Randomized controlled trial to evaluate screening and brief intervention for drug-using multiethnic emergency and trauma department patients

Abstract

BackgroundScreening and brief intervention (SBI) is a comprehensive, integrated public health approach to identify and deliver a spectrum of early detection and intervention services for substance use in general medical care settings. Although the SBI approach has shown promise for alcohol use, relatively little is known about its effectiveness for illicit drug use. We are evaluating the SBI approach for drug use using a rigorous randomized controlled trial. The purpose of the report is to describe the overall trial and its programmatic and methodological strengths with a focus on health educator (HE) selection and training. In addition, the baseline characteristics of the recently enrolled multiethnic cohort are described.Methods/designA randomized two-group repeated measures design is being used in which drug-related outcomes of an intervention group will be compared with those of an attention-placebo control group. Selection of bicultural paraprofessional HEs—their training in research concepts, comorbid mental health issues, special treatment of marijuana use, and nonscripted enhanced motivational interviewing as well as their ongoing monitoring and evaluation—are among the features described. The HEs enrolled, consented, and conducted an intervention among 700 illicit drug users in two large hospital emergency departments/trauma units. To be eligible, a participant needed to be an adult (age ≥18 years), an English or Spanish speaker, awake and able to give consent, and reachable by telephone to schedule a six-month follow-up interview.DiscussionA comprehensive HE training protocol combined with rigorous, ongoing process measurement resulted in skill mastery in many areas and a successful participant recruitment period. Strengths and limitations of the study protocol are discussed as well as the characteristics of those recruited. This trial will be among the first to provide information about the effectiveness of SBI for illicit drug use. Outcome analysis has not yet been completed, but demonstrated programming and design successes have implications for future research and service delivery.Trial registrationhttp://NCT01683227

Aplicação do instrumento Alcohol, Smoking and Substance Involvement Screening Test (ASSIST): uma revisão integrativa

“…Many professionals proceeded to the implementation of ASSIST and among them, we highlight different health professionals (53.8%) (5,7,10,(17)(18)(19)21,(23)(24)(25)(26)28,(31)(32) , followed by trained individuals named as interviewers (34.6%) (2,6,8,11,20,22,27,33) , and researchers (authors), which corresponded to 11,5% (9,16,25) . Regarding the database which the studies were obtained, 34.6% (5,7,11,(16)(17)(18)21,23,26) were from PubMed, followed by the CAPES Journal Portal with 26.9% (2,20,22,25,(31)(32)(33) , SciELO with 19.2% (19,24,(27)(28)(29) , LILACS with 15.4% (6,8,9,…”

“…This IRL shows that 34.6% (5,7,11,(16)(17)(18)(19)(20)(21) of the studies came from the PubMed database, followed by CAPES Journals with 26.9% (2,(21)(22)(23)(24)(25)(26) , SciELO with 19.2% (19,24,(27)(28)(29) , Lilacs, with 15.4% (6,(8)(9)30) and Medline, with 3.8% (10) , 19 studies were duplicated in these databases. After selection, 26 studies were intended for analysis.…”

“…The application was conducted in heterogeneous groups with adult prevalence (73.1%) (2,(5)(6)(7)(8)(9)11,17,(20)(21)(22)(23)(24)(25)(26)(27)(30)(31)(32)(33) , followed by young students (15.4%) (16,17,19,28) , adolescents (7.7%) (10,29) and elderly (3.8%) (17) . Regarding the level of evidence, the higher prevalence studies referred to those with level IV, that is, cross-sectional studies, which corresponded to 69.2% of the sample (2,(4)(5)(6)(7)(8)(9)(10)16,(18)(19)(20)(23)(24)(27)(28)(29)33) .…”

“…Regarding the level of evidence, the higher prevalence studies referred to those with level IV, that is, cross-sectional studies, which corresponded to 69.2% of the sample (2,(4)(5)(6)(7)(8)(9)(10)16,(18)(19)(20)(23)(24)(27)(28)(29)33) . Many professionals proceeded to the implementation of ASSIST and among them, we highlight different health professionals (53.8%) (5,7,10,(17)(18)(19)21,(23)(24)(25)(26)28,(31)(32) , followed by trained individuals named as interviewers (34.6%) (2,6,8,11,20,22,27,33) , and researchers (authors), which corresponded to 11,5% (9,16,25) . Regarding the database which the studies were obtained, 34.6% (5,7,11,(16)(17)…”

“…Regarding the database which the studies were obtained, 34.6% (5,7,11,(16)(17)(18)21,23,26) were from PubMed, followed by the CAPES Journal Portal with 26.9% (2,20,22,25,(31)(32)(33) , SciELO with 19.2% (19,24,(27)(28)(29) , LILACS with 15.4% (6,8,9,30) and Medline with 3,8% (10) . With regard to place of publication, 50% (5,7,(17)(18)(19)(20)(21)23,25,26,(31)(32)(33) of the studies were international, 42.3% (6,8,9,10,11,16,24,(27)(28)(29)(30) were national and 7.7% …”