Engaging Undergraduate Students in Substance Use and Related Mental Health Disorders Research within South Dakota: A Review of the Summer Program for Undergraduate Research in Addiction (SPURA)

Abstract

Background:

The Summer Program for Undergraduate Research in Addiction (SPURA) at the University of South Dakota provides research opportunities to better understand substance use and related mental health disorders. The program was initiated in 2014 from funding from the National Institute on Drug Abuse with a mission to provide high-quality mentorship and research experiences for undergraduate students, including those underrepresented in science, technology, engineering, and math.

Methods:

Students from the University of South Dakota were recruited to participate in this program. Survey responses and demographic information were collected from the students.

Results:

During the first five years, 37 students completed the program. Many of these students were underrepresented in science. Of the students that had completed their undergraduate degree at the time of the last survey, most students either continued their education in a health professional or graduate program, or were employed in a career related to mental health or substance use.

Conclusion:

The current report reflects upon the outcomes of the program and future directions. With continued effort, SPURA will provide critical education for future leaders and health care professionals on topics related to substance use and mental health disorders, resulting in a greater number of advocates for those afflicted by substance use.

Introduction

Undergraduate research is associated with a variety of positive outcomes. Students performing mentored research develop identities as scholars and scientists.¹ Further, they are more likely to persist in highly skilled careers.² Studies have demonstrated that undergraduate research is particularly helpful for underrepresented populations, not only for persistence until graduation, but also for fostering interest in pursuing science, technology, engineering, and mathematics (STEM) careers.^2–5 As such, a goal of the Summer Program for Undergraduate Research in Addiction (SPURA) was to provide opportunities for underrepresented students to participate in research.

Although at the surface, South Dakota may not seem rich in underrepresented populations, the state is uniquely diverse. As defined by the National Institutes of Health, students can be considered underrepresented in STEM for a variety of reasons, including race or ethnicity, disability, and disadvantaged backgrounds.⁶ Approximately 9% of the state’s population is Native American compared to 1.3% in the United States as a whole.⁷ Additionally, the state is home to a variety of students who qualify as economically disadvantaged.⁷ Poverty rates in the state exceed the national average, and household incomes are also below that of the nation; thus, many students are considered to be economically disadvantaged due to their background, and maybe less able to engage in research unless provided a stipend. Additionally, the vast majority of the state is considered rural. This creates additional barriers in obtaining postsecondary education including reduced educational resources and proximity to campuses, especially when combined with other forms of economic hardships.^8–10 Further, only 28.5% of South Dakota’s population age 25 years old or older have a bachelor’s degree. First-generational college students are also considered disadvantaged in STEM, according to the National Institutes of Health. Recent studies suggest that both socioeconomic status and first-generational students, have poorer academic outcomes compared to continuing-generation peers.^11–12 These underrepresented students may have reduced cultural capital to help navigate the social and technical aspects of higher education.¹¹ Mentoring may serve as a key to help these students navigate the unique challenges of higher education. Overall, many of the students in the state are considered to be from a disadvantaged background in STEM, according to the National Institute of Health’s definition of diversity.⁶ Therefore, although diversity in the state may look different from other areas of the country, the state has many underrepresented students who could benefit from both the mentorship and paid work experiences offered by undergraduate research programs.

Interdisciplinary research opportunities can be particularly useful for undergraduate students, especially for underrepresented groups. Studies have suggested collaborative sciences may improve motivation in research, especially among underrepresented females.¹³ Further, for many undergraduates, research experience offers a unique insight into careers that are unfamiliar to them. Students entering into a research program may have pre-conceived ideas of the options available in health professional careers. Providing interdisciplinary research opportunities allows these students to explore alternative or complementary research paths.¹⁴ Further, the skills and background knowledge acquired by research programs may also aid students in furthering their career goals in a future profession directed towards improving outcomes for those suffering from substance use disorders. Therefore, providing interdisciplinary research opportunities may lead to more diverse and research savvy future professionals.

Residents of South Dakota report a high unmet need for both substance use and mental health treatment access.¹⁵ A path to alleviate this would be to increase interest in careers in these fields as well as training more providers in these services. Previous research suggests that education and access to short courses on substance use improves not only knowledge of the disorders but also improves professional perception and attitudes towards patients with substance use disorders.¹⁶ While this review found most programs focused on medical and premedical programs, other research suggests that substance abuse treatment may be more effective if implemented using a multidisciplinary team approach.¹⁷ As such, providing multidisciplinary training in the complexities involved in substance use disorders and treatments, especially during undergraduate education, may help direct students towards careers in substance use and mental health professions and build the critical infrastructure to aid those suffering from substance use in the state.

Program Goals

The Summer Program for Undergraduate Research in Addiction at the University of South Dakota began in 2014 from funding provided by the National Institute on Drug Abuse. The goals for this program included: 1. Expand undergraduate research opportunities for students in South Dakota, with an emphasis on quality training of first-generation college students, students from rural backgrounds, and students who are from underrepresented populations; 2. Encourage a higher number of South Dakotan students to participate in research and to ultimately pursue post-graduate research careers and/or training in areas related to substance abuse and mental health issues; 3. Advance the field of substance abuse and related or underlying mental health issues by fostering cross-collaborative student training and research at the University of South Dakota. As the first iteration of the program has been completed, we report the outcomes and future goals of the program.

Methods

Undergraduates from the University of South Dakota were recruited through advertisements for the program distributed throughout campus both in print and electronically. In addition, materials promoting the program were made available to students participating in relevant courses. Finally, the directors advertised the program to on-campus groups promoting diversity in academia, such as the University’s TRiO and the local American Indian Science and Engineering Society chapter. With guidance from the program directors, student applicants sought out a research mentor that aligned with their interests, and together the student and mentor developed a research plan. Additional application materials included a letter of recommendation from the mentor, a personal statement from the student, and an unofficial transcript. Completed applications were then reviewed by an independent panel of reviewers to assess the fit of the applicant with the goals of the program. Recommended applicants were then offered a 12-week research fellowship in the form of a SPURA scholar. This offer consisted of 480 h of paid research experience as well as a small research and/or travel budget to help the students complete and present their research.

The program consisted of 12-weeks of research activities, with the majority of the time devoted to research under the supervision of their mentor. Cohort building activities also occurred throughout the research program. This included a SPURA picnic as a kickoff to the program where students and their families interacted with their mentors and other program participant. Weekly luncheons were also available where all undergraduate students on campus were welcome to dine together and discuss their activities. Both the picnic and the luncheons included participation and facilitation by peer mentors who were either graduate students from the participating laboratories or senior undergraduates, many of whom had previously completed the SPURA program. Following each luncheon, a seminar was presented encompassing a wide range of background information related to substance use disorders, mental health, developing research, and professional skills, including presentation of research findings. Towards the end of the seminar series, each student gave a research-in-progress presentation to disseminate their results and receive feedback within a supportive environment. As a final product of their research experience, students presented their findings at the Center for Brain and Behavioral Research Annual Meeting. This allowed students to share their research with peers as well as interact with local researchers and invited speakers from throughout the country.

Students were required to complete a survey on the first day of the program detailing the expectations of their experience, a follow-up survey after the completion of the program, and a yearly report thereafter. Mentors were also asked to complete a survey on their students, as well as their overall thoughts on the benefits of participating both for themselves and for their research. Prior to submitting this manuscript, IRB approval was sought to share the results of these surveys and was determined to be exempt.

Results- Program Outcomes

A total of 37 students completed the program during the first five years of the program. Of these participants, 49% were self-identified as female. In line with our first goal of expanding undergraduate research opportunities for first-generation college students, students from rural backgrounds, and students who are from underrepresented populations in South Dakota, many of these students were underrepresented (Figure 1A). Nearly three-quarters of the student participants (73%) were from a rural background. Close to one-third of participants (32%) reported that they were first-generation college students. Nearly half of student participants (47%) were eligible for need-based financial support. Additionally, 11% of these students were considered under-represented ethnic or racial minorities. During our first five years of the program, significant progress towards achieving the first goal of the SPURA program was made.

Figure 1.

Outcomes of the first five years of the SPURA program. A. Demographic information of students who have completed the program. B. Outcomes of the students who have completed the SPURA program. Students reported sustained interest in research resulting in continued research productivity. C. Many students who completed their undergraduate career continued on to enroll in a health professional or graduate program or were employed in areas related to substance use disorder and mental health. C. A variety of interdisciplinary workshops were available to promote collaborative efforts among disciplines.

The second goal of the program was to encourage a higher number of South Dakotan students to participate in research and to ultimately pursue post-graduate research careers and/or training in areas related to substance abuse and mental health issues (Figure 1B). In alignment with this goal, 94% of student alums agreed that the research experience provided by SPURA was beneficial. More specifically, 91% of alums agreed that their SPURA experience helped them reach their educational goals, 80% agreed that the experience helped them achieve their career goals, and 94% agreed that it helped them academically. Moreover, 63% of student alums participated in additional research experiences after completing the program. As a result, students were included in 15 peer-reviewed publications and 13 student presentations at internationally attended professional conferences outside of USD.

Importantly, many of these alums also continued their education in fields related to mental health or substance use treatment. Approximately 20% of students enrolled in a health professional program with the majority of students enrolling in medical school (Figure 1C). Similarly, 24% enrolled in a graduate program. Moreover, 22% of students were employed in professions related to the aims of SPURA, including but not limited to social services, addiction counseling, and child protective services. The remaining students were either participating in internships or still pursuing their undergraduate degrees. The promising results of the first five years of the program suggest SPURA may have a meaningful impact on increasing the workforce in South Dakota who are working towards improving outcomes of those suffering from substance use and mental health disorders.

The final goal of the program was to advance the field of substance use and related mental health disorders by fostering cross-collaborative student training and research at the University of South Dakota. Mentors were recruited from over ten disciplines, including the biological sciences, psychology, counseling, and addiction studies, to offer a wide variety of addiction-related research options. To facilitate collaborative interactions, weekly luncheons and seminars (Figure 1D) were provided to promote interaction and discussion among students from 13 different disciplines, as well as Responsible Conduct of Research training, which included over 50 participants. During this time, students and their mentors discussed their specific area of research as it applies to mental health and substance use disorders, and students were encouraged to explore how their field could relate with others to better approach substance use and treatment research problems. Further, the capstone activity of the program was for the students to present their findings at the Center for Brain and Behavioral Research’s Annual Research Symposium. This symposium is attended by experts in various disciplines, as well as over 80 local researchers to foster interactions among fields and allows students to interact with both internal researchers and distinguished external speakers. Time during the symposium (lunch) was reserved for the students to meet with one of the four external speakers to discuss research and professional development. Although these efforts helped promote cross-collaborative training, a future goal of this program is to expand these training experiences through peer experiences and meeting the industry needs.

Discussion

The opportunities offered by SPURA afforded students a paid research experience to better understand the many facets of substance use and mental health disorders. The outcomes of the first five years were promising, with nearly forty students successfully completing the program. Many of these students came from a background that is underrepresented in STEM and reported the program as benefitting their academic goals and being an overall positive experience. Approximately half of these students are already engaged in careers or pursuing educational opportunities that will directly aid those suffering from substance use and mental health disorders. This includes research and educational experience related to understanding substance use disorders for students who go onto medical school and other health professions who will eventually directly treat those suffering from these disorders. Given the high need for providers and advocates of substance use and mental health treatments in South Dakota,¹⁵ these are critical steps to aiding the state. A continued goal of the program is to provide growth in South Dakota’s mental health and substance use disorders treatment infrastructure by training future professionals in various disciplines.

Although the program made great strides towards achieving the first two goals, the program will continue to work to increase cross-collaborative training and research opportunities for students. Substance use disorder has a vast impact on all areas of society and results in significant healthcare-related expenditures each year.¹⁸ Moreover, it results in a significant economic impact resulting in an estimated annual cost of $510.8 billion.¹⁹ Recent estimates from the opioid crisis alone suggest its cost was $78,503 million dollars in 2013, including losses in productivity, criminal justice expenses, and healthcare-related expenses.²⁰ Given the vast impact of substance use disorders, multidiscipline and cross-collaborative efforts are necessary to adequately address and create effective treatments and prevention solutions for substance use and mental health disorders.

As the program continues, efforts are underway to increase cross-collaborative efforts. The USD Center for Brain and Behavior Research will partner with the Beacom School of Business, which houses a Health Services Administration (HSAD) Program to develop a Peer-to-Peer research collaboration. This arm of the SPURA program will allow an HSAD student to be paired with a SPURA student during the summer research program. There is a bi-directional benefit to having the SPURA student serve as a peer mentor for the HSAD student. The HSAD student brings a business background to the research project that identifies any factors that could potentially limit the research from being translated or applied to practice. Both students have an opportunity to better understand data-driven decision-making. A second recommendation for enhancing cross-collaborative efforts will be a Bringing STEM to the Classroom research collaboration. For this arm of the improvement endeavors, we will ask faculty members from disciplines other than the SPURA student’s major to permit the student to present their research in a large classroom or event setting. The audience will then discuss and develop potential strategies on how their field could help further this research or help address the problem introduced by the SPURA student. This presentation allows the student to demonstrate how the results of the research may be disseminated into the industry, particularly those that are not immediately obviously impacted by the research. This opportunity encourages interdisciplinary engagement; it gives the SPURA student more presentation experience, and it increases their awareness of translating research into practice. We believe these two additional research efforts will expand the student’s performance in the program.

In summary, SPURA continues to strive to provide underrepresented students with paid research opportunities to better understand substance use and mental health disorders. As the program continues, we encourage mentors and students in multiple disciplines to come together and develop projects to better address the needs of those suffering from substance use and mental health disorders as well as create effective prevention strategies within the state. While this program’s goals were specific to that of South Dakota, substance misuse, including fatal overdoses, has increased exponentially across the United States.²¹ Additional undergraduate programs to promote substance use training building upon the structure of the current program may help improve the infrastructure necessary to treat those suffering from substance use disorder.