Screening and Brief Intervention News Feed from PubMed

Subscribe to Screening and Brief Intervention News Feed from PubMed feed Screening and Brief Intervention News Feed from PubMed
NCBI: db=pubmed; Term=screening brief intervention substance
Updated: 1 day 2 hours ago

Sensitivity and specificity of the gain short-screener for predicting substance use disorders in a large national sample of emerging adults.

Thu, 01/19/2017 - 4:32pm
Related Articles

Sensitivity and specificity of the gain short-screener for predicting substance use disorders in a large national sample of emerging adults.

Addict Behav. 2017 Jan 06;68:14-17

Authors: Smith DC, Bennett KM, Dennis ML, Funk RR

Abstract
BACKGROUND AND OBJECTIVES: Emerging Adults (ages 18-25) have the highest prevalence of substance use disorders and rarely receive treatment from the specialty care system. Thus, it is important to have screening instruments specifically developed for emerging adults for use in Screening, Brief Intervention and Referral to Treatment (SBIRT) models. Optimal cutoffs for the widely-used GAIN Short-Screener's (GAIN-SS) Substance Disorder Screener (SDScrY) are not established specifically for emerging adults. Therefore, this study examined the sensitivity and specificity of the SDScrY in predicting emerging adult (ages 18-25) substance use disorders.
METHODS: We analyzed data from emerging adults in a large clinical sample (n=9,808) who completed both the five-item SDScrY (α=0.85) and the full criteria set for DSM-IV Substance Use Disorders. We estimated the sensitivity, specificity and area under the curve to determine optimal cutoffs.
RESULTS: Analyses revealed a high correlation between the SDScrY screener and its longer parent scale (r=0.95, p<0.001). Sensitivity (83%) and specificity (95%) were highest at a cutoff score of two (AUC=94%) on the SDScrY for any past year substance use disorder. Sensitivity (85%) was also high at a cutoff score of two on the SDScrY for any past year alcohol disorder.
CONCLUSIONS: The five-item Substance Use Disorder Screener is a sensitive and specific screener for emerging adults, and could be used to identify emerging adults who may benefit from SBIRT interventions.

PMID: 28088053 [PubMed - as supplied by publisher]

The SBIRT program matrix: a conceptual framework for program implementation and evaluation.

Thu, 01/12/2017 - 4:33pm
Related Articles

The SBIRT program matrix: a conceptual framework for program implementation and evaluation.

Addiction. 2017 Feb;112 Suppl 2:12-22

Authors: Del Boca FK, McRee B, Vendetti J, Damon D

Abstract
BACKGROUND AND AIMS: Screening, Brief Intervention and Referral to Treatment (SBIRT) is a comprehensive, integrated, public health approach to the delivery of services to those at risk for the adverse consequences of alcohol and other drug use, and for those with probable substance use disorders. Research on successful SBIRT implementation has lagged behind studies of efficacy and effectiveness. This paper (1) outlines a conceptual framework, the SBIRT Program Matrix, to guide implementation research and program evaluation and (2) specifies potential implementation outcomes.
METHODS: Overview and narrative description of the SBIRT Program Matrix.
RESULTS: The SBIRT Program Matrix has five components, each of which includes multiple elements: SBIRT services; performance sites; provider attributes; patient/client populations; and management structure and activities. Implementation outcomes include program adoption, acceptability, appropriateness, feasibility, fidelity, costs, penetration, sustainability, service provision and grant compliance.
CONCLUSIONS: The Screening, Brief Intervention and Referral to Treatment Program Matrix provides a template for identifying, classifying and organizing the naturally occurring commonalities and variations within and across SBIRT programs, and for investigating which variables are associated with implementation success and, ultimately, with treatment outcomes and other impacts.

PMID: 28074572 [PubMed - in process]

Screening, brief intervention and referral to treatment (SBIRT): implementation barriers, facilitators and model migration.

Thu, 01/12/2017 - 4:33pm
Related Articles

Screening, brief intervention and referral to treatment (SBIRT): implementation barriers, facilitators and model migration.

Addiction. 2017 Feb;112 Suppl 2:23-33

Authors: Vendetti J, Gmyrek A, Damon D, Singh M, McRee B, Del Boca F

Abstract
AIMS: To identify barriers and facilitators associated with initial implementation of a US alcohol and other substance use Screening, Brief Intervention, and Referral to Treatment (SBIRT) grant program, and to identify modifications in program design that addressed implementation challenges.
DESIGN: A mixed-method approach used quantitative and qualitative data, including SBIRT provider ratings of implementation barriers and facilitators, staff interview responses and program documentation.
SETTING: Multiple sites within the first seven programs funded in a national demonstration program in the United States.
PARTICIPANTS: One hundred and two SBIRT providers were surveyed; 221 SBIRT stakeholders and staff were interviewed.
MEASUREMENTS: Mean ratings of barriers and facilitators were calculated using provider survey responses. An inductive content analysis of interview responses identified factors perceived to support and challenge implementation; program modifications that occurred over time were recorded.
FINDINGS: Providers rated pre-selected implementation facilitators higher than barriers. Content analysis of interview responses revealed six themes: committed leaders; intra- and inter-organizational communication/collaboration; provider buy-in and model acceptance; contextual factors; quality assurance; and grant requirements. Over time, programs tended to: adopt more efficient 'pre-screen' item sets; screen for risk factors in addition to alcohol/substance use; use contracted specialists to deliver SBIRT services; conduct services in high-volume emergency department and trauma center settings; and implement on-site and telephonic treatment delivery.
CONCLUSIONS: Screening, Brief Intervention and Referral to Treatment program implementation in the United States is facilitated by committed leadership and the use of substance use specialists, rather than medical generalists, to deliver services. Many implementation challenges can be addressed by an adequate start-up phase focused on comprehensive education and training, and on the development of intra- and inter-organizational communication and collaboration; opinion leader support; and practitioner and host site buy-in.

PMID: 28074571 [PubMed - in process]

Screening, Brief Intervention and Referral to Treatment: implications of SAMHSA&#039;s SBIRT initiative for substance abuse policy and practice.

Thu, 01/12/2017 - 4:33pm
Related Articles

Screening, Brief Intervention and Referral to Treatment: implications of SAMHSA's SBIRT initiative for substance abuse policy and practice.

Addiction. 2017 Feb;112 Suppl 2:110-117

Authors: Babor TF, Del Boca F, Bray JW

Abstract
AIMS: This paper describes the major findings and public health implications of a cross-site evaluation of a national Screening, Brief Intervention and Referral to Treatment (SBIRT) demonstration program funded by the US Substance Abuse and Mental Health Services Administration (SAMHSA).
METHODS: Eleven multi-site programs in two cohorts of SAMHSA grant recipients were each funded for 5 years to promote the adoption and sustained implementation of SBIRT. The SBIRT cross-site evaluation used a multi-method evaluation design to provide comprehensive information on the processes, outcomes and costs of SBIRT as implemented in a variety of medical and community settings.
FINDINGS: SBIRT programs in the two evaluated SAMHSA cohorts screened more than 1 million patients/clients. SBIRT implementation was facilitated by committed leadership and the use of substance use specialists, rather than medical generalists, to deliver services. Although the quasi-experimental nature of the outcome evaluation does not permit causal inferences, pre-post differences were clinically meaningful and statistically significant for almost every measure of substance use. Greater intervention intensity was associated with larger decreases in substance use. Both brief intervention and brief treatment were associated with positive outcomes, but brief intervention was more cost-effective for most substances. Sixty-nine (67%) of the original performance sites adapted and redesigned SBIRT service delivery after initial grant funding ended. Four factors influenced SBIRT sustainability: presence of program champions, availability of funding, systemic change and effective management of SBIRT provider challenges.
CONCLUSIONS: The US Substance Abuse and Mental Health Services Administration's Screening, Brief Intervention and Referral to Treatment (SBIRT) demonstration program was adapted successfully to the needs of early identification efforts for hazardous use of alcohol and illicit drugs. SBIRT is an innovative way to integrate the management of substance use disorders into primary care and general medicine. Screening, Brief Intervention and Referral to Treatment implementation was associated with improvements in treatment system equity, efficiency and economy.

PMID: 28074569 [PubMed - in process]

The relative impact of brief treatment versus brief intervention in primary health-care screening programs for substance use disorders.

Thu, 01/12/2017 - 4:33pm
Related Articles

The relative impact of brief treatment versus brief intervention in primary health-care screening programs for substance use disorders.

Addiction. 2017 Feb;112 Suppl 2:54-64

Authors: Aldridge A, Dowd W, Bray J

Abstract
AIMS: To assess the relative impact of brief treatment (BT) compared with brief intervention (BI) on changes in substance use behavior in primary care screening programs for substance use disorders, overall and by patient severity.
DESIGN AND PARTICIPANTS: A total of 9029 patients with both baseline and follow-up interviews were identified in the US Government Performance and Results Act (GPRA) data from October 2004 and February 2008. Using a propensity score framework, multiple generalized linear mixed models and a local linear matching method with a difference in difference estimator, patients from the BI group that resemble BT patients were used to determine the relative treatment effect of BT. A total of 3218 of these US patients with baseline and follow-up interviews were used in the final analysis sample after the propensity score-matching procedure (1448 patients assigned to a BI service category and 1770 assigned to a BT service category).
SETTING: United States.
MEASUREMENTS: Dependent variables were the number of days of use in the past 30 days of any alcohol, alcohol to intoxication, illicit drugs and marijuana.
FINDINGS: The relative impact of BT was not significant for alcohol (0.269; P > 0.1) or alcohol to intoxication (0.462; P > 0.1). BT was found to reduce the frequency of use of illicit drugs at follow-up by 0.634 days more than BI (P < 0.05). Marijuana days were not affected significantly by assignment to BT (-0.128; P > 0.1). Higher severity patients assigned to BT had a decrease in days of illicit drug use of 1.765 (P < 0.05).
CONCLUSIONS: In the United States, brief treatment appears to have a stronger impact on reducing illicit drug use than brief intervention but is similar to brief intervention for reducing alcohol use, alcohol to intoxication and marijuana use alone.

PMID: 28074568 [PubMed - in process]

The cost-effectiveness of brief intervention versus brief treatment of Screening, Brief Intervention and Referral to Treatment (SBIRT) in the United States.

Thu, 01/12/2017 - 4:33pm
Related Articles

The cost-effectiveness of brief intervention versus brief treatment of Screening, Brief Intervention and Referral to Treatment (SBIRT) in the United States.

Addiction. 2017 Feb;112 Suppl 2:73-81

Authors: Barbosa C, Cowell A, Dowd W, Landwehr J, Aldridge A, Bray J

Abstract
AIMS: To conduct a cost-effectiveness analysis (CEA) comparing the delivery of brief intervention (BI) with brief treatment (BT) within Screening, Brief Intervention and Referral to Treatment (SBIRT) programs.
DESIGN: Quasi-experimental differences in observed baseline characteristics between BI and BT patients were adjusted using propensity score techniques. Incremental comparison of costs and health outcomes associated with BI and BT.
SETTING: Health-care settings in four US states participating in Substance Abuse and Mental Health Services Administration SBIRT grant programs.
PARTICIPANTS: Ninety patients who received BT and 878 who received BI.
MEASUREMENTS: Per-patient cost of SBIRT, patient demographics and six measures of substance use: proportion using alcohol, proportion using alcohol to intoxication, days of alcohol use, days of alcohol use to intoxication, proportion using drugs and days using drugs.
FINDINGS: BI and BT were associated with better outcomes. The cost of SBIRT was significantly higher for BT patients ($75.54 versus 16.32, 95% confidence interval, P < 0.01). BT would be cost-effective if the decision-maker had a willingness to pay of $8.90 for a 1 percentage point reduction in the probability of using any alcohol. For the other five outcomes, BT was less effective and more costly, and BI would be a better use of resources.
CONCLUSIONS: It might be cost-effective to offer brief treatment if the goal is to abstain from alcohol. However, the higher effectiveness of brief treatment for this outcome is associated with considerable uncertainty and, because both brief intervention and brief treatment improve all outcomes, brief treatment does not appear to be a good use of resources.

PMID: 28074567 [PubMed - in process]

Screening, Brief Intervention and Referral to Treatment (SBIRT): rationale, program overview and cross-site evaluation.

Thu, 01/12/2017 - 4:33pm
Related Articles

Screening, Brief Intervention and Referral to Treatment (SBIRT): rationale, program overview and cross-site evaluation.

Addiction. 2017 Feb;112 Suppl 2:3-11

Authors: Bray JW, Del Boca FK, McRee BG, Hayashi SW, Babor TF

Abstract
AIMS: Since 2003, the US Substance Abuse and Mental Health Services Administration, Center for Substance Abuse Treatment (SAMHSA, CSAT) has awarded 32 Screening, Brief Intervention and Referral to Treatment (SBIRT) grants to states, territories and tribal organizations to enhance services for persons with, or at risk for, substance use disorders. The grants supported an expansion of the continuum of care to include screening, brief intervention, brief treatment and referral to treatment in general medical and community settings. This paper describes the SAMHSA SBIRT program in the context of the scientific research that motivated its development, as well as the two cross-site evaluations that are the subject of subsequent papers in this Supplement.
METHODS: A narrative review of research evidence pertaining to SBIRT and of the cross-site evaluation design that made it possible to determine whether the SAMHSA SBIRT grant program achieved its intended aims. The 11 programs within the two cohorts of grant recipients that were the subject of the cross-site evaluations are described in terms of SBIRT service components, performance sites, providers, management structure/activities and patient/client characteristics.
CONCLUSION: The US SAMHSA SBIRT program is an effective way to introduce a variety of new services that extend the continuum of care for substance-involved individuals, ranging from early intervention with non-dependent substance users to referral of more serious cases to specialized substance abuse treatment.

PMID: 28074566 [PubMed - in process]

Sustaining SBIRT in the wild: simulating revenues and costs for Screening, Brief Intervention and Referral to Treatment programs.

Thu, 01/12/2017 - 4:33pm
Related Articles

Sustaining SBIRT in the wild: simulating revenues and costs for Screening, Brief Intervention and Referral to Treatment programs.

Addiction. 2017 Feb;112 Suppl 2:101-109

Authors: Cowell AJ, Dowd WN, Mills MJ, Hinde JM, Bray JW

Abstract
AIMS: To examine the conditions under which Screening, Brief Intervention and Referral to Treatment (SBIRT) programs can be sustained by health insurance payments.
DESIGN: A mathematical model was used to estimate the number of patients needed for revenues to exceed costs.
SETTING: Three medical settings in the United States were examined: in-patient, out-patient and emergency department. Components of SBIRT were delivered by combinations of health-care practitioners (generalists) and behavioral health specialists.
PARTICIPANTS: Practitioners in seven SBIRT programs who received grants from the US Substance Abuse and Mental Health Services Administration (SAMHSA).
MEASUREMENTS: Program costs and revenues were measured using data from grantees. Patient flows were measured from administrative data and adjusted with prevalence and screening estimates from the literature.
FINDINGS: SBIRT can be sustained through health insurance reimbursement in out-patient and emergency department settings in most staffing mixes. To sustain SBIRT in in-patient programs, a patient flow larger than the national average may be needed; if that flow is achieved, the range of screens required to maintain a surplus is narrow. Sensitivity analyses suggest that the results are very sensitive to changes in the proportion of insured patients.
CONCLUSIONS: Screening, Brief Intervention and Referral to Treatment programs in the United States can be sustained by health insurance payments under a variety of staffing models. Screening, Brief Intervention and Referral to Treatment programs can be sustained only in an in-patient setting with above-average patient flow (more than 2500 screens). Screening, Brief Intervention and Referral to Treatment programs in out-patient and emergency department settings can be sustained with below-average patient flows (fewer than 125 000 out-patient visits and fewer than 27 000 emergency department visits).

PMID: 28074564 [PubMed - in process]

A time and motion study of Screening, Brief Intervention, and Referral to Treatment implementation in health-care settings.

Thu, 01/12/2017 - 4:33pm
Related Articles

A time and motion study of Screening, Brief Intervention, and Referral to Treatment implementation in health-care settings.

Addiction. 2017 Feb;112 Suppl 2:65-72

Authors: Cowell AJ, Dowd WN, Landwehr J, Barbosa C, Bray JW

Abstract
AIMS: Screening and brief intervention for harmful substance use in medical settings is being promoted heavily in the United States. To justify service provision fiscally, the field needs accurate estimates of the number and type of staff required to provide services, and thus the time taken to perform activities used to deliver services. This study analyzed the time spent in activities for the component services of the substance misuse Screening, Brief Intervention and Referral to Treatment (SBIRT) program implemented in emergency departments, in-patient units and ambulatory clinics.
DESIGN: Observers timed activities according to 18 distinct codes among SBIRT practitioners.
SETTING: Twenty-six US sites within four grantees.
PARTICIPANTS: Five hundred and one practitioner-patient interactions; 63 SBIRT practitioners.
MEASUREMENTS: Timing of practitioner activities.
INTERVENTIONS: Delivery of component services of SBIRT.
FINDINGS: The mean (standard error) time to deliver services was 1:19 (0:06) for a pre-screen (n = 210), 4:28 (0:24) for a screen (n = 97) and 6:51 (0:38) for a brief intervention (n = 66). Estimates of service duration varied by setting. Overall, practitioners spent 40% of their time supporting SBIRT delivery to patients and 13% of their time delivering services.
CONCLUSIONS: In the United States, support activities (e.g. reviewing the patient's chart, locating the patient, writing case-notes) for substance abuse Screening, Brief Intervention and Referral to Treatment require more staff time than delivery of services. Support time for screens and brief interventions in the emergency department/trauma setting was high compared with the out-patient setting.

PMID: 28074563 [PubMed - in process]

The influence of state-level policy environments on the activation of the Medicaid SBIRT reimbursement codes.

Thu, 01/12/2017 - 4:33pm
Related Articles

The influence of state-level policy environments on the activation of the Medicaid SBIRT reimbursement codes.

Addiction. 2017 Feb;112 Suppl 2:82-91

Authors: Hinde J, Bray J, Kaiser D, Mallonee E

Abstract
AIMS: To examine how institutional constraints, comprising federal actions and states' substance abuse policy environments, influence states' decisions to activate Medicaid reimbursement codes for screening and brief intervention for risky substance use in the United States.
METHODS: A discrete-time duration model was used to estimate the effect of institutional constraints on the likelihood of activating the Medicaid reimbursement codes. Primary constraints included federal Screening, Brief Intervention and Referral to Treatment (SBIRT) grant funding, substance abuse priority, economic climate, political climate and interstate diffusion. Study data came from publicly available secondary data sources.
RESULTS: Federal SBIRT grant funding did not affect significantly the likelihood of activation (P = 0.628). A $1 increase in per-capita block grant funding was associated with a 10-percentage point reduction in the likelihood of activation (P = 0.003) and a $1 increase in per-capita state substance use disorder expenditures was associated with a 2-percentage point increase in the likelihood of activation (P = 0.004). States with enacted parity laws (P = 0.016) and a Democratic-controlled state government were also more likely to activate the codes.
CONCLUSION: In the United States, the determinants of state activation of Medicaid Screening, Brief Intervention and Referral to Treatment (SBIRT) reimbursement codes are complex, and include more than financial considerations. Federal block grant funding is a strong disincentive to activating the SBIRT reimbursement codes, while more direct federal SBIRT grant funding has no detectable effects.

PMID: 28074562 [PubMed - in process]

Substance use outcomes of patients served by a large US implementation of Screening, Brief Intervention and Referral to Treatment (SBIRT).

Thu, 01/12/2017 - 4:33pm
Related Articles

Substance use outcomes of patients served by a large US implementation of Screening, Brief Intervention and Referral to Treatment (SBIRT).

Addiction. 2017 Feb;112 Suppl 2:43-53

Authors: Aldridge A, Linford R, Bray J

Abstract
AIMS: To estimate changes in the substance use behaviors of patients who received services as part of the US Substance Abuse and Mental Health Services Administration's (SAMHSA) Screening, Brief Intervention and Referral to Treatment (SBIRT) grant program.
METHODS: We use a pre-post design and performance monitoring data collected by SBIRT organizations. For a sample of 17 575 patients, we compare pre-SBIRT substance use with substance use 6 months after receipt of SBIRT services. SBIRT's correlation with changes in substance use was estimated using generalized linear mixed models to account for the clustering of patients within health-care facility and US state.
RESULTS: From pre- to post-SBIRT we found large and statistically significant decreases for almost every measure of substance use. Model-adjusted means indicate that the prevalence of alcohol use was lower 6 months later by 35.6%, heavy drinking by 43.4% and illicit drug use by 75.8%. Greater intervention intensity was associated with larger decreases in substance use. The study design does not support causal conclusions and estimated decreases in reported substance use are due, at least in part, to a well-known set of confounders and natural substance use patterns that may be unrelated to any particular SBIRT intervention.
CONCLUSIONS: Compared with previously published findings on the Screening, Brief Intervention and Referral to Treatment grant program, our estimates of substance use reduction were smaller, but still consistently large in absolute magnitude and within ranges of estimates from past trials of Screening, Brief Intervention and Referral to Treatment.

PMID: 28074561 [PubMed - in process]

Alcohol use screening and intervention by American primary care providers.

Thu, 12/29/2016 - 4:31pm
Related Articles

Alcohol use screening and intervention by American primary care providers.

Int J Drug Policy. 2016 Dec 24;41:29-33

Authors: Sahker E, Arndt S

Abstract
BACKGROUND: Regular/chronic drinking, defined by five or more drinks in one sitting on each of five or more occasions in the past 30 days, is a significant problem contributing to negative health outcomes, morbidity, and mortality. Regular/chronic and heavy episodic drinking largely goes undetected by primary care providers due to a lack of screening and intervention. The present study explores the extent to which healthcare practitioners screen for alcohol use, provide interventions, and refer to treatment across different types of drinkers.
METHODS: A retrospective analysis of the 2014 National Survey on Drug Use and Health was analysed in 2016. Respondents who visited primary care settings were asked if healthcare providers queried them about their drinking, amount they drank, frequency of drinking, and if they received interventions. Simple tests among proportions and logistic regression were used to analyse these data.
RESULTS: Healthcare professionals asked 76.5% of patients if they drank alcohol at all in the past year, and only 11.8% were asked if they had a drinking problem. The chance of being asked increased for heavy episodic and regular/chronic drinkers (F[1.97, 98.38]=44.81, p<0.001). Healthcare providers infrequently suggested cutting down on drinking (5.5% overall), but the chance of receiving a suggestion increased across heavy episodic and regular/chronic drinkers (F[1.92,96.02]=196.22, p<0.001). Information about alcohol treatment referral was rarely given (7.3% of regular/chronic drinkers). Moreover, minority, older, male, and uninsured patients were queried about alcohol use less often.
CONCLUSION: Healthcare practitioners in primary care are screening for alcohol use at moderate rates, yet follow-up questions, brief advice, and treatment referrals are inconsistently targeted. There is a need for consistent screening of all patients and systematic follow-up protocols in primary care delivery.

PMID: 28027484 [PubMed - as supplied by publisher]

Screening and Brief Intervention in High Schools: School Nurse Practices and Attitudes in Massachusetts.

Thu, 12/29/2016 - 4:31pm
Related Articles

Screening and Brief Intervention in High Schools: School Nurse Practices and Attitudes in Massachusetts.

Subst Abus. 2016 Dec 27;:0

Authors: Lunstead J, Weitzman ER, Kaye D, Levy S

Abstract
BACKGROUND: Screening, Brief Intervention, and Referral to Treatment (SBIRT) is recommended as a strategy to prevent or reduce adolescent substance use. Offering SBIRT in schools may provide an opportunity to reach adolescents not accessing primary care. Our objective is to assess school nurses' attitudes and practices regarding adolescent SBIRT.
METHODS: We administered electronically and in person a questionnaire including 29 items on SBIRT attitudes and practices to school nurses registered for the Northeastern University's School Health Institute Summer Program in Massachusetts (N = 168). Survey questions were adapted from a questionnaire originally developed by the American Academy of Pediatrics.
RESULTS: One hundred and forty-four nurses completed the survey for a response rate of 85.7%. Almost three quarters of the respondents (74.3%) were in favor of universal alcohol screening in schools. None of the respondents reported screening their students on a regular basis. More than half (64.4%) of nurses reported screening students, however, they did so only when they suspected alcohol use. During these instances, only 16.1% used a validated screening tool and almost all (98.4%) used face-to-face clinical interviews. When addressing alcohol use by a student, the large majority of respondents reported including the following recommended clinical strategies: asking about problems related to alcohol use (78.4%), explaining the harms of alcohol use (85.8%), and advising abstinence (82.8%). On average, respondents spend 5-10 minutes discussing alcohol use with their students.
CONCLUSION: Survey respondents were supportive of universal alcohol screening in school, though few were doing so at the time. When respondents identified students using alcohol their interventions were closely aligned with clinical recommendations for brief intervention. Implementation of SBIRT that focuses on standardized, annual screening has the potential to deliver high quality care in this setting.

PMID: 28027019 [PubMed - as supplied by publisher]

&#039;SBIRT&#039; is the answer? Probably not.

Thu, 12/15/2016 - 4:30pm
Related Articles

'SBIRT' is the answer? Probably not.

Addiction. 2015 Sep;110(9):1416-7

Authors: Saitz R

PMID: 26223169 [PubMed - indexed for MEDLINE]

Reducing Risky Alcohol Use: What Health Care Systems Can Do.

Thu, 12/08/2016 - 4:29pm
Related Articles

Reducing Risky Alcohol Use: What Health Care Systems Can Do.

Issue Brief (Mass Health Policy Forum). 2016 Apr 27;(46):1-50

Authors: Quinn AE, Brolin M, Stewart MT, Evans B, Horgan C

Abstract
Risky, non-dependent alcohol use is prevalent in the United States, affecting 25% of adults (Centers for Disease Control and Prevention, 2014b). Massachusetts has higher rates of alcohol use and binge drinking than most states (Substance Abuse and Mental Health Services Administration, 2015). Serious physical, social, and economic consequences result. Excessive alcohol use contributes to cancer, cardiovascular disease, sleep disorders, birth defects, motor vehicle injuries, and suicide, and it complicates management of chronic illnesses (Green, McKnight-Eily, Tan, Mejia, & Denny, 2016; Laramee et al., 2015; Mokdad, Marks, Stroup, & Gerberding, 2004; Rehm et al., 2009). Excessive alcohol use is one of the top causes of death, and over 240 alcohol-related deaths occur daily in the US (Mokdad et al., 2004; Stahre, Roeber, Kanny, Brewer, & Zhang, 2014). In comparison, 78 people die from an opioid overdose each day (Centers for Disease Control and Prevention, 2016). Excessive drinking is estimated to cost over $249 billion annually in the US and $5.6 billion in the Commonwealth (Sacks, Gonzales, Bouchery, Tomedi, & Brewer, 2015). This issue brief describes the scope of the risky drinking problem in the US and associated costs and consequences. The brief then examines the evidence base for tools to address risky drinking and outlines policy strategies that health care system stakeholders may employ to address further this critical public health issue. Screening and brief intervention (SBI) is an evidence-based, cost-effective practice to address risky alcohol use, typically using a short validated screening tool followed by a brief counseling session if a patient screens positive. Research shows SBI conducted in primary care outpatient settings significantly reduces alcohol use (Bertholet, Daeppen, Wietlisbach, Fleming, & Burnand, 2005b; Bien, Miller, & Tonigan, 1993; Kaner et al., 2009; Saitz, 2010a), hospitalizations (Fleming, Barry, Manwell, Johnson, & London, 1997b) and mortality (Cuijpers, Riper, & Lemmers, 2004). Alcohol SBI saves an estimated $217.95 per person screened (Barbosa, Cowell, Bray, & Aldridge, 2015).

PMID: 27911073 [PubMed - in process]

Brief Report: A Randomized Control Trial Assessing the Influence of a Telephone-based Intervention on Readmissions for Patients with Severe Mental Illness in a Developing Country.

Thu, 12/08/2016 - 4:29pm
Related Articles

Brief Report: A Randomized Control Trial Assessing the Influence of a Telephone-based Intervention on Readmissions for Patients with Severe Mental Illness in a Developing Country.

Community Ment Health J. 2016 Nov 30;

Authors: Botha UA, Koen L, Mazinu M, Jordaan E, Niehaus DJ

Abstract
Whilst comprehensive post-discharge interventions have been successful in reducing readmissions in our setting, they are possibly not sustainable due to limited resources. We assessed the impact of a more cost-effective telephone-based intervention on readmissions in a developing country over 12 months. 100 patients with severe mental illness were randomized to facilitated care or treatment as usual. All were interviewed prior to discharge and after 12 months. Facilitated care consisted of structured telephonic interviews and motivational support to patients and families. At 12 months no significant differences in either readmissions (p = 0.10) or days in hospital (p = 0.44) could be demonstrated. Substance use was high (64%), particularly methamphetamine (44%) in both groups. The intervention did not have any impact on inpatient usage in our setting. Though this study was limited by its small sample size, the results indicated that affordable post-discharge services may not be comprehensive enough to reduce readmission rates and would have to be tailored to the distinct population of dual diagnosis patients identified in this study.

PMID: 27900649 [PubMed - as supplied by publisher]

Faculty Development Efforts to Promote Screening, Brief Intervention and Referral to Treatment (SBIRT) in an Internal Medicine Faculty-Resident Practice.

Thu, 12/01/2016 - 4:29pm

Faculty Development Efforts to Promote Screening, Brief Intervention and Referral to Treatment (SBIRT) in an Internal Medicine Faculty-Resident Practice.

Subst Abus. 2016 Nov 29;:0

Authors: Stone A, Wamsley M, O'Sullivan P, Satterfield J, Satre DD, Julian K

Abstract
BACKGROUND: Screening, brief intervention, and referral to treatment (SBIRT) is a practical means to address substance misuse in primary care. Important barriers to implementing SBIRT include adequacy of training and provider confidence as well as logistical hurdles and time constraints. A faculty development initiative aimed at increasing SBIRT knowledge and treatment of substance use disorders (SUDs) should lead to increased use of SBIRT by faculty and the residents they teach. This study examined how a faculty development program to promote SBIRT influenced faculty practice and resident teaching.
METHODS: This was a cross-sectional study of faculty exposed to multiple SBIRT educational interventions over a five-year period in an academic resident-faculty general medicine practice. Participants completed a brief online survey followed by a semi-structured interview. Quantitative responses were examined descriptively. Qualitative questions were reviewed to identify key themes.
RESULTS: Fifteen of 29 faculty (52%) completed the survey and 13 (45%) completed the interviews regarding faculty development interventions. Faculty thought that SBIRT was an important skill and had confidence in screening for substance use disorders, though confidence in making treatment referrals and prescribing pharmacotherapy were rated lower. Many faculty reported screening more frequently for SUDs after attending faculty development sessions. However, several reported that the training did not improve their SBIRT teaching to residents during clinic precepting sessions. To improve uptake of SBIRT, a majority of faculty recommended electronic health record (EHR) alerts.
CONCLUSIONS: SBIRT is a highly valued set of skills and training may enhance rates of screening for substance misuse. However, participants did not report a substantial change in SBIRT teaching as a result of faculty development. In the future, small targeted faculty development sessions, potentially involving strategies for using the EHR, may be an effective way to enhance primary care SBIRT skills.

PMID: 27897470 [PubMed - as supplied by publisher]

SBIRT-Based Interventions to Improve Pediatric Oral Health Behaviors and Outcomes: Considerations for Future Behavioral SBIRT Interventions in Dentistry.

Thu, 11/24/2016 - 4:29pm
Related Articles

SBIRT-Based Interventions to Improve Pediatric Oral Health Behaviors and Outcomes: Considerations for Future Behavioral SBIRT Interventions in Dentistry.

Curr Oral Health Rep. 2016 Sep;3(3):187-192

Authors: Cuevas J, Chi DL

Abstract
Dental caries is the most common chronic disease in children and is caused by poor oral health behaviors. These behaviors include high-sugar diet, inadequate exposure to topical fluorides, and irregular use of professional dental care services. A number of behavioral intervention approaches have been used to modify health behaviors. One example is the Screening, Brief Intervention, and Referral to Treatment (SBIRT) model, which has been widely used to reduce substance abuse in both adults and children. SBIRT is a promising behavior change approach that could similarly be used to address problematic oral health behaviors. In this paper, we will review oral health studies that have adopted SBIRT components, assess if these interventions improved oral health behaviors and outcomes, and outline considerations for researchers interested in developing and testing future oral health-related SBIRT interventions in dentistry.

PMID: 27857880 [PubMed - in process]

[Barriers to implementing screening, brief intervention and referral to treatment for substance use in HIV/AIDS health services in Peru].

Thu, 11/17/2016 - 4:28pm
Related Articles

[Barriers to implementing screening, brief intervention and referral to treatment for substance use in HIV/AIDS health services in Peru].

Rev Peru Med Exp Salud Publica. 2016 Jul-Sep;33(3):432-437

Authors: Hoffman KA, Beltrán J, Ponce J, García-Fernandez L, Calderón M, Muench J, Benites C, Soto L, McCarty D, Fiestas F

Abstract
Objectives.: Screening and treatment for substance use among people living with HIV/AIDS (PLWHA) is highly recommended. Nevertheless, in Peru healthcare for PLWHA does not include a standardized or systematic assessment to identify substance use. The aim of this study was to assess the feasibility of implementing screening, brief intervention and referral to treatment (SBIRT) in healthcare settings attending people living with PLWHA.
Materials and methods.: After providing training in SBIRT for PLWHA's healthcare personnel (including nurses and physicians) focus groups were conducted to explore knowledge, beliefs and perceived barriers to implementation and interviews were conducted to assess the barriers and facilitators of two tertiary hospitals in Lima, Peru.
Results.: focus groups and interviews' thematic coding revealed three dimensions: 1) the unknown extent of substance use within PLWHA, 2) space and time limitations hinder completion of brief interventions during routine visits, and 3) insufficient access to substance use treatment appropriate for HIV patients.
Conclusions.: Multiple barriers, including lack of awareness of substance use problems, limited space and time of providers, and lack of specialized services to refer patients for treatment make it difficult to implement SBIRT in the Peruvian healthcare system.

PMID: 27831605 [PubMed - in process]

Examining the efficacy of a computer facilitated HIV prevention tool in drug court.

Thu, 11/17/2016 - 4:28pm
Related Articles

Examining the efficacy of a computer facilitated HIV prevention tool in drug court.

Drug Alcohol Depend. 2016 May 1;162:44-50

Authors: Festinger DS, Dugosh KL, Kurth AE, Metzger DS

Abstract
BACKGROUND: Although they have demonstrated efficacy in reducing substance use and criminal recidivism, competing priorities and limited resources may preclude drug court programs from formally addressing HIV risk. This study examined the efficacy of a brief, three-session, computer-facilitated HIV prevention intervention in reducing HIV risk among adult felony drug court participants.
METHODS: Two hundred participants were randomly assigned to an HIV intervention (n=101) or attention control (n=99) group. All clients attended judicial status hearings approximately every six weeks. At the first three status hearings following study entry, clients in the intervention group completed the computerized, interactive HIV risk reduction sessions while those in the control group viewed a series of educational life-skill videos of matched length. Outcomes included the rate of independently obtained HIV testing, engagement in high risk HIV-related behaviors, and rate of condom procurement from the research site at each session.
RESULTS: Results indicated that participants who received the HIV intervention were significantly more likely to report having obtained HIV testing at some point during the study period than those in the control condition, although the effect was marginally significant when examined in a longitudinal model. In addition, they had higher rates of condom procurement. No group differences were found on rates of high-risk sexual behavior, and the low rate of injection drug reported precluded examination of high-risk drug-related behavior.
CONCLUSIONS: The study provides support for the feasibility and utility of delivering HIV prevention services to drug court clients using an efficient computer-facilitated program.

PMID: 26971228 [PubMed - indexed for MEDLINE]

Pages