II. Telephone health coach
overdose, OUD
PCP
The Telephone Health Coaches (hereafter referred to as Coaches) deliver a series of individual health coaching sessions. The coaches are not affiliated with the clinics but provide a national phone bank available to patients of any of the study clinics. This allows patients to discuss clinic related barriers they face and to discuss issues that they do not want recorded in their EHR. The Coaches utilize elements of Motivational Interviewing (MI) and Cognitive Behavioral Therapy (CBT) to improve patient participant motivation and self-efficacy to change health behavior and behavioral outcomes [All patient participants in the STOP arm are offered the two initial health coaching sessions with or without video, based on patient participant preference, at approximately 2- and 4-weeks post-baseline. See Table Enhanced coaching (Step 2):Patient participants who may benefit from additional coaching following the Step 1 sessions are offered up to 4 additional sessions with the same Coach. These sessions ideally start within two weeks of the patient participant’s referral into Step 2 and occur once a week for four consecutive weeks. Enhanced coaching may be recommended by the NCM or PCP, or offered at the discretion of the Coach, based on patient preference as well as clinical criteria which may include ongoing or escalating nonmedical or illicit opioid use, overdose risk behavior, symptoms of OUD, overdose episodes, and/or consequences of opioid and other substance use. Enhanced coaching is offered by the Coach at the time of the second Step 1 session, and patients are free to decline. (Table 