School-Based Screening and Brief Intervention for Adolescent Substance Use With Telehealth-Delivered Case Consultation and Education.

Carol Vidal, Annastasia Kezar, Rheanna Platt, Jill Owczarzak, Christopher J Hammond
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Abstract

BACKGROUND Screening, brief intervention, and referral to treatment (SBIRT) is a public health framework for addressing adolescent substance use. Implementation of SBIRT in schools carries the potential to improve substance use treatment access and service acceptance for students, but faces barriers related to knowledge deficits, low comfort, and lack of training in screening and brief interventions among school-based mental health (SBMH) providers. This report describes the development and acceptability evaluation of a school-based SBIRT program designed to overcome common implementation barriers of SBIRT related to provider confidence, knowledge, and training deficits by supplementing the traditional model with telehealth-delivered addiction consultation and education (ACE). METHODS Program components include core SBIRT trainings, telehealth-delivered ACE sessions, and outreach support for SBMH providers. Each ACE session included a didactic expert presentation on a clinical topic and a provider-presented patient case with discussion. Sessions were delivered using a Project ECHO-based hub-and-spoke format with monthly 1-hour virtual meetings. Interviews and surveys with SBMH providers on substance use screening and intervention practices and perceived barriers were used to inform program design choices and tailor the curriculum. Acceptability data were collected at 9 months. RESULTS SBMH provider participants reported increased confidence, knowledge, and evidence-based screening and early intervention practices, and high acceptability, satisfaction, and benefit from the program. Ongoing barriers to referral to treatment were reported. CONCLUSION This pilot study suggests that supplementing traditional SBIRT with telehealth-delivered ACE sessions can address common implementation barriers and serve as a scalable model to improve SBIRT adoption in schools.
通过远程医疗提供的个案咨询和教育,对青少年药物使用进行校本筛查和简单干预。
背景筛查、简单干预和转介治疗(SBIRT)是解决青少年药物使用问题的公共卫生框架。在学校实施 SBIRT 有可能改善学生接受药物使用治疗和服务的情况,但却面临着知识缺陷、舒适度低以及校本心理健康(SBMH)服务提供者缺乏筛查和简单干预培训等障碍。本报告介绍了一项校本 SBIRT 项目的开发和可接受性评估,该项目旨在通过远程医疗提供的成瘾咨询和教育(ACE)对传统模式进行补充,从而克服与提供者信心、知识和培训不足有关的 SBIRT 常见实施障碍。每节 ACE 课程都包括专家就临床主题进行的说教式演讲和医疗服务提供者提供的患者病例讨论。会议采用基于 ECHO 项目的中心辐射形式,每月举行一次 1 小时的虚拟会议。对 SBMH 医疗服务提供者进行了关于药物使用筛查和干预实践以及感知障碍的访谈和调查,为项目设计选择和课程定制提供了依据。结果SBMH医疗服务提供者的参与者报告说,他们的信心、知识、循证筛查和早期干预实践都得到了提高,他们对该计划的接受度、满意度和受益度都很高。结论这项试点研究表明,通过远程医疗提供的 ACE 课程来补充传统的 SBIRT,可以解决常见的实施障碍,并可作为一种可扩展的模式来改善学校中 SBIRT 的采用情况。
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