Substance Use Screening, Brief Intervention, and Referral to Treatment

Levy, Sharon; Williams, Janet F.; Ryan, Sheryl; Gonzalez, Pamela K.; Patrick, Stephen W.; Quigley, Joanna; Siqueira, Lorena M.; Smith, Vincent C.; Walker, Leslie R.

doi:10.1542/peds.2016-1211

Cited by 252 publications

(185 citation statements)

References 54 publications

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“…11,16 Pediatric-specific information was consistent with the AAP's ''Substance Abuse SBIRT for Pediatricians'' policy statement. 2 …”

Section: Methodsmentioning

confidence: 99%

Online Versus In-Person Screening, Brief Intervention, and Referral to Treatment Training in Pediatrics Residents

Giudice¹,

Lewin²,

Welsh³

et al. 2015

Journal of Graduate Medical Education

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Background Pediatricians underestimate the prevalence of substance misuse among children and adolescents and often fail to screen for and intervene in practice. The American Academy of Pediatrics recommends training in Screening, Brief Intervention, and Referral to Treatment (SBIRT), but training outcomes and skill acquisition are rarely assessed. Objective We compared the effects of online versus in-person SBIRT training on pediatrics residents' knowledge, attitudes, behaviors, and skills. Methods Forty pediatrics residents were randomized to receive either online or in-person training. Skills were assessed by pre- and posttraining standardized patient interviews that were coded for SBIRT-adherent and -nonadherent behaviors and global skills by 2 trained coders. Thirty-two residents also completed pre- and postsurveys of their substance use knowledge, attitudes, and behaviors (KABs). Two-way repeated measures multivariate analyses of variance (MANOVAs) and analyses of variance (ANOVAs) estimates were used to assess group differences in skill acquisition and KABs. Results Findings indicated that both groups demonstrated skill improvement from pre- to postassessment. Results indicated that both groups increased their knowledge, self-reported behaviors, confidence, and readiness with no significant between-group differences. Follow-up univariate analyses indicated that, while both groups increased their SBIRT-adherent skills, the online training group displayed more “undesirable” behaviors posttraining. Conclusions The current study indicates that brief training, online or in-person, can increase pediatrics residents' SBIRT skills, knowledge, self-reported behaviors, confidence, and readiness. The findings further indicate that in-person training may have incremental benefit in teaching residents what not to do.

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“…11,16 Pediatric-specific information was consistent with the AAP's ''Substance Abuse SBIRT for Pediatricians'' policy statement. 2 …”

Section: Methodsmentioning

confidence: 99%

Online Versus In-Person Screening, Brief Intervention, and Referral to Treatment Training in Pediatrics Residents

Giudice¹,

Lewin²,

Welsh³

et al. 2015

Journal of Graduate Medical Education

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“…Because adolescents who drink alcohol while pregnant could have a child with a FASD, policies from the American Academy of Pediatrics (AAP) and public domain tools are available to promote pediatrician skills and practices related to alcohol and other drug use screening, brief intervention, and referral to treatment. [78][79][80] Given the prevalence in the United States of alcohol use by women who are sexually active or pregnant, pediatricians, through the medical home, should maintain a high level of suspicion for FASD, become familiar with FASD features, and conduct screening to detect PAE and FASD patients as early as possible. Maternal markers that increase the likelihood of a child having had PAE include the mother's past history of alcohol or drug use problems, such as addiction, multiple drug use, a previous alcoholexposed pregnancy, little or no prenatal care, unemployment, a transient lifestyle, incarceration, and/or a heavily drinking partner or family member.…”

Section: The Role Of the Pediatrician And The Medical Homementioning

confidence: 99%

Fetal Alcohol Spectrum Disorders

Williams¹,

Smith²

2015

Pediatrics

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256

138

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Prenatal exposure to alcohol can damage the developing fetus and is the leading preventable cause of birth defects and intellectual and neurodevelopmental disabilities. In 1973, fetal alcohol syndrome was first described as a specific cluster of birth defects resulting from alcohol exposure in utero. Subsequently, research unequivocally revealed that prenatal alcohol exposure causes a broad range of adverse developmental effects. Fetal alcohol spectrum disorder (FASD) is the general term that encompasses the range of adverse effects associated with prenatal alcohol exposure. The diagnostic criteria for fetal alcohol syndrome are specific, and comprehensive efforts are ongoing to establish definitive criteria for diagnosing the other FASDs. A large and growing body of research has led to evidence-based FASD education of professionals and the public, broader prevention initiatives, and recommended treatment approaches based on the following premises:▪ Alcohol-related birth defects and developmental disabilities are completely preventable when pregnant women abstain from alcohol use.▪ Neurocognitive and behavioral problems resulting from prenatal alcohol exposure are lifelong.▪ Early recognition, diagnosis, and therapy for any condition along the FASD continuum can result in improved outcomes.▪ During pregnancy:◦no amount of alcohol intake should be considered safe;◦there is no safe trimester to drink alcohol;◦all forms of alcohol, such as beer, wine, and liquor, pose similar risk; and◦binge drinking poses dose-related risk to the developing fetus.

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“…Nevertheless, most of these risk behaviours keep hidden after a health care visit. For this reason most of researchers intercede for the use of structured tools ideally suited for preventing problematic behaviours and for a consistent screening [6,7]. Screening, brief intervention, and referral to treatment model may be well-suited for identifying and intervening with adolescents who are at-risk of developing substance use disorders and those adolescents whose substance consumption puts them at risk for injury or illness.…”

Section: Editorialmentioning

confidence: 99%