246131 Reducing Alcohol & Substance Misuse:

SBIRT in Action with Patients and Practices

Monday, October 31, 2011: 8:30 AM

Richard Goldsworthy, MSEd, PhD , Academic Edge, Inc., Bloomington, IN
     
Background:Alcohol and substance misuse represent a significant public health problem in the U.S. Substance use disorders affect an estimated 25% of primary care patients and many more are affected by at-risk use. Public health clinic/primary care clinic providers are uniquely positioned to address patients' risky use behaviors through Screening, Brief Intervention, and Referral to Treatment. SBIRT is endorsed by numerous organizations and agencies, including SAMSHA, and adoption is gaining momentum. Despite this opportunity, there are few cases illustrating SBIRT patient-provider interactions (PPIs) and none that address organization-wide implementation issues.

Methods: An established user-centered instructional design process grounded in social learning theory drove PPI case development among substance use subject-matter-experts and experienced providers. An early-adopter primary care clinic served as the organizational case. Cases were captured using experienced providers interacting with actors role-playing patients at different levels of risk. Cases include participant reflection/debriefing statements and third-party critiques.

Results:One organizational and four patient cases were created (1.25 hours of edited video). In formative evaluation, cases rated highly on realism, quality, engagement, and self-efficacy impact scales. Suggestions included additional organizational case diversity (e.g. setting, size, type), and more diverse PPI cases and heightened emphasis on motivational interviewing as a cross-cutting skill.

Conclusions: SBIRT can reduce adverse alcohol and substance misuse related public health outcomes. Adoption and implementation remains a challenge at the individual provider and organizational levels. The developed cases, freely available, are a valuable learning and adoption facilitation tool. Additional cases, support materials, and evaluation are merited. Supported in part by NIDA/NIH#N43DA-8-2215.

Learning Areas:
Planning of health education strategies, interventions, and programs
Program planning
Public health or related education

Learning Objectives:
1. Describe the need for and process used to generate video case studies of SBIRT adoption and implementation at both the organizational and individual public health provider levels 2. Describe the underlying theory, the review and formative evaluation processes and outcomes, and the content of the public health agency adoption and individual patient-provider interaction cases.

Keywords: Alcohol Problems, Substance Abuse

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have served as principle investigator on this multiyear, multi-institutional NIH-funded effort, to develop and evaluate how different educational tools affect SBIRT adoption and implemention. Efforts have included the present abstract, using social VR for training, and supporting SAMSHA rollout of SBIRT training in large residency/community-based organizations. I have 15 years experience as a lead researcher and a health instructional designer, and my areas of work have included alcohol use and abuse, FASD, screening and intervention, suicide-prevention, conflict resolution, STD prevention, and others.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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