Screening, Brief Intervention, And Referral To Treatment Training Research Articles

Training health professional students to conduct SBIRT: A step forward to interprofessional collaboration to address substance use

Substance use (SU) remains a significant public health problem. Screening, brief intervention, and referral to treatment (SBIRT) is an evidence-based method to address patient SU. Training students from multiple disciplines can positively impact continuity of care for these patients.The SBIRT training was incorporated into the physician assistant, physical therapy, pharmacy and counseling curricula via online modules and live skills practice. Knowledge about screening for harmful SU and developing confidence to discuss SU using motivational interviewing (MI) to facilitate positive behavior changes were the outcomes.Training outcomes were measured for three consecutive years, assessed via pre- and post-training assessments and ratings of SBIRT interactions with patients. Knowledge gains and improved perceived competence to address SU were found. Successful curricular integration was achieved and has been maintained.Online training modules and resources are available through the Program Evaluation and Research Unit (PERU) at the University of Pittsburgh at https://www.peru.pitt.edu/ihsi/.

Comfort Levels of Outpatient Health Care Professionals When Asking About Substance Use-Related Sexual Activity: A Pilot Survey.

Screening, brief intervention, and referral to treatment (SBIRT) is an evidence-based intervention for substance use. Health care professionals may not receive SBIRT training or know of substance use's intersection with sexual activity. This pilot survey inquired about SBIRT training history, attitudes, and comfort among outpatient health care professionals, including assessing sexual activity-related use. We conducted a snowball cross-sectional survey of outpatient health care professionals at a large southeastern academic medical center in June 2021 with 4-point Likert questions covering demographics, substance use attitudes, SBIRT training history, and comfort implementing SBIRT. Analysis used descriptive statistics and stratification by demographic and practice characteristics. Seventy-three professionals responded, of whom 82% were White and 66% were female. Forty-seven percent were 30 to 39 years old, 33% were internal medicine professionals, and 59% reported previous SBIRT training. All participants reported believing substance use is a significant health issue. Most reported that they were comfortable or somewhat comfortable assessing patients for substance use (85%), dropping to 60% discussing sexual activity. Advanced practice providers and physicians identified more comfort with rapport building around substance use than other health care respondents. Professionals in infectious diseases and psychiatry reported the greatest comfort assessing substance use with concurrent sexual activity. There are gaps in SBIRT training and beliefs among health care professionals. Although health care workers report that assessing substance use is important, some professionals endorsed more comfort discussing substance use with patients than others, especially when inquiring about sexual activity. Future work could replicate the pilot to inform increasing comfort through training in the intersection of substance use and sexuality.

Expanding interprofessional teams: Training future health care professionals in screening, brief intervention, and referral to treatment (SBIRT).

Substance misuse persists and is undertreated across the United States (Substance Abuse and Mental Health Services Administration, 2021). Further enhancing the skill sets and capacity of interprofessional members of primary care teams to include proficiency in the Screening, Brief Intervention, and Referral to Treatment (SBIRT) model could help to alleviate the "treatment gap" (those requiring treatment, but not receiving it) by enhancing interprofessional teams at the pregraduate level (e.g., health educators, health coaches) to expand capacity and meet the volume of patients with substance use-related needs. In this study, SBIRT knowledge, training satisfaction, and efficacy were evaluated among undergraduate and graduate health and behavioral health students before and after exposure to a series of online training modules. On completion of the training, there were positive percent increases in overall mean knowledge and self-efficacy when compared with pretraining. At posttraining, graduate level students, regardless of discipline, reported greater knowledge than undergraduate students; there were no differences in efficacy or satisfaction among the groups. Additional analysis at the graduate level evaluated differences between behavioral health and medical trainees. No differences were found in knowledge or efficacy between groups at posttest, despite medical trainees reporting significantly lower efficacy at pretest. The findings of this study reinforce the need and potential to incorporate SBIRT training into higher education curricula for interprofessional health care professions to begin expanding the integrated care team's knowledge and efficacy in the provision of SBIRT to address the treatment gap. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Student Nurse Screening, Brief Intervention and Referral to Treatment Training Program: Analysis 2016-2019.

Screening, brief intervention and referral to treatment (SBIRT) is an evidence-based set of skills and strategies used by health care providers. Data have suggested SBIRT should be used in detecting persons at risk for substance use and be included in every primary care encounter, as many needing substance abuse treatment do not receive it. This descriptive study evaluated data for 361 undergraduate student nurses who participated in SBIRT training. Pretraining and 3-month posttraining surveys were used to evaluate changes in trainees' knowledge, attitudes, and skills toward people with substance use disorder. A satisfaction survey immediately after the training measured satisfaction with and usefulness of the training. Eighty-nine percent of students self-reported that the training increased their knowledge and skills related to screening and brief intervention. Ninety-three percent reported that they intended to use these skills in the future. Pre-post measures indicated statistically significant increases in knowledge, confidence, and perceived competence on all measures. Both formative and summative evaluation assisted in improving trainings each semester. These data confirm the need to integrate SBIRT content across the undergraduate nursing curriculum and include faculty and preceptors to improve rates of screening in clinical practice.

Substance Use Screening, Brief Intervention, and Referral to Treatment in Multiple Settings: Evaluation of a National Initiative

PurposeThis study evaluated the implementation and outcomes of a multisite initiative to identify and intervene in adolescent substance use across the many settings where youth interact. This paper focuses on the implementation and intermediate outcomes of the initiative, while others in the supplement address impact and ultimate outcomes. MethodsA mixed-methods cross-grantee evaluation was conducted from 2014 to 2019 among 56 recipients of funding from the Conrad N. Hilton Foundation to implement screening, brief intervention, and referral to treatment (SBIRT) across more than 1,266 youth-facing settings. Qualitative and quantitative data were collected from grantees on a quarterly basis, as well as from grantee proposals, progress reports, monthly grantee monitoring calls, and survey findings. ResultsGrantees reported increased capacity to provide SBIRT to youth across various settings: pediatric and primary care practices, community behavioral health organizations, juvenile justice programs, schools, and community-based organizations. Collectively, grantees screened 141,230 youth for substance use, 12,272 received a brief intervention, and 2,212 were referred to treatment. As part of the initiative, grantees provided SBIRT training to over 37,000 nursing and social work students, medical residents, addiction medicine fellows, and others. Implementation challenges included fitting screening into the workflow of primary care settings, confidentiality and consent in schools, reimbursement, and lack of specialist providers to refer to for substance use disorder treatment. Intermediate outcomes collected include total numbers of youth screened, received a brief intervention, and/or referred to more intensive treatment based on their screening scores. ConclusionsResearch on SBIRT in adolescents has been limited to date despite positive outcomes reported in adults. This mixed-methods evaluation of an initiative to expand SBIRT implementation demonstrates feasibility of expanding access to substance use screening and intervention for youth across multiple settings and identifies challenges of implementation that differ somewhat based on settings.

The Status of SBIRT Training in Health Professions Education: A Cross-Discipline Review and Evaluation of SBIRT Curricula and Educational Research.

To assess the quality of curricular research on the Screening Brief Intervention and Referral to Treatment (SBIRT) approach and determine the presence of useful training modalities, particularly motivational interviewing (MI) training, across health care training curricula. The authors conducted a systematic review of published, peer-reviewed studies in PubMed, ERIC, CINAHL, Ovid HealthSTAR, and PsycINFO databases through March 2021 for English-language studies describing SBIRT, a curriculum for health care trainees, and curricular intervention outcomes. After the records were independently assessed, data were extracted and 20% of the studies were double-coded for interrater reliability. Of 1,856 studies, 95 were included in the review; 22 had overlapping samples and were consolidated into 10 nested studies, leaving 83 total. Interrater reliability ranged from moderate (κ = .74, P < .001) to strong (κ = .91, P < .001) agreement. SBIRT training was delivered to trainees across many professions, including nursing (n = 34, 41%), medical residency (n = 28, 34%), and social work (n = 24, 29%). Nearly every study described SBIRT training methods (n = 80, 96%), and most reported training in MI (n = 54, 65%). On average, studies reported 4.06 (SD = 1.64) different SBIRT training methods and 3.31 (SD = 1.59) MI training methods. Their mean design score was 1.92 (SD = 0.84) and mean measurement score was 1.89 (SD = 1.05). A minority of studies measured SBIRT/MI skill (n = 23, 28%), and 4 studies (5%) set a priori benchmarks for their curricula. SBIRT training has been delivered to a wide range of health care trainees and often includes MI. Rigor scores for the studies were generally low due to limited research designs and infrequent use of objective skill measurement. Future work should include predefined training benchmarks and validated skills measurement.

Outcomes and lessons learned from an interprofessional student training program in Screening, Brief Intervention, and Referral to Treatment (SBIRT) at an academic health sciences center

Background and objectivesScreening, Brief Intervention, and Referral to Treatment (SBIRT) is a public health intervention to address overuse and risky use of alcohol and illegal substances. In order to increase SBIRT in clinical practice, training should start with future health care provider students and faculty. The main objective of this program was to improve and enhance the training of health professions students to provide competent screening, brief intervention and referral to treatment for persons who have or are at-risk for substance use disorder. This paper shares the results of an SBIRT training program at an academic health sciences center for undergraduate nursing, graduate nursing, and medical students. Design, setting and participants1229 undergraduate and graduate nursing students, medical students, faculty and preceptors at an academic medical center completed SBIRT coursework integrated into their existing curriculum. Coursework utilized an online learning platform as well as in-person skills training experiences. MethodsAn interprofessional team collaborated to create an online SBIRT curriculum consisting of 5 primary modules (total 3 h) and an SBIRT Booster module (0.5 h). The team also developed pre- and post-module quizzes and satisfaction surveys to measure changes in knowledge, confidence, and satisfaction; as well as simulations, videos, a screening tool, a provider pocket card, and an online resource library to support learning. Faculty and preceptors were trained in the program to model skills and answer student questions. A motivational interviewing specialist provided the in-person skills training sessions. ResultsA sustainable interprofessional SBIRT training program demonstrated gains in knowledge, confidence, and skills across all programs. The team used clinical opportunities and simulation with education to promote clinical proficiency. ConclusionsInterprofessional training mirrors real world clinical situations and encourages all providers to implement SBIRT in practice and decrease poor outcomes associated with substance use disorders.

Research Note—Online SBIRT Training for On-Campus, Satellite Campus, and Online MSW Students: Pre–Post Perceptions and Practice

ABSTRACT Social workers are in an ideal position to address the need for increased access to screening, brief intervention, and referral to treatment (SBIRT) for substance use disorder. This pre–post study explores the effects of SBIRT education and training among social work students from three campus environments (traditional, online, and satellite). Results demonstrated that participation in online training was related to increased levels of confidence, sense of responsibility, and practice of SBIRT and a decrease in perceived barriers. On-campus students showed the greatest post-training gains in confidence to use SBIRT. Results suggest that SBIRT education and training is beneficial for students from various backgrounds and should be included in social work students’ core clinical practice curriculum.

Screening, Brief Intervention, Referral to Treatment Training for Undergraduate Nursing Students: A Quasi-Experimental Comparison of Distance and Face-to-Face Learning.

Alcohol and drug misuse continue to result in negative outcomes in the United States. Training nurses in screening, brief intervention, and referral to treatment (SBIRT) has been proposed as one approach to mitigating those harms. Such training can lead to improved attitudes and intention to use SBIRT in clinical practice, but whether those outcomes manifest similarly for distance or face-to-face learning has not been investigated. The current study is a quasi-experimental comparison of face-to-face and distance SBIRT education for undergraduate nursing students performed in Fall 2019. No differences in attitudes or intentions were observed between face-to-face and distance learning approaches. Self-reported competence meaningfully increased in both study arms, and there was some evidence of additional increases in perceived role legitimacy and intention to use SBIRT. To the degree that benefits are observed for SBIRT training, they may not vary between face-to-face and distance learning implementations of the same curriculum. [Journal of Psychosocial Nursing and Mental Health Services, 60(8), 46-51.].

Screening, brief intervention, and referral to treatment (SBIRT) training reduces stigma and prepares orthopaedic providers to identify and intervene in opioid misuse: a prospective cohort study

Background: Despite the evolution of responsible opioid prescription for musculoskeletal pain, patients remain at risk for opioid problematic use, misuse, and addiction. Screening, brief intervention and referral to treatment (SBIRT) is an evidence-based practice to identify, reduce, and prevent those outcomes. This pilot study investigated the use of SBIRT practices developed to target opioid misuse in the orthopaedic practice environment and its applicability in the orthopaedic population. Methods: In this prospective cohort study, 19 orthopaedic providers underwent SBIRT training. Participants reported on their use of SBIRT over 6 wk and completed the Medical Condition Regard Scale (MCRS). Results: Twelve participants successfully implemented SBIRT, screening an average of 58.5% of patients. Seventeen percent of patients screened to an elevated risk level. Patients who screened as medium or high risk were 5.8 and 8.4 times more likely, respectively, to receive intervention compared with patients who screened to low risk or not screened (P&lt;0.01). Regard for patients with opioid use for pain increased from an MCRS score of 44.6 to 52.5 (P&lt;0.01). Ninety-five percent of participants found the training useful, and 89% would recommend the training to a colleague. Conclusions: This study demonstrated integration of SBIRT practices into an orthopaedic environment in which a significant proportion of orthopaedic patients screened to elevated risk of opioid misuse and qualified for brief intervention by the orthopaedic provider. SBIRT training had a positive impact on opioid-use stigma, a recognized barrier to care. Further study is warranted to determine the effect on patient outcomes and optimal implementation strategy. Level of Evidence: Level II.

SBIRT training: how do social work students compare to medical learners?

ABSTRACT Background: SBIRT (Screening, Brief Intervention, and Referral to Treatment) is an effective early intervention approach for individuals with substance misuse. The purpose of this study was to determine if medical learners are more adept at learning a brief substance use intervention compared to non-medical learners (e.g., social work students). The dissemination of SBIRT training among many helping professions can increase service delivery for substance use problems. Methods: A total of 2,488 participants completed SBIRT training, representing 15 different disciplines and over 20 different institutions. General linear models and paired t-tests were used to investigate the effects of SBIRT training on changes in knowledge and attitude of alcohol and drug use and satisfaction. Results: There were no statistical differences in the change of satisfaction, knowledge, and attitude between medical and non-medical discipline participants. Both medical and non-medical participants had greater improvement in attitude and knowledge scores post-training. Similar improvements in attitude, knowledge, and satisfaction were observed in all the health-care discipline participants. Discussion: SBIRT skills may be transferable to disciplines including non-prescribing professionals (e.g., social work, nursing, physical therapy, rehabilitation science, and pharmacy). In an effort to expand treatment, health-care training institutions adopt SBIRT as a core competency for professional practice.

Implementation of Screening, Brief Intervention, and Referral to Treatment (SBIRT) Training in Large Cohorts of Second Year Medical Students

ABSTRACT Substance use disorders are debilitating disorders with far reaching effects. However, many healthcare providers do not receive sufficient training on how to identify or respond to individuals who are at risk for SUDs. Because of this, residents of rural communities, who are served by fewer healthcare providers, are unlikely to encounter providers who are trained to respond effectively to SUDs. SBIRT is a tool used to intervene among patients engaging in risky substance use. Although numerous SBIRT training programs exist across the country, most have focused on relatively small groups of trainees, and have prioritized the training of mental health professionals. In response to this finding, we implemented a large-scale SBIRT training program designed to prepare approximately 540 medical students to meet the needs of patients at risk for or suffering from SUDs in West Texas. In this paper, we focused on medical student perceptions of the quality and utility of our SBIRT educational initiative. Student evaluations of the SBIRT training remained high across three cohorts of second-year medical students. The goal of this report is to provide recommendations to help enable any group to develop, adapt, and implement large-scale SBIRT training programs in other locations.

Outcomes of an interprofessional SBIRT training program: Knowledge attainment and perceived competence for practice

Background: One way to address substance misuse is to train health professional students in Screening, Brief Intervention, and Referral to Treatment (SBIRT), an early intervention strategy. This study evaluated a semester-long, 50-hour elective SBIRT training that blended online coursework with interprofessional experiences. Medicine, nursing, pharmacy, and social work students completed an interprofessional standardized patient experience and completed a minimum of two interprofessional SBIRT experiences at community agencies. Methods: We analyzed longitudinal data from 197 students using structural equation modeling to examine gains in knowledge and perceived competence, as well as to test if background variables predicted 30-day application of SBIRT knowledge and skills, 30-day satisfaction’ 12-month frequencies of care for performing SBIRT; and number of SBIRT clients/patients served directly. Results: Overall, student SBIRT knowledge and perceived competence both increased by more than a standard deviation during the course. Students who experienced larger gains in perceived competence rated the course significantly higher in terms of relevance and usefulness and, in turn, served significantly more SBIRT clients/patients during the following year. We did not find evidence that intra-individual growth in knowledge impacted the degree to which students ultimately applied SBIRT components. Finally, students who had more previous training and experience related to substance abuse ultimately reported greater application of SBIRT knowledge and skills. Interprofessional differences included: At baseline, medicine students had significantly lower substance abuse education knowledge as compared to the other disciplines. Pharmacy and social work students were more likely to have had previous experience with motivational interviewing. Baseline perceived competence in applying SBIRT was higher in social work and nursing. Upon completion, pharmacy and medicine students had lower satisfaction with the course. Conclusions: These findings suggest that SBIRT courses can increase knowledge and perceived competence; moreover, student background characteristics, work settings, and experiences may have important effects on learning SBIRT.

A Pilot Study of Peer-to-Peer SBIRT Simulation as a Clinical Telehealth Training Tool During COVID-19.

Screening, Brief Intervention and Referral to Treatment (SBIRT), is an evidence-based approach to screening and early intervention for those at risk of substance use disorders. With the ongoing health concerns related to COVID-19, there is an increased need for social workers who can competently deliver evidence-based interventions, such as SBIRT, via telehealth. Due to the COVID-19 pandemic, traditional SBIRT training approaches using face-to-face (FTF) instruction and FTF simulated practice may not be a safe or feasible way to develop students’ SBIRT- related skills. This study explores 35 social work graduate students’ experiences of learning SBIRT skills in a remote learning format and subsequently delivering a SBIRT intervention to a live “client” via a peer-to-peer simulated telehealth session. Overall, students reported that the shift from FTF to remote learning made learning SBIRT skills difficult, and that providing brief intervention and referral was the most difficult step of the simulated SBIRT telehealth intervention. Qualitative feedback indicates that overall, students found the simulated telehealth sessions a valuable learning experience, but also reported that richer educational experiences would have resulted from additional practice opportunities and real time feedback. Implications for future research, simulation-based education and clinical practice are discussed.

Screening, brief intervention, and referral to treatment (SBIRT) expansion of training to non-physician healthcare graduate students: Counseling psychology, nursing, occupational therapy, physical therapy, and physician assistant studies

Background Although Screening, Brief Intervention and Referral to Treatment (SBIRT) has now been disseminated in many areas of the United States (US), much remains to be discovered about the training outcomes of non-physician professional trainees such as nurses, physician assistants, physical therapists, occupational therapists, and psychologists following SBIRT training. Methods: Training in SBIRT, an evidence-based approach to screening substance use, was embedded into five health science graduate curricula: Physician Assistant Studies, Nursing, Occupational Therapy, Physical Therapy, and Psychology. The SBIRT curriculum was adapted for each profession to include a brief introductory module addressing SBIRT’s relevance for each profession, as well as profession-specific case examples and terminology. Using a nonequivalent group design, participants completed pre-and post-training assessments of substance use related attitudes, perceived competency and knowledge. Data were analyzed using a parametric test to compare pre- and post-differences. Results: Findings suggest improved attitudes as well as increased perceived competencies and core knowledge following the graduate-curriculum embedded SBIRT training, as well as between group differences on the same variables. Conclusions: SBIRT training of non-physician healthcare graduate student-trainees is a feasible training activity and results in improved trainee attitudes, perceived competency, and knowledge. SBIRT training embedded into graduate health science curricula offers an early foundation to this well-established, universal screening approach.

Primary Care Screening, Brief Intervention, and Referral to Treatment for Adolescent Substance Use in Lebanon: A National Cross-sectional Study.

Introduction:Substance use among adolescents is on the rise globally. Adolescents rarely seek help for problematic substance use and healthcare professionals can easily fail to identify adolescents with risky substance use. There is therefore a significant global need for substance use screening by healthcare professionals followed by appropriate intervention. Screening, brief intervention, and referral to treatment (SBIRT) is an evidence-based practice that enables clinicians to determine adolescents’ risk for substance use and intervene accordingly. However, little effort has been placed on empowering primary care clinicians to use it in Lebanon. We explored the attitudes, perceptions, and practices of primary care nurses and physicians regarding adolescent SBIRT use.Methods:The study used a cross-sectional multisite survey design targeting urban and rural areas in Lebanon. A national sample of 140 physicians and nurses was recruited using random sampling stratified by governorate. Participants completed mailed or online surveys addressing their practices, attitudes, role perceptions, and self-efficacy regarding SBIRT use.Results:This study revealed that 57.8% of healthcare professionals were not familiar with the SBIRT model and that 76.2% did not practice SBIRT in their setting. The majority addressed the problem of substance use through educating and counseling adolescents about the dangers of substance use (84.2%) and encouraged them to stop (82%) but only 2% reported using standardized instruments for substance use screening. Most participants (88.1%) reported their willingness to use SBIRT in their clinical practice and 92.4% expressed an interest in receiving SBIRT training. Overall, the results showed positive attitudes (M = 4.38, SD = 0.89) and role responsibility (M = 4.47, SD = 1.62) toward addressing substance use in adolescents, in addition to a high level of perceived self-efficacy in addressing substance use (M = 4.04, SD = 0.92). Our results showed minimal differences between nurses’ and physicians’ perceptions and self-efficacy regarding SBIRT use.Conclusions:Our study confirms the lack of a standardized approach toward adolescent substance use screening and intervention by primary healthcare providers in Lebanon but revealed the readiness and willingness to receive training and proper support to adopt an evidence-based approach such as SBIRT.

Reducing Alcohol and Opioid Use Among Youth in Rural Counties: An Innovative Training Protocol for Primary Health Care Providers and School Personnel.

BackgroundGiven that youth alcohol use is more common in rural communities, such communities can play a key role in preventing alcohol use among adolescents. Guidelines recommend primary care providers incorporate screening, brief intervention, and referral to treatment (SBIRT) into routine care.ObjectiveThe aim is to train primary care providers and school nurses within a rural 10-county catchment area in Pennsylvania to use SBIRT and facilitate collaboration with community organizations to better coordinate substance use prevention efforts.MethodsTo build capacity to address underage drinking and opioid use among youth aged 9-20 years, this project uses telehealth, specifically Project ECHO (Extension for Community Healthcare Outcomes), to train primary care providers and school nurses to address substance use with SBIRT. Our project will provide 120 primary care providers and allied health professionals as well as 20 school nurses with SBIRT training. Community-based providers will participate in weekly virtual ECHO sessions with a multidisciplinary team from Penn State College of Medicine that will provide SBIRT training and facilitate case discussions among participants.ResultsTo date, we have launched one SBIRT ECHO project with school personnel, enrolling 34 participants. ECHO participants are from both rural (n=17) and urban (n=17) counties and include school nurses (n=15), school counselors (n=8), teachers (n=5), administrators (n=3), and social workers (n=3). Before the study began, only 2/13 (15.5%) of schools were screening for alcohol use.ConclusionsThis project teaches primary care clinics and schools to use SBIRT to prevent the onset and reduce the progression of substance use disorders, reduce problems associated with substance use disorders, and strengthen communities’ prevention capacity. Ours is an innovative model to improve rural adolescent health by reducing alcohol and opioid use.International Registered Report Identifier (IRRID)DERR1-10.2196/21015

Screening, Intervention, and Referral in the Clinical Setting

The prevalence of substance use disorder in the United States is rapidly growing, particularly in adolescents. Screening, brief intervention, and referral to treatment (SBIRT) has been used in clinical care for over 40 years, yet providers still do not incorporate this into daily practice. This article offers background information and describes a project that considered SBIRT in the clinical setting using two student-led focus groups to discuss a gap between education and practice noted by nursing students trained in this technique. We present findings for each group and a discussion that synthesizes the results and includes implications for education and practice. Data were analyzed using the scissor and sort method, with themes emerging about SBIRT benefits, barriers, training, and individual and system level factors. Study recommendations included incorporating SBIRT content across the nursing curriculum with repeated smaller training and practice sessions. Also noted is the need for ongoing SBIRT education for practicing nurses.

Innovations in pre‐doctoral dental education: Influencing attitudes and opinions about patients with substance use disorder

Screening, Brief Intervention, and Referral to Treatment (SBIRT) is an evidence-based model for managing patients with substance use disorders (SUD). Historically, SUD were seen as a criminal issue and access to treatment was limited, but that paradigm is shifting and substance abuse is now being recognized as a disease state and the management of patients with SUD is increasingly within the healthcare system starting with primary healthcare settings including dental facilities. In a new training initiative, first-year dental students (DDS1) attended a 90-minute SBIRT training. An Attitudes and Opinion Survey (AOS) consisting of 8 questions that separately assesses DDS1 attitudes toward alcohol and drug use disorders was utilized to evaluate the training. Assenting DDS1 anonymously completed the AOS before and following the training. Over 3 years, we analyzed changes in the AOS of 230 DDS1 using Chi-squared test for bivariate comparison. We then applied a Bonferroni correction to the P-values. Response rate was 95.5%. The SBIRT training improved DDS1 attitudes and opinions toward patients with SUD with respect to all AOS questions. There was a statistically significant improvement (P < 0.003) in DDS1 attitudes and opinions with respect to whether other patients care suffers because of time and resources spent on patients with SUD and whether the SBIRT training provided adequate education to prepare DDS1 to manage patients with SUD. SBIRT training is relevant to dental education. It fills an important educational gap and is a suitable model for other dental schools.

Implementation and evaluation of SBIRT training in a Community Health nursing course.

The purpose of this paper is to report on the implementation and evaluation of a Screening, Brief Intervention and Referral to Treatment (SBIRT) educational program into an undergraduate nursing curriculum and to recommend modifications for future trainings. A one-group pre-test/post-test design was used. The sample consisted of senior level undergraduate nursing students. Core knowledge, perceived competency, and program satisfaction were measured. Process evaluation activities were performed to gather feedback on the training and solicit ideas and recommendations for improvement. Of the 354 nursing students enrolled in the training, 249 (70%) participated in the research portion, with 240 (96%) completed the pre- and post-training evaluations. All four core knowledge components and 13 perceived competency indicators were statistically significant (p≤.001) when comparing pre- and post-t test values. Process evaluation data collected through 25 telephone interviews found that the training improved the students' confidence and ability to screen for substance misuse with patients. Findings support the implementation of SBIRT training into an undergraduate nursing curriculum. Modifications for future training and research are proposed.