An Innovative Approach to Market Research Through Online Continuing Medical Education

Background:  Defining the Challenge Often public health researchers promote adoption of evidence-based practices (EPB), without knowledge of whether they are realistic and useful in specific clinical settings.  Market research with the providers is a necessary first step in developing a plan to foster adoption of innovative practices.  However, conducting formative research with this target market can be challenging, given cost, time, and regulatory constraints.  Collecting data from busy physicians can also be difficult.   Abt Associates employed an innovative research tool to overcome these challenges.   With the Substance Abuse and Mental Health Services Administration (SAMHSA ), we worked  with Medscape to  create a clinical practice assessment (CPA) that provides continuing medical education credits for the physicians and answers to critical questions for the agency.

Program background:  Understanding the Current Situation Since 2003, SAMHSA implemented screening, brief intervention, and referral to treatment (SBIRT) programs nationwide. While recent evidence has shown SBIRT’s effectiveness in reducing mental and substance use disorder, widespread use of SBIRT in primary care practices is slow.

Evaluation Methods and Results:  Formulating a Win/Win Research Solution The CPA was designed to learn about primary care providers (PCPs):

• current SBIRT practices;
• perceived barriers to screening, treatment and reimbursement and referrals;
• continuing education needs ;and
• communication preferences.

Implementing the CPA and its Findings The CPA was implemented between July and December 2011. Respondents included 319 primary care physicians (PCPs) and 644 mental health specialists. Information included practice settings, practice size, and degree of primary/ behavioral healthcare integration. Key findings about PCPs included:

• One third indicated that a lack of staff time for screening, lack of resources and low staff comfort with screening and diagnosis are barriers.
• Almost half indicated that lack of time for treatment, availability of reimbursement and availability of behavioral health services are major obstacles.
• The most requested topics for staff education are evidence-based treatment for mental and substance use disorders; best practices for behavioral health screening and diagnosis; and strategies for connecting to local and regional behavioral health providers.
• PCPs in private practice are more likely to find information about availability of reimbursement and coding helpful.
• Most clinicians prefer to use online methods to receive information such as web based resources guides, and online CME,  as well as patient education materials, guides, manuals and toolkits.

Conclusions:  Evaluating The CPA’s Strengths and Weaknesses The CPA is a useful tool for conducting market research among end users of a desired practice innovation.  We identified the following strengths and weaknesses in this approach:

• Strengths
  • Efficient process
  • Less costly than custom research
  • CME credits
  • Current Data
  • Ability to repeat for evaluation purposes

 

• Weaknesses
  • Difficult to stratify sample size
  • Static report with no ability to perform custom analyses

Implications for research and/or practice:  Using the Information to Foster Adoption of SBIRT  SAMHSA  and other organizations can use this data to:

• Design educational programs, technical assistance, and materials to address  desired topics;
• Deliver the programs using the most preferred formats ; and
• Promote the programs through the most effective media.