of the key informants we interviewed either did not listen to the radio, or were unfamiliar with our specific radio programming. Key informants did express enthusiasm and belief that radio is an important medium for reaching the local populations in both program areas. An original outcome objective of our work (#5) was to prompt the increased use of mental health and substance abuse services. We are concerned now that this would be impossible to untangle from the effects of COVID which has both increased the need for services but also limited the services available. A behavioral health workforce crisis exists in both of our regions. In time outside of the grant, we are making connections between behavioral/mental health leaders in our health systems, and leaders at the Oregon State University College of Education (Dean Susan Gardner and Counseling Graduate Program Chair Thomas Field), which is home to counseling programs. This is one thing we are able to do, to prompt any increases in service availability or use. With regard to outcome objectives #6 and #7, community efficacy and community plans, we do not yet have data on which to report. However, this will be included in future progress updates.
Publications
- Type:
Conference Papers and Presentations
Status:
Published
Year Published:
2020
Citation:
Ceraso, M., Edison, C., Li, T., Linnell, D., Maille, R., Myers, A., . . . & Seifert, M. (2020). Coast to Forest: Promoting Mental Health in Rural Oregon During COVID-19. Oral session presented to the annual meeting of the Oregon Public Health Association, Corvallis, OR, October 13, 2020.
- Type:
Other
Status:
Published
Year Published:
2021
Citation:
Myers, A., Ceraso, M., Linnell, D., Maille, R., & Phibbs, S. (2021). Coast to Forest: Promoting Mental Health and Preventing Substance Use in Rural Oregon. Invited talk presented to virtual meeting of Oregon Overdose Prevention Coordinators, January 6, 2021.
- Type:
Other
Status:
Published
Year Published:
2021
Citation:
Myers, A., Ceraso, M., Linnell, D., Maille, R., & Phibbs, S. (2021). Promoting Mental Health and Preventing Substance Use in Rural Oregon. Invited talk presented to virtual meeting of Oregon Overdose Prevention Coordinators, January 6, 2021.
- Type:
Other
Status:
Published
Year Published:
2021
Citation:
Myers, A. & Phibbs, S.. (2021). Introducing Coast to Forest: Outreach to Promote Mental Health and Prevent Substance Use in Oregon. Invited talk presented to virtual meeting of Oregon Department of Agriculture, Board of Trustees, September 15, 2021.
- Type:
Websites
Status:
Published
Year Published:
2020
Citation:
We developed and launched the Coast to Forest website: https://extension.oregonstate.edu/coast-forest-mental-health-promotion-rural-oregon.
|
Progress 09/01/19 to 08/31/20
Outputs
Target Audience:The NIFA-funded Coast to Forest project experienced a difficult year. We are purposefully submitting this first-year Progress Report at the last possible time, to give as accurate an update as possible. The project start date was meant to be September 1, 2019. We received an Award Face Sheet releasing funds on March 24, 2020 (signed by Mark Heap, Authorized Departmental Officer). We began work shortly thereafter but adhered to both Oregon Governor Kate Brown's "Stay at Home" Order to protect public health in the COVID-19 pandemic, and Oregon State University's administrative regulations for COVID-19 response. Notably, our team remains unable (by Executive and organizational order) to meet in-person or hold in-person events, thus limiting progress. Also notable, we received revised Award Face Sheets withholding funds on May 27, 2020 and June 2, 2020 (signed by Kendra Edwards, Authorized Departmental officer) pending IRB approval. We submitted an IRB application to the Oregon State University Human Research Protection Program on August 4th, 2020 and received approval on November 10th, 2020. Ultimately, funds were officially, finally released (by email and without an amended Award Face Sheet) for the project until November 13, 2020 (after the end of the Year 1 reporting period from 9/1/19 to 8/31/20). Target audiences for Coast to Forest efforts are diverse adult Oregonians living in two areas that are hard-hit by the opioid epidemic: one western coastal area (Tillamook and Lincoln counties) and one eastern rural/frontier area (Union and Baker Counties). Project activities are intended to reach people from high risk industries, health care, social services and other first responders, parents, local decision makers other interested parties. Coast to Forest efforts and specific audiences include: 1. Community Conversations about Mental Health, targeting engaged community members in 4 counties, MHFA participants, coalition members, and other key stakeholders; 2. Mental Health First Aid training, targeting Adult community members in 4 counties, including public health, social service and healthcare providers, county decision makers, community coalition leaders and members, law enforcement, farmers and agricultural sector workers, parents (through the parenting hubs), 4-H volunteers, and other stakeholders; 3. Radio programming, targeting all community members in the four counties, and the radio listening audience; 4. County Mental Health and Substance Abuse Resource Guides, targeting all community members in 4 counties, particularly those engaged in providing mental health and substance abuse referrals and support on a professional or volunteer basis; and, 5. Prevention Week, targeting all community members in the four Coast to Forest counties. Changes/Problems:We experienced delays in project start-up because of award notifications, release of funds, and securing IRB approval. The project start date was meant to be September 1, 2019. We received an Award Face Sheet releasing funds on March 24, 2020 (signed by Mark Heap, Authorized Departmental Officer). We received revised Award Face Sheets withholding funds on May 27, 2020 and June 2, 2020 (signed by Kendra Edwards, Authorized Departmental officer) pending IRB approval. We submitted an IRB application to the Oregon State University Human Research Protection Program on August 4th, 2020 and received approval on November 10th, 2020. Ultimately, funds were officially, finally released (by email and without an amended Award Face Sheet) for the project until November 13, 2020 (after the end of the Year 1 reporting period from 9/1/19 to 8/31/20). We also are experiencing problems in our approach because of the COVID-19 pandemic. We began work after the first release of funds notification on March 24th, 2020, but that was during Oregon Governor Kate Brown's "Stay at Home" Order for COVID-19. At the time, and still, Oregon State University does not allow in-person activities. We are doing everything we can to keep the project moving using remote technologies and gatherings, and will continue to do so. What opportunities for training and professional development has the project provided?During the Progress Reporting Period of 9/1/19 to 8/31/20, without the release of funds or IRB approval, and in the midst of statewide shutdowns from COVID-19, we have only been able to provide radio programming. We offered four events on KTIL radio in Tillamook, Oregon. On May 4th, July 6th, August 3rd, and August 31st, we conducted interviews with mental health and substance use service providers serving Tillamook County and Oregon: National Alliance for Mental Illness, OSU Extension (to introduce the Coast to Forest project), Adventist Health, and Tillamook Family Counseling, respectively. How have the results been disseminated to communities of interest?We do not yet have results to disseminate. What do you plan to do during the next reporting period to accomplish the goals?Going forward, we will aim to conduct all project activities as proposed, with the exception of holding them with Zoom or other remote technology given the COVID-19 crisis. Through the project period, we will: · Provide evidence-based Mental Health First Aid training in two high-need regions of the state, comprising four heavily impacted counties; · Assess population mental health needs (educational and systems-level), resources and readiness, and conduct strategic planning through the Substance Abuse and Mental Health Services Administration's (SAMHSA) program, Community Conversations about Mental Health; · Build capacity to address needs by training community partners in Mental Health First Aid and disseminating local mental health resource directories; · Implement health education strategies to reach broad community audiences, including through novel local Extension radio programming and educational offerings during Prevention Week; and · Conduct monitoring and evaluation, and disseminate project results to policymakers and other critical stakeholder audiences.
Impacts
What was accomplished under these goals?
As of this writing on December 1, 2020, we do not know yet what has been accomplished under these goals. We received IRB approval to begin evaluation data collection on November 10th, 2020 and funds were released on the project on November 13th, 2020. (Admittedly, these are dates outside of the Progress Report reporting period of 9/1/19 to 8/31/20.) Going forward, we will collect evaluation data as proposed, to include (a) pre/post questionnaires for Community Conversation event attendees and (b) surveys sent to Mental Health First Aid training participants.
Publications
|