1
|
Reif S, Brolin M, Beyene TM, D’Agostino N, Stewart MT, Horgan CM. Payment and Financing for Substance Use Screening and Brief Intervention for Adolescents and Adults in Health, School, and Community Settings. J Adolesc Health 2022; 71:S73-S82. [PMID: 36122974 PMCID: PMC9945348 DOI: 10.1016/j.jadohealth.2022.04.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 04/01/2022] [Accepted: 04/27/2022] [Indexed: 10/14/2022]
Abstract
Screening and brief intervention (SBI) is an evidence-based, cost-effective practice to address unhealthy substance use. With SBI services expanding beyond healthcare settings (e.g., schools, community organizations) and reaching younger populations, sustainability efforts must consider payment and financing. This narrative review incorporated rapid scoping review methods and a search of the gray literature to determine payment and financing approaches for SBI with adolescents and to describe related barriers and facilitators for its sustainability. We sought information relevant to adolescents and settings in which they receive SBI, but also reviewed sources with an adult focus. Few peer-reviewed articles met inclusion criteria, and those mostly highlighted healthcare settings. School-based settings were better described in the gray literature; little was found about community settings. SBI is mostly paid through grant funding and public and commercial insurance; school-based settings use a range of approaches including grants, public insurance, and other public funding. We call upon researchers and providers to describe the payment and financing of SBI, to inform how the uptake of SBI may be practicable and sustainable. The increasing activation and use of insurance billing codes, and the expansion of SBI beyond healthcare, is encouraging to address unhealthy substance use by adolescents.
Collapse
Affiliation(s)
- Sharon Reif
- Institute for Behavioral Health, Heller School for Social Policy and Management, Brandeis University, Waltham, Massachusetts.
| | - Mary Brolin
- Institute for Behavioral Health, Heller School for Social Policy and Management, Brandeis University, 415 South Street, Waltham, MA, 02453, USA
| | - Tiginesh M. Beyene
- Institute for Behavioral Health, Heller School for Social Policy and Management, Brandeis University, 415 South Street, Waltham, MA, 02453, USA
| | - Nicole D’Agostino
- Institute for Behavioral Health, Heller School for Social Policy and Management, Brandeis University, 415 South Street, Waltham, MA, 02453, USA
| | - Maureen T. Stewart
- Institute for Behavioral Health, Heller School for Social Policy and Management, Brandeis University, 415 South Street, Waltham, MA, 02453, USA
| | - Constance M. Horgan
- Institute for Behavioral Health, Heller School for Social Policy and Management, Brandeis University, 415 South Street, Waltham, MA, 02453, USA
| |
Collapse
|
2
|
Strategies for Alcohol Screening, Brief Intervention, and Referral to Treatment Sustainability in the Emergency Department. Adv Emerg Nurs J 2020; 42:225-230. [PMID: 32739952 DOI: 10.1097/tme.0000000000000311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Alcohol misuse remains the fourth leading cause of preventable death in the United States, with nearly 90,000 deaths occurring annually as a consequence of alcohol misuse. Screening, brief intervention, and referral to treatment (SBIRT) is an evidence-based strategy that includes initial screening using a valid tool, determining the need for intervention, a brief motivational interview, and referral to treatment leading to follow-up care when necessary. Although an abundance of evidence-based practices now exist as a guideline for quality patient care, an inconsistency persists between protocols supported by research and those actually integrated into daily clinical practice. Currently, there is little in the literature examining the sustainability of SBIRT programs in emergency departments. The authors examine challenges to SBIRT implementation in the emergency department and propose a number of strategies to ensure continued sustainability of this evidence-based practice.
Collapse
|
3
|
McDaniel JT, Albright DL, Laha-Walsh K, Henson H, McIntosh S. Alcohol screening and brief intervention among military service members and veterans: rural-urban disparities. BMJ Mil Health 2020; 168:186-191. [PMID: 32349987 DOI: 10.1136/bmjmilitary-2020-001479] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 04/06/2020] [Accepted: 04/08/2020] [Indexed: 11/03/2022]
Abstract
BACKGROUND Access to screening, brief intervention and referral to treatment programmes for alcohol use have been shown to be effective; however, little is known about access to these services among service members and veterans. We examined the association of service member or veteran rural-dwelling area and the following outcomes: recent general health check-up, alcohol screening and alcohol brief intervention. METHODS Data on 5080 military service members and veterans were obtained from the 2017 Behavioural Risk Factor Surveillance System of the USA. We estimated rural-urban disparities in the receipt of a recent voluntary general health check-up, as well as the receipt of alcohol screening and brief intervention, using a mixed logit model. RESULTS Of the 5080 participants in the study, a total of 4666 (90.49%, 95% CI 89.39% to 91.48%) reported a general health check-up in the last 2 years. Results showed 7.48% of the sample (95% CI 6.64% to 8.41%) exhibited heavy alcohol consumption patterns. Of the 414 participants who did not undergo a general health check-up, 13.80% (95% CI 9.63% to 19.41%) exhibited a pattern of heavy alcohol consumption. Rural individuals were less likely to report a recent health check-up (adjusted OR=0.82, 95% CI 0.79 to 0.87). Rurality was also independently associated with decreased likelihood of receiving an alcohol screening and brief intervention. CONCLUSION Greater access to telehealth or other geographically flexible screening and brief intervention programmes is needed in rural areas for service members and veterans.
Collapse
Affiliation(s)
- Justin T McDaniel
- School of Human Sciences, Southern Illinois University Carbondale, Carbondale, Illinois, USA
| | - D L Albright
- School of Social Work, The University of Alabama, Tuscaloosa, Alabama, USA
| | - K Laha-Walsh
- School of Social Work, The University of Alabama, Tuscaloosa, Alabama, USA
| | - H Henson
- School of Education, Southern Illinois University Carbondale, Carbondale, Illinois, USA
| | - S McIntosh
- School of Social Work, The University of Alabama, Tuscaloosa, Alabama, USA
| |
Collapse
|
4
|
Factors Impacting on Development and Implementation of Training Programs for Health Professionals to Deliver Brief Interventions, with a Focus on Programs Developed for Indigenous Clients: A Literature Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17031094. [PMID: 32050440 PMCID: PMC7037654 DOI: 10.3390/ijerph17031094] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 01/31/2020] [Accepted: 02/06/2020] [Indexed: 11/17/2022]
Abstract
This paper reviews the literature on evaluations of brief intervention training programs for health professionals which address one or more lifestyle factors of chronic disease to identify factors impacting on development and implementation of programs. A search was conducted of the literature evaluating brief intervention training programs from 2000–2019 in the databases: Medline, CINAHL, Psychinfo, Academic Premier, Science Direct, Ovid (Including EMBASE and Healthstar), Web of Science and Informit. The content analysis and data extraction were aligned to the domains in the Consolidated Framework for Implementation Research (CFIR) to assist in the narrative synthesis. The search identified eight evaluations of programs targeting multiple risk factors, and 17 targeting single risk factors. The behavioural risk factor most commonly addressed was smoking, followed by alcohol and drug use. Programs consisted of face-to-face workshops and/or online or distance learning methods. Facilitators included availability of sustainable funding, adapting the program to suit the organisation’s structural characteristics and adoption of the intervention into routine client care. For Indigenous programs, the use of culturally appropriate images and language, consultation with Indigenous communities, and development of resources specific to the communities targeted were important considerations.
Collapse
|
5
|
Wolf JP, Dellor ED. Investigating Relationships Between Drinking Venues, Drinking Companions, and Corporal Punishment of Children. CHILD MALTREATMENT 2019; 24:45-55. [PMID: 30453766 PMCID: PMC7988428 DOI: 10.1177/1077559518811955] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Limited evidence suggests that how much a parent drinks in a particular venue, such as a bar, restaurant, or a friend's home, is associated with use of corporal punishment. However, these relationships could differ depending on their drinking companions (e.g., spouse or friends). In this study, weighted zero-inflated Poisson models were used to examine whether the relationships between venue-specific drinking frequency, heavier drinking, and corporal punishment are moderated by drinking companions in a mixed-mode sample of parents ( n = 1,599). The relationships between drinking frequency, heavier drinking, and corporal punishment varied by drinking companions, with some combinations being protective and others conferring risk. While most alcohol screening tools focus on individual alcohol use, more nuanced assessment examining where and with whom parents are drinking could be helpful in understanding risk of physical discipline.
Collapse
Affiliation(s)
- Jennifer Price Wolf
- Division of Social Work, California State University, Sacramento, 600 J Street Sacramento, CA 95812, United States
- Pacific Institute for Research and Evaluation, Prevention Research Center, 180 Grand Avenue, Oakland, CA 94612, United States
| | - Elinam D. Dellor
- Pacific Institute for Research and Evaluation, Prevention Research Center, 180 Grand Avenue, Oakland, CA 94612, United States
| |
Collapse
|
6
|
Belfiore MN, Blinka MD, BrintzenhofeSzoc K, Shields J. Screening, brief intervention, and referral to treatment (SBIRT) curriculum integration and sustainability: Social work and nursing faculty perspectives. Subst Abus 2017; 39:255-261. [PMID: 28895809 DOI: 10.1080/08897077.2017.1377672] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND The Substance Abuse and Mental Health Services Administration (SAMHSA) has funded grants to universities to provide training and conduct research on the dissemination of Screening, Brief Intervention, and Referral to Treatment (SBIRT) to health care professionals. However, when it comes to integrating SBIRT content into an existing curriculum, difficulties can arise. When there is so much content already in the curriculum, adding more can be challenging. Additionally, some faculty believe that course curricula should be driven by the expertise and knowledge of faculty, not by opportunities afforded because of grant funding. METHODS Using qualitative semi-structured faculty interviews and thematic data analysis, this study explored the process and content issues surrounding the integration of SBIRT content into the Masters of Social Work (MSW) and Masters of Science in Nursing (MSN) curricula at one university. RESULTS Guidelines for the successful integration of SBIRT content into MSW and MSN curricula fall into two thematic areas: 1. Encourage buy-in and ownership of SBIRT curriculum development by current faculty. 2. Use a scaffolded approach. SBIRT includes several unique content areas which should be integrated per competencies addressed in each course. SBIRT content areas lend themselves to integration into a range of courses, employing an array of learning techniques and teaching materials. Scaffolding content requires creativity, which serves as the basis of the six subthemes that guide a scaffolded SBIRT integration approach. CONCLUSIONS SBIRT offers an evidence based intervention that uses a public health approach to reduce harm from substance use. As such, professional nursing and social work education programs should teach SBIRT to their master's level practitioners. This paper proposes guidelines for integrating that content into existing curricula.
Collapse
Affiliation(s)
- M Nicole Belfiore
- a National Catholic School of Social Service , The Catholic University of America
| | - Marcela D Blinka
- a National Catholic School of Social Service , The Catholic University of America
| | | | - Joseph Shields
- a National Catholic School of Social Service , The Catholic University of America
| |
Collapse
|
7
|
Singh M, Gmyrek A, Hernandez A, Damon D, Hayashi S. Sustaining Screening, Brief Intervention and Referral to Treatment (SBIRT) services in health-care settings. Addiction 2017; 112 Suppl 2:92-100. [PMID: 28074565 DOI: 10.1111/add.13654] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2014] [Revised: 09/01/2014] [Accepted: 03/06/2015] [Indexed: 11/27/2022]
Abstract
AIMS To assess the sustainability of Screening, Brief Intervention and Referral to Treatment (SBIRT) services after cessation of initial start-up funding. DESIGN Descriptive study with quantitative and qualitative data collected from 34 staff participants from six grantees (comprising 103 sites) funded previously through a large, federally supported SBIRT program. SETTING Primary care out-patient clinics and hospitals in the United States. PARTICIPANTS Thirty-four grantee-related staff members, including administrators, evaluators, key stakeholders and SBIRT service providers from six grantees. MEASUREMENTS Changes to levels and types of service delivery activities after federal funding stopped, alternative sources of funding and obstacles to delivery of services. FINDINGS Of the 103 original sites in the six SBIRT grantee programs, 69 sites continued providing services in some capacity (same as before, reduced, modified or expanded). Most of the 69 sites (67%) adapted and redesigned the delivery of SBIRT services post-initial grant funding. In addition, new sites were added after grant funding ended, bringing the total number of sites to 88. Analysis of participant responses identified four primary factors that influenced SBIRT sustainability: presence of champions, funding availability, systemic change and SBIRT practitioner characteristics. CONCLUSIONS Almost 70% of the Screening, Brief Intervention and Referral to Treatment (SBIRT) services in the United States funded initially through a federal program were able to sustain operations after federal funding ceased and some expanded SBIRT services beyond the original sites. The key factors related to sustainability were securing new funding, having champions, adapting and making system changes and managing program staffing challenges.
Collapse
Affiliation(s)
- Manu Singh
- JBS International, 5515 Security Lane, North Bethesda, MD, 20852
| | - Amanda Gmyrek
- JBS International, 5515 Security Lane, North Bethesda, MD, 20852
| | | | - Donna Damon
- UConn Health, Department of Community Medicine and Health Care, 263 Farmington Avenue Farmington, CT, 06030-6325
| | - Susan Hayashi
- JBS International, 5515 Security Lane, North Bethesda, MD, 20852
| |
Collapse
|
8
|
Abstract
There are many barriers to screening for alcohol and drug abuse. Screening, brief intervention, and referral to treatment (SBIRT) principles can be used in identifying and helping patients with substance abuse problems. This article introduces SBIRT, discusses barriers to implementation, and reviews current practice recommendations.
Collapse
Affiliation(s)
- Sherrie Ladegast
- Sherrie Ladegast is an FNP at Pacific Family Practice, San Francisco, Calif., and recent DNP graduate from the University of San Francisco
| |
Collapse
|
9
|
An Examination of the Workflow Processes of the Screening, Brief Intervention, and Referral to Treatment (SBIRT) Program in Health Care Settings. J Subst Abuse Treat 2016; 60:21-6. [DOI: 10.1016/j.jsat.2015.08.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2015] [Revised: 07/30/2015] [Accepted: 08/03/2015] [Indexed: 11/23/2022]
|
10
|
Mitchell SG, Monico LB, Gryczynski J, O'Grady KE, Schwartz RP. Staff Views of Acceptability and Appropriateness of a Computer-Delivered Brief Intervention for Moderate Drug and Alcohol Use. J Psychoactive Drugs 2015; 47:301-7. [PMID: 26375411 DOI: 10.1080/02791072.2015.1075631] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The use of computers for identifying and intervening with stigmatized behaviors, such as drug use, offers promise for underserved, rural areas; however, the acceptability and appropriateness of using computerized brief intervention (CBIs) must be taken into consideration. In the present study, 12 staff members representing a range of clinic roles in two rural, federally qualified health centers completed semi-structured interviews in a qualitative investigation of CBI vs. counselor-delivered individual brief intervention (IBI). Thematic content analysis was conducted using a constant comparative method, examining the range of responses within each interview as well as data across interview respondents. Overall, staff found the idea of providing CBIs both acceptable and appropriate for their patient population. Acceptability by clinic staff centered on the ready availability of the CBI. Staff also believed that patients might be more forthcoming in response to a computer program than a personal interview. However, some staff voiced reservations concerning the appropriateness of CBIs for subsets of patients, including older patients, illiterate individuals, or those unfamiliar with computers. Findings support the potential suitability and potential benefits of providing CBIs to patients in rural health centers.
Collapse
Affiliation(s)
| | - Laura B Monico
- b Research Associate , Friends Research Institute , Baltimore , MD
| | - Jan Gryczynski
- a Senior Research Scientist , Friends Research Institute , Baltimore , MD
| | - Kevin E O'Grady
- c Associate Professor of Psychology , University of Maryland , College Park , MD
| | - Robert P Schwartz
- d Medical Director/Senior Research Scientist , Friends Research Institute , Baltimore , MD
| |
Collapse
|
11
|
Gryczynski J, Mitchell SG, Ondersma SJ, O'Grady KE, Schwartz RP. Potential radiating effects of misusing substances among medical patients receiving brief intervention. J Subst Abuse Treat 2015; 55:39-44. [PMID: 25812927 DOI: 10.1016/j.jsat.2015.02.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Revised: 01/17/2015] [Accepted: 02/12/2015] [Indexed: 10/24/2022]
Abstract
BACKGROUND The societal benefits of substance use interventions are largely driven not by reducing use per se, but by the broader implications of those reductions. This encompasses "potential radiating effects of misusing substances" (PREMiS) such as utilization of high-cost hospital and emergency care, injury, productivity losses, incarceration, and driving while impaired. METHODS This study is a secondary analysis from a randomized trial comparing in-person vs. computerized brief intervention among 360 adult community health center patients with moderate-risk illicit drug use (N = 302 with complete data through 12 months of follow-up). This study aims to examine four aspects of PREMiS outcomes in this sample: (1) their frequency; and their association with (2) type of brief intervention received (by random assignment), (3) type of drug misused, and (4) baseline drug problem severity (within the moderate risk range). RESULTS 12-month prevalence was 18.5% for hospitalization (399 cumulative days), 33.1% for emergency department utilization (166 cumulative visits), 39.1% for injury (1818 injury-days), and 8.3% for incarceration (278 days of detention). There were 729 missed work days among those who reported employment. Fifty percent reported driving under the influence (DUI) of substances. There were no differences in PREMiS outcomes by type of brief intervention. Participants with only marijuana misuse at baseline were not at lower risk of experiencing PREMiS events than participants with other drug misuse. Higher baseline drug problem severity was predictive of future hospitalization (p < .05) and number of hospitalization days (p < .01). CONCLUSION This community health center sample with moderate-risk illicit drug use reported considerable high-cost healthcare utilization, injury, missed work, and DUI. Interventions are needed that can reliably lower risk of negative outcomes among drug users.
Collapse
Affiliation(s)
| | | | | | - Kevin E O'Grady
- University of Maryland, College Park, Department of Psychology, College Park, MD, USA
| | | |
Collapse
|
12
|
Gryczynski J, Mitchell SG, Gonzales A, Moseley A, Peterson TR, Ondersma SJ, O'Grady KE, Schwartz RP. A randomized trial of computerized vs. in-person brief intervention for illicit drug use in primary care: outcomes through 12 months. J Subst Abuse Treat 2014; 50:3-10. [PMID: 25282578 DOI: 10.1016/j.jsat.2014.09.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2014] [Revised: 08/29/2014] [Accepted: 09/05/2014] [Indexed: 10/24/2022]
Abstract
This study examined outcomes through 12 months from a randomized trial comparing computerized brief intervention (CBI) vs. in-person brief intervention (IBI) delivered by behavioral health counselors for adult community health center patients with moderate-level drug misuse (N=360). Data were collected at baseline, 3-, 6-, and 12-month follow-up, and included the Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) and laboratory analysis of hair samples. Repeated measures analyses examined differential change over time. There were no significant differences in drug-positive hair tests over time or by condition. Global ASSIST scores decreased in both conditions (p<.001), but there were no significant differences between conditions in overall change across 12 months of follow-up (p=.13). CBI produced greater overall reductions in alcohol (p=.04) and cocaine (p=.02) ASSIST scores than IBI, with initial differences dissipating over time. Computerized brief interventions present a viable alternative to traditional in-person brief interventions.
Collapse
Affiliation(s)
| | | | - Arturo Gonzales
- Sangre de Cristo Community Health Partnership, Santa Fe, NM USA
| | - Ana Moseley
- Sangre de Cristo Community Health Partnership, Santa Fe, NM USA
| | | | | | - Kevin E O'Grady
- University of Maryland, College Park, Department of Psychology, College Park, MD USA
| | | |
Collapse
|
13
|
Schwartz RP, Gryczynski J, Mitchell SG, Gonzales A, Moseley A, Peterson TR, Ondersma SJ, O’Grady KE. Computerized versus in-person brief intervention for drug misuse: a randomized clinical trial. Addiction 2014; 109:1091-8. [PMID: 24520906 PMCID: PMC4086904 DOI: 10.1111/add.12502] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2013] [Revised: 11/05/2013] [Accepted: 01/28/2014] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND AIMS Several studies have found that brief interventions (BIs) for drug misuse have superior effectiveness to no-treatment controls. However, many health centers do not provide BIs for drug use consistently due to insufficient behavioral health staff capacity. Computerized BIs for drug use are a promising approach, but their effectiveness compared with in-person BIs has not been established. This study compared the effectiveness of a computerized brief intervention (CBI) to an in-person brief intervention (IBI) delivered by a behavioral health counselor. METHODS Two-arm randomized clinical trial, conducted in two health centers in New Mexico, United States. Participants were 360 adult primary care patients with moderate-risk drug scores on the Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) who were randomly assigned on a 1 : 1 basis to a computerized brief intervention (CBI) or to an in-person brief intervention (IBI) delivered by a behavioral health counselor. Assessments were conducted at baseline and 3-month follow-up, and included the ASSIST and drug testing on hair samples. RESULTS The IBI and CBI conditions did not differ at 3 months on global ASSIST drug scores [b = -1.79; 95% confidence interval (CI) = -4.37, 0.80] or drug-positive hair tests [odds ratio (OR) = 0.97; 95% CI = 0.47, 2.02]. There was a statistically significant advantage of CBI over IBI in substance-specific ASSIST scores for marijuana (b = -1.73; 95% CI = -2.91, -0.55; Cohen's d = 0.26; P = 0.004) and cocaine (b = -4.48; 95% CI = -8.26, -0.71; Cohen's d = 0.50; P = 0.021) at 3 months. CONCLUSIONS Computerized brief intervention can be an effective alternative to in-person brief intervention for addressing moderate drug use in primary care.
Collapse
Affiliation(s)
- Robert P. Schwartz
- Friends Research Institute, Baltimore, MD USA,Please address correspondence to Robert P. Schwartz, M.D., Friends Research Institute, Inc., 1040 Park Avenue, Suite 103, Baltimore, MD 21201 USA; Voice: 410-837-3977 x276; Fax: 410-752-4218; (R. Schwartz)
| | | | | | - Arturo Gonzales
- Sangre de Cristo Community Health Partnership, Santa Fe, NM USA
| | - Ana Moseley
- Sangre de Cristo Community Health Partnership, Santa Fe, NM USA
| | | | | | - Kevin E. O’Grady
- University of Maryland, College Park, Department of Psychology, College Park, MD USA
| |
Collapse
|
14
|
McCambridge J, Cunningham JA. The early history of ideas on brief interventions for alcohol. Addiction 2014; 109:538-46. [PMID: 24354855 PMCID: PMC3992901 DOI: 10.1111/add.12458] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2012] [Revised: 08/06/2013] [Accepted: 12/11/2013] [Indexed: 11/29/2022]
Abstract
AIMS This study explores the early development of brief interventions for alcohol using a history of ideas approach with a particular focus on intervention content. METHODS The source publications of the key primary studies published from approximately 1962 to 1992 were examined, followed by a brief review of the earliest reviews in this field. These studies were placed in the context of developments in alcohol research and in public health. RESULTS After early pioneering work on brief interventions, further advances were not made until thinking about alcohol problems and their treatment, most notably on controlled drinking, along with wider changes in public health, created new conditions for progress. There was then a golden era of rapid advance in the late 1980s and early 1990s, when preventing the development of problem drinking became important for public health reasons, in addition to helping already problematic drinkers. Many research challenges identified at that time remain to be met. The content of brief interventions changed over the period of study, although not in ways well informed by research advances, and there were also obvious continuities, with a renewed emphasis on the facilitation of self-change being one important consequence of the development of internet applications. CONCLUSIONS Ideas about brief interventions have changed in important ways. Brief interventions have been studied with different populations of drinkers, with aims embracing both individual and population-level perspectives, and without well-specified contents. The brief intervention field is an appropriate target for further historical investigations, which may help thinking about addressing alcohol and other problems.
Collapse
Affiliation(s)
- Jim McCambridge
- Faculty of Public Health and Policy, London School of Hygiene and Tropical MedicineLondon, UK,Correspondence to: Jim McCambridge, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK. E-mail:
| | - John A Cunningham
- Centre for Mental Health Research, The Australian National UniversityCanberra, Australia,Centre for Addiction and Mental HealthToronto, Canada
| |
Collapse
|
15
|
Salvalaggio G, Dong K, Vandenberghe C, Kirkland S, Mramor K, Brown T, Taylor M, McKim R, Cummings GG, Wild TC. Enhancing screening, brief intervention, and referral to treatment among socioeconomically disadvantaged patients: study protocol for a knowledge exchange intervention involving patients and physicians. BMC Health Serv Res 2013; 13:108. [PMID: 23517813 PMCID: PMC3610268 DOI: 10.1186/1472-6963-13-108] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2013] [Accepted: 03/11/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Screening, Brief Intervention, and Referral for Treatment (SBIRT) is an effective approach for managing alcohol and other drug misuse in primary care; however, uptake into routine care has been limited. Uptake of SBIRT by healthcare providers may be particularly problematic for disadvantaged populations exhibiting alcohol and other drug problems, and requires creative approaches to enhance patient engagement. This knowledge translation project developed and evaluated a group of patient and health care provider resources designed to enhance the capacity of health care providers to use SBIRT and improve patient engagement with health care. METHODS/DESIGN A nonrandomized, two-group, pre-post, quasi-experimental intervention design was used, with baseline, 6-, and 12-month follow-ups. Low income patients using alcohol and other drugs and who sought care in family medicine and emergency medicine settings in Edmonton, Canada, along with physicians providing care in these settings, were recruited. Patients and physicians were allocated to the intervention or control condition by geographic location of care. Intervention patients received a health care navigation booklet developed by inner city community members and also had access to an experienced community member for consultation on health service navigation. Intervention physicians had access to online educational modules, accompanying presentations, point of care resources, addiction medicine champions, and orientations to the inner city. Resource development was informed by a literature review, needs assessment, and iterative consultation with an advisory board and other content experts. Participants completed baseline and follow-up questionnaires (6 months for patients, 6 and 12 months for physicians) and administrative health service data were also retrieved for consenting patients. Control participants were provided access to all resources after follow-up data collection was completed. The primary outcome measure was patient satisfaction with care; secondary outcome measures included alcohol and drug use, health care and addiction treatment use, uptake of SBIRT strategies, and physician attitudes about addiction. DISCUSSION Effective knowledge translation requires careful consideration of the intended knowledge recipient's context and needs. Knowledge translation in disadvantaged settings may be optimized by using a community-based participatory approach to resource development that takes into account relevant patient engagement issues. TRIAL REGISTRATION Northern Alberta Clinical Trials and Research Centre #30094.
Collapse
Affiliation(s)
- Ginetta Salvalaggio
- Department of Family Medicine, University of Alberta, 1702 College Plaza, Edmonton, AB, T6G 2C8, Canada
| | - Kathryn Dong
- Department of Emergency Medicine, University of Alberta, Room 565 CSC, Royal Alexandra Hospital, 10240 Kingsway Avenue, Edmonton, AB T5H 3V9, Canada
| | | | - Scott Kirkland
- Department of Emergency Medicine, University of Alberta, Edmonton, AB, Canada
| | | | - Taryn Brown
- Department of Emergency Medicine, University of Alberta, Edmonton, AB, Canada
| | - Marliss Taylor
- Streetworks, 10116-105 Ave, Edmonton, AB, T0B 4J0, Canada
| | - Robert McKim
- Edmonton South Side and Edmonton West Primary Care Networks, Edmonton, AB, Canada
| | - Greta G Cummings
- Faculty of Nursing, 5–110 ECHA, University of Alberta, Edmonton, AB, T6G 0C1, Canada
| | - T Cameron Wild
- School of Public Health, 3–277 ECHA, University of Alberta, Edmonton, AB, T6G 2G4, Canada
| |
Collapse
|