1. Project ARK- Washington University School of Medicine
SPNS Fourth All Grantee Meeting
June 15-16, 2017
SPNS Team Members:
Katie Plax, MD Principal Investigator
Kim Donica, LCSW Program Director
Jeff Glotfelty, MPH Project Coordinator
Julia Schlueter, MPH Evaluator
Maria Freshman, MA Data Coordinator
Stacey Slovacek, LSCW Project Assistant
Project ARK- Washington University School of Medicine

2. Future SPNS Leaders!!

3. Implementation Start Date: 2/6/17 Enrollment Period: 2/6/17 – 8/31/17
Enrollment Goal for Project: 100 youth
Monthly enrollment targets for the duration of the enrollment period: 14
Number of Enrolled Clients: 57
Average length of time it takes to enroll from time of referral: 18 Days
Shortest Length of Time from Referral to Enrollment: Same Day (7 Occurrences)
Longest Length of Time from Referral to Enrollment: 120 days
Average Number of Appointments scheduled before enrollment is completed: 1 (one)
Mode: 0 -Same Day Referral (7 occurrences)
Median: 8 Days

4. Implementation Current status of referrals
Current status of enrollments

5. implementation Enrollment:
Currently enrolling youth to meet enrollment goal of 100 participants
Patient Portal Enrollment:
Currently registering youth for EMR
37 out of 57 youth currently registered for portal access.
Virtual Support Group:
Plan to begin enrollment after recruitment of participants is completed.
Identifying vendor for technology (working with nametag.chat)
Creating structure to chat sessions with mental health specialist/moderator
Video Production:
Video filmed last month and is currently in post-production.
MCM Texting Intervention:
Minimum of one text per month to each enrolled client
Text messaging throughout month with enrolled clients
Texts uploaded and sent to qualitative evaluator

6. Implementation Epharmix (Two-Way Automated) Texting Intervention
Youth Receive:
Medication Reminders – (1 text per day)
General Check-in – (2 texts per week)
Housing/Bills Check-In – (I text per month)
Appointment Reminders – (As needed, 5 days before appt & 1 day before appt)
Staff responding to alerts and monitoring dashboard for engagement.

7. Implementation
Epharmix Dashboard identifies unengaged clients:

8. Implementation Successes and Challenges
We receive monthly reports from Epharmix and Follow My Health on youth utilization of product – reports indicate youth are engaged in project
Our clinic population has reported the highest response rate for Epharmix surveys
Receiving feedback from clinic staff that youth report liking text reminders
Challenges:
Staff Fatigue with day-to-day requirements of implementation/documentation
Have not identified desired vendor for virtual support group
Vendor challenges – vendor moved out of state during video production and creation of marketing plan
Space challenges to complete enrollment in some clinical settings
Steps for Overcoming Challenges?:
Additional booster trainings for staff and designated “office hours” to provide additional support to staff
Continue to interview vendors to build chat group appropriate for intervention

9. Outreach and Recruitment
Recruitment Dates:
2/6/17-8/31/17
recruitment
strategies
Start Date: 2/6/17
Estimated # of Eligible Clients: 269
Referrals: 97
Completed Enrollments: 57
Washington University Clinic Sites:
St. Louis Children’s Hospital
Adult ID Clinic
SPOT Clinic
Recruitment Strategy: In-Reach with MCM Staff
Weekly review of scheduled medical appointments & eligibility screening
MCM Referrals
EMR Review by Data Team
Print Materials
Clinic Electronic Advertisements

10. Recruitment/Marketing Materials: Before Youth Advisory Council Meeting
Notes - Youth Feedback:
People look ”too old” for youth
Doesn’t portray “privacy” – people are looking over each other’s shoulders to read text messages
Too Wordy – difficult to read
Youth ”don’t brunch”
The blue print-add looks like an alien and is “creepy”

11. Recruitment/Marketing Materials: After Youth Advisory Council Meeting

12. Recruitment Successes and Challenges
MCM staff have been effective in referring clients into the program
We are over 50% of our enrollment goal
Being physically present in clinical spaces (e.g. The SPOT)helps with referrals during visit
Balancing persistence and giving space
Steps for Overcoming Challenges?:
MCM staff can directly schedule SPNS enrollment on a shared calendar
SPNS PC/PA review eligibility one week before every medical clinic and send eligibility to MCM staff
Additional resources allocated to meet transportation needs
Staff attend scheduled clinic sessions to complete on-site enrollment
Challenges:
Estimated 50% no-show rate for scheduled enrollments
Barriers of Enrollment: transportation barriers, sporadic cell phone coverage, and competing priorities(family obligations, work, etc.)
Some staff have reported difficulty referring clients into the program
Space challenges to meet with referred clients in clinical settings

13. Additional Updates clinic orientation video
Video: “What You Can Expect During Your First Visit”
Jun Bae, Videographer
HLM (Health Literacy Missouri)
Target Population: Newly diagnosed clients and/or clients attending services for the first time in featured clinic
Orientation Includes Intro to Key Staff Seen During Appt:
Front Desk Staff
Case Managers (Linkage to Care & Youth Case Manager)
Nursing Staff
Physician
Youth Participants

14. Washington University in St. Louis
Discussion
Jeffrey Glotfelty, MPH
Project ARK
Washington University in St. Louis
4169 Laclede Avenue
St. Louis, MO 63108
(314) x 205