CC2-02: Feasibility of Implementing Screening, Brief Intervention, and Referral to Treatment (SBIRT) at Kaiser Permanente Colorado

Abstract

Background/Aims: Programs to translate the Diabetes Prevention Program (DPP) into effective real-life interventions are needed. In the Call-2-Health pilot study we designed and tested a telephone-based intervention modeled on the DPP. Here we present the impact of Call-2-Health on participants' report of support from friends and family for diet changes. Social support may be critical to long-term maintenance of behavioral changes. Methods: Between September 2010 and January 2011, we mailed recruitment letters to 438 overweight English-speaking non-diabetic Group Health members aged 45-74 for whom electronic health records indicated at least one elevated blood glucose or HbA1c. We followed up with phone screening and laboratory tests to confirm eligibility and willingness to participate. Eligible and consenting participants (N=47; 49% men) were randomly assigned 1:1 to usual care (UC) and intervention groups (IG) for the 24-week study. The IG received 12 weekly intervention calls plus 4 maintenance calls over the subsequent 12 weeks. The interventionist delivered a DPP-based curriculum, using motivational interviewing and behavioral techniques to encourage exercise, dietary change, and weight loss. Three UC participants failed to complete the study; IG participants completed 95% of intervention calls. Study questionnaires included the Sallis Social Support scale for eating, completed at baseline and 24 weeks. Results: At baseline, the UC group had mean scores (95%CI) of 10.82 (7.93, 13.70) on the family and 8.55 (6.43, 10.66) on the friend diet encouragement scales. Mean scores for the IG were comparable, at 10.58 (8.09, 13.08) and 7.17 (6.03, 8.30). At 24 weeks, the measures remained essentially unchanged for UC and increased by 3.71 (1.56, 5.86) (p=0.016) and 3.46 (1.93, 4.99) (p=0.003) for the IG. At 24 weeks the mean weight lost for the IG was 8.6% of baseline weight (5.6, 11.5) as compared to 1.5% (-0.8, 3.9) for UC. Intervention participants' weight loss and their reported increase in dietary support were highly correlated (family r=0.70, friends r=0.64). Discussion: As compared to the usual care group, participants in the Call-2-Health phone intervention reported at 24 weeks a significant increase in supportive behaviors from friends and family regarding dietary change, with increases in support correlating strongly with weight loss success.

The Pandemic Experience for People with Depressive Symptoms: Substance Use, Finances, Access to Treatment, and Trusted Sources of Information

“…Although such screening should already be in place, given the well-described comorbidity of substance abuse with serious medical and mental health conditions, 44 many health care settings fail to systematically screen for unhealthy substance use, or do not use best evidence interventions. 45 …”

“…Although such screening should already be in place, given the well-described comorbidity of substance abuse with serious medical and mental health conditions, 44 many health care settings fail to systematically screen for unhealthy substance use, or do not use best evidence interventions. 45 As with any survey, self-selection bias is a potential concern, and, since this was an online survey administered only in English, people with limited internet access and/or computer skills, and non-English speakers are likely under-represented. Additionally, the respondents included a disproportionate number of healthcare workers, an employment category which may have influenced participants' experience of and reactions to the pandemic.…”

Study protocol for a type III hybrid effectiveness-implementation trial of strategies to implement firearm safety promotion as a universal suicide prevention strategy in pediatric primary care

“…Firearm materials and training. Clinicians will be strongly encouraged by pediatric leadership to access brief online training prior to trial launch [ 70 , 71 ]. The video will include targeted information on how to counsel parents about firearm safety using motivational interviewing, an evidence-based approach that takes a nonjudgmental stance.…”

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