Center for Urban Population Health

Presentation Notes

Poster presented at: Aurora Scientific Day; May 22, 2019; Milwaukee, WI.


Background: Screening, Brief Intervention, and Referral to Treatment (SBIRT) for substance misuse is an evidence-based, public health approach for early identification and intervention of risky alcohol and other substance use. Recent SBIRT dissemination efforts have included training grants to medical schools and university programs of nursing and social work. These efforts come at a time of greater focus by higher education accreditation bodies on competency-based education.

Purpose: The purpose of this study was to examine the effectiveness of a SBIRT training program for advanced-standing Master of Social Work students. The objective was to develop a program that would train students to competency in delivering an evidence-based SBIRT protocol.

Methods: A total of 91 students participated voluntarily in the study. All students received the same SBIRT training, consisting of an initial motivational interviewing module (8 hours) followed by the SBIRT protocol module (4 hours) conducted within a course on substance misuse interventions. Competency was assessed by a modified version of a valid brief intervention adherence scale as used by two trained raters. Raters independently listened to an audiotaped SBIRT protocol assignment submitted by each participant. Students achieved competency if at least 80% of the SBIRT protocol elements were deemed executed by both raters. Fidelity to each of the 4 SBIRT protocol subsections of engaging, focusing, eliciting, and planning also was examined.

Results: The overall average interrater reliability as assessed by proportion of agreement was 0.82, or moderate agreement (0.90=high agreement). In total, 75 of the 91 students (82%) achieved competency, while fidelity to each of the SBIRT protocol subsections was as follows: engaging 96%; focusing 92%; eliciting 46%; and planning 56%. For students who did not achieve competency (n=16, or 18%), most did not deliver to fidelity the eliciting (94%) and planning (88%) subsections.

Conclusion: The SBIRT training program was effective in training to competency 4 out of 5 Master of Social Work students. The vast majority of students, regardless of overall competency, delivered the engaging and focusing subsections with fidelity. Regardless of overall competency, most students tended to miss elements in the planning subsection, while students who did not achieve competency tended to also miss elements in the eliciting subsection, indicating more time and/or revised training strategies are needed to increase fidelity and, thus, competency.

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