Abstract

BackgroundHospitalized people with unhealthy substance use should be referred to treatment. Although inpatient referral resources are often available, clinicians report that outpatient referral networks are not well-established. The purpose of this manuscript is to describe the development and usability testing of a web-based Referral to Treatment Tool (RTT © 2020 Trustees of Indiana University, all rights reserved) designed to identify treatment centers for people with unhealthy substance use.ResultsThe RTT was conceptualized, developed, and then populated with public use and local survey data of treatment centers from 14 market ZIP codes of hospitals participating in an SBIRT implementation study. The tool underwent initial heuristic testing, followed by usability testing at three hospitals within a large healthcare system in the Midwest region of the United States. Administrative (n = 6) and provider (n = 12) users of the RTT completed a list of tasks and provided feedback through Think-Aloud Tests, the System Usability Scale, and in-person interviews. Patients (n = 4) assessed multiple versions of a take-home printout of referral sites that met their specifications and completed in-person interviews to provide feedback. Each administrative task was completed in less than 3 min, and providers took an average of 4 min and 3 s to identify appropriate referral sites for a patient and print a referral list for the patient. The mean System Usability Scale score (M = 77.22, SD = 15.57, p = 0.03) was significantly higher than the passable score of 70, indicating favorable perceptions of the usability of the RTT. Administrative and provider users felt that the RTT was useful and easy to use, but the settings and search features could be refined. Patients indicated that the printouts contained useful information and that it was helpful to include multiple referral sites on the printout.ConclusionThe web-based referral tool has the potential to facilitate voluntary outpatient referral to treatment for patients with unhealthy substance use. The RTT can be customized for a variety of health care settings and patient needs. Additional revisions based on usability testing results are needed to prepare for a broader multi-site clinical evaluation.Trial Registration Not applicable.

Highlights

  • Hospitalized people with unhealthy substance use should be referred to treatment

  • In an effort to improve care for people with unhealthy substance use in the United States, the Substance Abuse and Mental Health Services Administration (SAMHSA) provided grants to study the implementation of Screening, Brief Intervention, and Referral to Treatment (SBIRT)

  • We describe the development and usability testing of this web-based RTT designed to identify treatment centers for people with unhealthy substance use

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Summary

Introduction

Inpatient referral resources are often available, clinicians report that outpatient referral networks are not well-established. In an effort to improve care for people with unhealthy substance use in the United States, the Substance Abuse and Mental Health Services Administration (SAMHSA) provided grants to study the implementation of Screening, Brief Intervention, and Referral to Treatment (SBIRT). Patients who screen positive receive a brief intervention and, when indicated, referral to treatment for long-term management of substance misuse. According to one national study of more than 17,000 patients, alcohol and drug use were significantly lower 6 months after receiving SBIRT services [3]

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