Skills-Based Residency Training in Alcohol Screening and Brief Intervention: Results from the Georgia-Texas “Improving Brief Intervention” Project

Abstract

Alcohol screening and brief intervention (SBI) is recommended for all primary care patients but is underutilized. This project trained 111 residents and faculty in 8 Family Medicine residencies to conduct SBI and implement SBI protocols in residency clinics, then assessed changes in self-reported importance and confidence in performing SBI and brief intervention (BI) rates. Clinicians reported significant increases in role security, confidence, and ability to help drinkers reduce drinking and decreased importance of factors which might dissuade them from performing SBI. Stage of change measures indicated 37% of clinicians progressed toward action or maintenance in performing SBI, however numbers of reported BIs did not increase. At all time points 33–36% of clinicians reported BIs with 10% of the last 50 patients. Future studies should focus on increasing intervention rates using more patient-centered BI approaches, quality improvement approaches, and systems changes that could increase opportunities for performing BIs.

A Multisite Initiative to Increase the Use of Alcohol Screening and Brief Intervention Through Resident Training and Clinic Systems Changes

“…14-17 A larger multisite trial showed increases only in screening rates. 18 Beginning in 2010, the Southeastern Consortium on Substance Abuse Training (SECSAT), one of the aforementioned recipients of SAMHSA residency training grants, used a novel approach to disseminate and implement SBI into clinical settings. This approach was informed by the grantees' prior experience with the Georgia-Texas "Improving Brief Intervention" project 18 and a recent review of SBI implementation strategies.…”

“…18 Beginning in 2010, the Southeastern Consortium on Substance Abuse Training (SECSAT), one of the aforementioned recipients of SAMHSA residency training grants, used a novel approach to disseminate and implement SBI into clinical settings. This approach was informed by the grantees' prior experience with the Georgia-Texas "Improving Brief Intervention" project 18 and a recent review of SBI implementation strategies. 19 SECSAT sought to increase SBI rates in four primary care residency clinics by combining residency curriculum interventions with a comprehensive SBI implementation process.…”

Teaching Residents Screening, Brief Intervention, and Referral to Treatment (SBIRT) Skills for Alcohol Use: Using Chart-Stimulated Recall to Assess Curricular Impact

“…6,7 Assessing the impact of SBIRT curricular interventions for trainees is challenging. Most published studies show improvement in attitudes, confidence and substance use related knowledge [8][9][10][11][12] and some have demonstrated improvement in SBIRT skills as measured by standardized patient assessments. 13,14 However, standardized patient exams may not reflect the "real world" application of clinical skills.…”

Patterns of alcohol use and related issues: analysis of nurses' knowledge

“…As explanation for this result, one can point out the lack of knowledge about this problem among health workers, a phenomenon well documented in the literature (7,11,(15)(16) which prevents the recognition of the problem and a more appropriate approach for these professionals in different health services (4,17) . This result also reflects the little attention being given to the issue of addictions in nursing syllabus (11)(12)18) which was also evidenced in this study where 60% of participants received no training on this topic during nursing education. Among those who reported receiving some content on the issue, most mentioned were offered between 5 and 10…”