This project evaluated a web-based multimedia training for primary care providers in screening, brief intervention, and referral to treatment (SBIRT) for unhealthy use of alcohol, tobacco, and other drugs. Physicians (n=37), physician assistants (n=35), and nurse practitioners (n=20) were recruited nationally by email and randomly assigned to online access to either the multimedia training or comparable reading materials. At baseline, compared to non-physicians, physicians reported lower self-efficacy for counseling patients regarding substance use and doing so less frequently. All provider types in both conditions showed significant increases in SBIRT-related knowledge, self-efficacy, and clinical practices. Although the multimedia training was not superior to the reading materials with regard to these outcomes, the multimedia training was more likely to be completed and rated more favorably. Findings indicate that SBIRT training does not have to be elaborate to be effective. However, multimedia training may be more appealing to the target audiences.

Our study suggests that online education builds skills, improves knowledge, and thus increases the number and quality of fax referrals made to QLs by health care providers. Providers nonetheless reported ongoing barriers to providing tobacco services and referral, including lack of reimbursement and patient unwillingness to accept a referral.