Evaluation of telephone-based screenings for alcohol and other drug problems

With a growing body of evidence, policymakers and healthcare providers are beginning to promote and adopt screening and brief intervention strategies to identify and address alcohol and other drug problems among primary care patients. These strategies vary in their approach, sometimes bringing in trained health educators and other times integrating the SBI services within the current operations of primary care clinics. Within the MASBIRT (Massachusetts Screening, Brief Intervention, Referral and Treatment) Program, funded by the Substance Abuse and Mental Health Services Administration, we have developed and implemented a telephone-based screening system that screens patients prior to their scheduled healthcare appointment. Patients who screen positive for alcohol and other drug problems are then seen by a Health Promotion Advocate (HPA) for subsequent services. In this evaluation, we compare data on 300 patients who completed telephone-based screenings to a matched sample of 300 patients screened in-person by HPAs. We utilize a matched sample to minimize differences in results that are due to population characteristics. Using a chi-square test, the evaluation assesses whether the telephone-based screening results in significantly different screening results compared to in-persons screens and whether the distribution of patients needing brief intervention, brief treatment and referral to treatment differ significantly among those screened by telephone versus those screened in person. We also compare the cost per screen between the two approaches. The results will help policymakers and healthcare providers determine if automated telephone-based screening is a valid approach to screen their patient populations for alcohol and other drug problems.