Recognizing that community-based safety-net providers must be equipped to respond to the health needs of substance users in primary care settings, the proposed initiative seeks to build capacity to engage in participatory research related to the health needs of individuals with substance use disorders.

Specifically, the proposed initiatives will focus on building clinician and patient capacity to participate in research that addresses the concomitants of substance use, especially in three main areas: medication assisted therapy (MAT); addressing persistent pain; and reducing infectious disease. In addition, clinicians and patient stakeholders will be engaged to build capacity to participate in research design, implementation, and dissemination. Project activities will focus on building infrastructure to disseminate PCORI-funded research and products related to integrated behavioral health and primary care services to NNCC’s national network of nurse leaders and safety-net providers.

NNCC’s expertise will ensure that planning, capacity-building, and dissemination activities are rooted in PCORI-funded research and incorporate PCORI-designed resources. NNCC’s work in supporting nurse-led care in community health centers will help ensure that all training content is developed and tailored to the needs and priorities of the primary target audiences’ policy makers, clinicians, clinical administrators, and patients. The ultimate long-term objective is to prepare the nurses, clinical managers, and clients to engage as partners in PCOR/CER, especially as it relates to substance use care delivered in community health centers.

NNCC supports nurse-managed clinics nationwide. In these clinics, nurse practitioners direct care, and other advanced practice nurses offer a wide range of primary care, health promotion, and disease prevention services to low-income, vulnerable patients living in medically underserved areas. The majority of patients are either Medicaid recipients, uninsured, or self-paying. At the onset of the project, a strategic team of content experts, researchers, practitioners, and clients will be engaged to create a steering committee to focus discussion on the following topics: MAT, addressing persistent pain, and reducing infectious disease. Project steering committee members will include nurses working in safety-net settings such as nurse-managed health clinics, as well as other clinic staff members supporting them as part of an interprofessional team (e.g., health center social workers, behavioral health counselors, etc.). NNCC proposes to convene a steering committee comprised of nurses, including primary care providers, case managers, and academic nurses, as well as subject matter experts in treatment and infectious disease. Additionally, patients of nurse-led community health centers, including those with prior history of substance use, will be engaged to sit on the steering committee for the project.

The steering committee will solidify partnerships, ascertain community needs, and actively engage the nurse-led treatment community. Additionally, using a webinar platform and learning collaborative formats, NNCC will provide outreach and training opportunities for the aforementioned topic areas. A position paper will be developed on each topic in order to disseminate best practices and opportunities for expansion in nurse-led care. Finally, NNCC will leverage partnerships with health centers nationally to identify and develop potential research partnerships.

The expected outcomes of this project would be to:

• Identify and foster relationships with nurse-led health centers that support substance use disorder programming
• Develop a position paper related to the best practices and opportunities for substance use disorder program development in nurse-led health centers
• Engage patient perspectives from the beginning of the project
• Provide learning/training opportunities to health centers and patients related to MAT, pain management, and infectious disease control through a web-based format
• Build on relationships with health centers and patients for a future comparative treatment research program