Table 1.

Standardized Patient Profiles

	White/Caucasian	American Indian (Navajo)
Demographic information
Name	Leah Lapinski	Sasha Tso
Birth date	12/04/1997
Age	22
Relationship	Boyfriend, 1 child (age 2)
Employment	Not working/unemployed
Insurance	Medicaid
Personal information
Address	[vacant property in nearest municipality to clinic] OR [unavailable; staying with friend, moving to apartment]
Phone	[borrowing from a friend]
Email	trailwanderer95@gmail.com
Previous provider	“Dr. Patel”
Chief complaint	New prenatal care
Patient concerns	• Heroin relapse • Loss of child custody • Becoming suicidal again • Health/wellbeing of new baby • Financial stress/unemployment
Background
Recent relocation from	Denver, CO	Navajo Nation (Window Rock, AZ)
Medical history	Chronic neck pain • after motor vehicle accident ~ 7 years ago, treated with oxycodone for several years Opioid use disorder • arising from chronic oxycodone use, was aggressively tapered by previous provider, began using IV heroin • During pregnancy of first child, sought OUD treatment, started on Suboxone, child was hospitalized for 6 weeks with neonatal abstinence syndrome • Had one relapse with heroin for 2 months, has been stable on Suboxone without relapse for last 12 months Depression • Treated medically by PCP for last 4 years • 1 suicide attempt (oxycodone overdose) about 4 years ago
Allergies	None
Medications	Suboxone 8 mg/2 mg BID Zoloft 100 mg/day Prenatal vitamin
Immunizations	“up to date”
Set-up instructions (clinic visit only)
Clothing	Elastic exercise pants, dingy t-shirt, coat/jacket, disheveled hair
Equipment	Backpack, smart phone, snack (in backpack)	Backpack with attached dreamcatcher, smart phone, snack (in backpack)
Position	Sitting in chair (or on exam table if no chair available)
Symptoms (clinic visit only)	• Occasional neck spasms/pain, 6/10, sometimes improves a little with Motrin • Depressed/anxious: worried about pregnancy, finances/unemployment • No suicidality