Screening, Brief Intervention, and Referral to Treatment (SBIRT) for Alcohol and Other Drug Use Among Adolescents: Evaluation of a Pediatric Residency Curriculum
Department of Pediatrics, Yale University School of Medicine, New Haven, Connecticut, USA.Substance Abuse (Impact Factor: 1.62). 07/2012; 33(3):251-60. DOI: 10.1080/08897077.2011.640182
The objective of this study was to evaluate the integration of a screening, brief intervention, and referral to treatment (SBIRT) curriculum for alcohol and other drug use into a pediatric residency program. Pediatric and medicine/pediatric residents in an adolescent medicine rotation located in an urban teaching hospital participated in the study. Main outcome measures were pre- and post-training knowledge scores, performance of the Brief Negotiation Interview (BNI), training satisfaction, and adoption of the BNI into clinical practice. Thirty-four residents were trained. Significant pre- to post-training improvements were seen in knowledge scores (P < .001) and performance as measured by the BNI Adherence Scale (P < .001). Residents reported high satisfaction immediately post-training and at 30 days on a 1-5 Likert scale: mean 1.41 to 1.59 (1 = very satisfied) (P = 0.23). Over a 9-month period, 53% of residents documented performing at least 1 BNI, of which 2/3 reported ≥2 BNIs in a subsequent clinical setting. The results show that integrating a SBIRT curriculum into a pediatric residency program increases residents' knowledge and skills.
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ABSTRACT: Background: The Baylor College of Medicine SBIRT Medical Residency Training Program is a multilevel project that trains residents and faculty in evidenced-based screening, brief intervention, and referral to treatment methods for alcohol and substance use problems. Methods: This paper describes the training program created for pediatric residents and provides an evaluation of the program. Ninety-five first-year pediatric residents participated in the training program. They were assessed on satisfaction with the program, self-rated skills, observed competency, and implementation into clinical practice. Results: The program was successfully incorporated into the residency curricula in two pediatric residencies. Evaluations indicate a high degree of satisfaction with the program, self-reported improvement in SBIRT skills, observed proficiency in SBIRT skills, and utilization of SBIRT skills in clinical practice. Conclusions: SBIRT skills training can be incorporated into pediatric residency training, and residents are able to learn and implement the skills in clinical practice.
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ABSTRACT: Brief intervention (BI) can reduce harmful and hazardous drinking among emergency department patients. However, no psychometrically-validated instrument for evaluating the extent to which practitioners correctly implement BIs in clinical practice (e.g., adherence) exists. We developed and subsequently examined the psychometric properties of a scale that measures practitioner adherence to a BI, namely the Brief Negotiation Interview (BNI). Ratings of 342 audiotaped BIs in the emergency department demonstrated that the BNI Adherence Scale (BAS) has: (1) excellent internal consistency and discriminant validity; (2) good to excellent inter-rater reliability, and (3) good construct validity, with an eight-item, two-factor structure accounting for 62% of the variance, but (4) no predictive validity in this study. The BAS provides practitioners with a brief, objective method to evaluate their BNI skills and give feedback to them about their performance.