TY - JOUR
T1 - An evidence based alcohol screening, brief intervention and referral to treatment (SBIRT) curriculum for emergency department (ED) providers improves skills and utilization
AU - Bernstein, Edward
AU - Bernstein, Judith
AU - Feldman, James
AU - Fernandez, William
AU - Hagan, Melissa
AU - Mitchell, Patricia
AU - Safi, Clara
AU - Woolard, Robert
AU - Mello, Mike
AU - Baird, Janette
AU - Lee, Christina
AU - Bazargan-Hejazi, Shahrzad
AU - Broderick, Kerry
AU - LaPerrier, Kathryn A.
AU - Kellermann, Arthur
AU - Wald, Marlena M.
AU - Taylor, Robert E.
AU - Walton, Kim
AU - Grant-Ervin, Michelle
AU - Rollinson, Denise
AU - Edwards, David
AU - Chan, Theodore
AU - Davis, Dan
AU - Buchanan Marshall, Jean
AU - Aseltine, Robert
AU - James, Amy
AU - Schilling, Elizabeth
AU - Abu-Hasaballah, Khamis
AU - Baumann, Brigitte M.
AU - Boudreaux, Edwin D.
AU - Maio, Ronald F.
AU - Cunningham, Rebecca M.
AU - Murrell, Teresa
AU - Doezema, David
AU - Bauer, Michael J.
AU - Anglin, Deirdre
AU - Eliassen, Adriana
AU - Martin, Marcus
AU - Pines, Jesse
AU - Buchanan, Leslie
AU - Turner, James
AU - D'Onofrio, Gail
AU - Degutis, Linda C.
AU - Owens, Patricia
PY - 2007/11/27
Y1 - 2007/11/27
N2 - Objective: Emergency Departments (EDs) offer an opportunity to improve the care of patients with at-risk and dependent drinking by teaching staff to screen, perform brief intervention and refer to treatment (SBIRT). We describe here the implementation at 14 Academic EDs of a structured SBIRT curriculum to determine if this learning experience improves provider beliefs and practices. Methods: ED faculty, residents, nurses, physician extenders, social workers, and Emergency Medical Technicians (EMTs) were surveyed prior to participating in either a two hour interactive workshops with case simulations, or a web-based program (www.ed.bmc.org/sbirt). A pre-post repeated measures design assessed changes in provider beliefs and practices at three and 12 months post-exposure. Results: Among 402 ED providers, 74% reported < 10 hours of prior professional alcohol-related education and 78% had < 2 hours exposure in the previous year. At 3-month follow-up, scores for self-reported confidence in ability, responsibility to intervene, and actual utilization of SBIRT skills all improved significantly over baseline. Gains decreased somewhat at 12 months, but remained above baseline. Length of time in practice was positively associated with SBIRT utilization, controlling for gender, race and type of profession. Persistent barriers included time limitations and lack of referral resources. Conclusions: ED providers respond favorably to SBIRT. Changes in utilization were substantial at three months post-exposure to a standardized curriculum, but less apparent after 12 months. Booster sessions, trained assistants and infrastructure supports may be needed to sustain changes over the longer term.
AB - Objective: Emergency Departments (EDs) offer an opportunity to improve the care of patients with at-risk and dependent drinking by teaching staff to screen, perform brief intervention and refer to treatment (SBIRT). We describe here the implementation at 14 Academic EDs of a structured SBIRT curriculum to determine if this learning experience improves provider beliefs and practices. Methods: ED faculty, residents, nurses, physician extenders, social workers, and Emergency Medical Technicians (EMTs) were surveyed prior to participating in either a two hour interactive workshops with case simulations, or a web-based program (www.ed.bmc.org/sbirt). A pre-post repeated measures design assessed changes in provider beliefs and practices at three and 12 months post-exposure. Results: Among 402 ED providers, 74% reported < 10 hours of prior professional alcohol-related education and 78% had < 2 hours exposure in the previous year. At 3-month follow-up, scores for self-reported confidence in ability, responsibility to intervene, and actual utilization of SBIRT skills all improved significantly over baseline. Gains decreased somewhat at 12 months, but remained above baseline. Length of time in practice was positively associated with SBIRT utilization, controlling for gender, race and type of profession. Persistent barriers included time limitations and lack of referral resources. Conclusions: ED providers respond favorably to SBIRT. Changes in utilization were substantial at three months post-exposure to a standardized curriculum, but less apparent after 12 months. Booster sessions, trained assistants and infrastructure supports may be needed to sustain changes over the longer term.
KW - Alcohol education
KW - Alcohol screening
KW - Brief intervention
KW - Substance abuse
UR - http://www.scopus.com/inward/record.url?scp=36949025967&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=36949025967&partnerID=8YFLogxK
U2 - 10.1300/J465v28n04_01
DO - 10.1300/J465v28n04_01
M3 - Article
C2 - 18077305
AN - SCOPUS:36949025967
VL - 28
SP - 79
EP - 92
JO - Substance Abuse
JF - Substance Abuse
SN - 0889-7077
IS - 4
ER -