SBIRT for Alcohol Use Disorder

Overseen By Tiffany F Haynes, PhD

Age: 18+

Sex: Male

Trial Phase: Academic

Sponsor: University of Arkansas

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

600 Participants Needed

Trial Summary

What is the purpose of this trial?

Socially disadvantaged Black men are at increased risk for unhealthy drinking habits that may, in turn, increase preventable chronic disease. This project seeks to test the effectiveness of a Screening, Brief Intervention, and Referral to Treatment (SBIRT) intervention for use within barbershop settings to reduce average drinking days and the number of unhealthy drinking days. Data from this study will further our understanding of how to reduce the risk of alcohol-related morbidity and mortality among Black men. Data will also improve our understanding of strategies that can improve the implementation of evidence-based care models in non-clinical settings; thus, extending the reach of evidence-based care to communities with the highest need.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What data supports the effectiveness of the treatment SBIRT for Alcohol Use Disorder?

Research shows that SBIRT, which includes screening, brief intervention, and referral to treatment, is effective in identifying and reducing risky alcohol use. It has been successfully used in various healthcare settings, like emergency departments, to help people with alcohol problems get the treatment they need. ^{1 2 3 4 5}

Is SBIRT safe for humans?

SBIRT (Screening, Brief Intervention, and Referral to Treatment) is generally considered safe for humans as it involves non-invasive methods like interviews and counseling to help identify and reduce risky substance use. It has been used in various settings, including hospitals and primary care, without reports of harm. ^{2 3 4 6 7}

How is the SBIRT treatment for Alcohol Use Disorder different from other treatments?

SBIRT is unique because it focuses on early intervention through a structured process of screening, brief intervention, and referral to treatment, which is designed to be used in non-specialty settings like primary care. Unlike other treatments that may focus solely on therapy or medication, SBIRT integrates these components to address alcohol use before it becomes a severe disorder. ^{8 9 10 11 12}

Research Team

Tiffany F Haynes, PhD

Principal Investigator

University of Arkansas

Eligibility Criteria

This trial is for Black men aged 18 or older who are low-income, as indicated by eligibility for programs like Medicaid, food stamps, or subsidized housing. It aims to help those with unhealthy drinking habits.

Inclusion Criteria

Self-identify as Black

I am 18 years old or older.

Low income as defined by any indicator (e.g., Medicaid, Earned Income Tax Credit, Children's Health Insurance Plan, subsidized housing, child care subsidies, food stamps, low-income energy assistance, free/reduced lunch program, supplemental nutrition program, Head Start program)

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Screening days at barbershops

Brief Intervention

Participants receive a brief intervention and referral to treatment within barbershop settings

6 months

Regular visits to barbershops for intervention

Follow-up

Participants are monitored for changes in alcohol use, mental health, and social support

6 months

Treatment Details

Interventions

• SBIRT

Trial Overview The study tests a program called SBIRT (Screening, Brief Intervention, and Referral to Treatment) in barbershops to see if it can reduce the number of days these men drink excessively.

Participant Groups

Group I: Usual-care Experimental Treatment 1 Intervention

Six months after completion of Time 1, barbershops in the usual-care arm will receive the intervention.

Group II: SBIRT Experimental Treatment 1 Intervention

Each intervention barbershop, will hold screening days, where a trained community health worker will be onsite to provide Screening, Brief Intervention, and Referral to Treatment (SBIRT).

Who Is Running the Clinical Trial?

University of Arkansas

Lead Sponsor

Trials

500

Recruited

153,000+

Findings from Research

A proof-of-concept study involving 9 hospitalized medical patients with alcohol use disorder tested a two-session brief intervention that successfully facilitated referrals to community treatment, with 33% of participants receiving further substance abuse treatment.

Participants showed statistically significant improvements in alcohol use and related problems, highlighting the potential effectiveness of enhanced interventions in connecting patients to necessary care.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Referral to treatment for hospitalized medical patients with an alcohol use disorder: A proof-of-concept brief intervention study. Berger, L., Hernandez-Meier, J., Hyatt, J., et al.[2018]

A randomized controlled trial involving 572 patients in four emergency departments found that a computer-assisted Screening, Brief Intervention, and Referral to Treatment (SBIRT) did not significantly reduce daily alcohol consumption compared to a placebo-controlled nutrition education program after 12 months.

Both interventions showed similar outcomes, indicating that the computer-assisted SBIRT may not provide additional benefits for patients with hazardous drinking disorders detected during emergency department admissions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Impact of a computer-assisted Screening, Brief Intervention and Referral to Treatment on reducing alcohol consumption among patients with hazardous drinking disorder in hospital emergency departments. The randomized BREVALCO trial. Duroy, D., Boutron, I., Baron, G., et al.[2022]

This study will test a nurse-led toolkit designed to enhance the implementation of Screening, Brief Intervention, and Referral to Treatment (SBIRT) in 14 acute care hospitals, aiming to improve the recognition and treatment of risky substance use among patients.

The effectiveness of the SBIRT toolkit will be evaluated by analyzing documentation of its delivery in electronic medical records over 12 months, with the goal of improving clinician engagement in addressing substance use issues and ultimately reducing substance use disorders.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Study protocol testing toolkit versus usual care for implementation of screening, brief intervention, referral to treatment in hospitals: a phased cluster randomized approach. Newhouse, R., Janney, M., Gilbert, A., et al.[2020]

SBIRT (Screening, Brief Intervention, and Referral to Treatment) is an effective public health strategy for early intervention in individuals at risk of substance use disorders (SUDs), adaptable to various clinical settings such as hospitals and primary care.

While SBIRT can provide immediate support and referrals for those with SUDs, further research is necessary to optimize its implementation and effectiveness in different environments.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Integrating screening, brief intervention, and referral to treatment (SBIRT) into clinical practice settings: a brief review. Agerwala, SM., McCance-Katz, EF.[2022]

In a study analyzing over 1 million patient visits in Maryland emergency departments, 17.2% of patients screened positive for problematic alcohol or drug use, highlighting the need for effective screening methods in clinical settings.

The implementation of the SBIRT model led to significant outcomes, including 79,899 brief interventions and a successful linkage to outpatient treatment for 38.3% of those referred, demonstrating its effectiveness in addressing substance use disorders in emergency departments.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

One million screened: Scaling up SBIRT and buprenorphine treatment in hospital emergency departments across Maryland. Monico, LB., Oros, M., Smith, S., et al.[2020]

The SBIRT intervention showed some effectiveness in reducing risky alcohol use among higher-risk military personnel, as indicated by significant reductions in AUDIT-C scores and increased self-efficacy for controlled drinking in a complete case analysis.

However, the intent-to-treat analyses did not support the effectiveness of the SBIRT intervention overall, suggesting that while some individuals may benefit, the intervention may not be universally effective across all participants.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Results of a Randomized Trial of Screening, Brief Intervention, and Referral to Treatment (SBIRT) to Reduce Alcohol Misuse Among Active-Duty Military Personnel. Reed, MB., Woodruff, SI., DeMers, G., et al.[2022]

SBIRT (Screening, Brief Intervention, and Referral to Treatment) has been shown to yield short-term health improvements for individuals with substance use disorders through effective screening and intervention methods, supported by over a hundred clinical trials.

While long-term population health benefits of SBIRT have not yet been conclusively demonstrated, simulation models indicate that these benefits could be significant, highlighting the potential impact of this integrated approach on public health.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Screening, Brief Intervention, and Referral to Treatment (SBIRT): toward a public health approach to the management of substance abuse. Babor, TF., McRee, BG., Kassebaum, PA., et al.[2022]

The SBIRT approach is an effective early intervention strategy for adolescents and young adults at risk of alcohol misuse, aiming to reduce the associated health risks.

This comprehensive method includes screening, brief interventions, and referrals to treatment, providing a structured way to address alcohol-related disorders before they escalate.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[Early intervention for people with alcohol related disorders or at-risk for alcohol use]. Khazaal, Y., Khan, R.[2012]

A survey of 73 outpatient health care professionals revealed that while 59% had received SBIRT training, there are significant gaps in comfort discussing substance use in relation to sexual activity, with only 60% feeling comfortable addressing this topic.

Despite recognizing substance use as a major health issue, professionals showed varying levels of comfort in assessing it, particularly in the context of sexual activity, indicating a need for targeted training to improve these discussions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Comfort Levels of Outpatient Health Care Professionals When Asking About Substance Use-Related Sexual Activity: A Pilot Survey. Argenyi, MS., Evans, JK., Veach, LJ., et al.[2023]

A curriculum teaching Screening, Brief Intervention, and Referral to Treatment (SBIRT) to 146 third-year medical students resulted in significant improvements in their knowledge and attitudes towards alcohol use interventions, as well as high mastery of SBIRT skills during clinical assessments.

Despite the improvements in knowledge and confidence, these factors did not correlate with actual clinical skill ratings, indicating that practical skill in delivering SBIRT may require different evaluation methods than knowledge-based assessments.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Multidimensional Evaluation of Screening Brief Intervention and Referral to Treatment Training for Medical Students. McAfee, NW., Schumacher, JA., Williams, DC., et al.[2023]

The SBIRT training program, involving 1229 nursing and medical students and faculty, effectively improved knowledge, confidence, and skills related to screening and intervention for substance use disorders through a combination of online coursework and in-person training.

The interprofessional approach of the training not only enhanced clinical proficiency but also encouraged future healthcare providers to implement SBIRT in practice, aiming to reduce negative outcomes associated with substance use.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

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. Gainey, S., Muzzy, W., Dooley, M., et al.[2022]

The study identified seven distinct SBIRT processes for substance use and five for tobacco use across 14 acute care facilities, highlighting variability in implementation despite a consistent overall function.

To effectively disseminate SBIRT in acute care settings, it is crucial to understand and tailor the implementation strategies to the specific local contexts and clinician involvement at each facility.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Variation in SBIRT delivery among acute care facilities. Keen, A., Thoele, K., Newhouse, R.[2020]

References

1. United States pubmed.ncbi.nlm.nih.gov

Referral to treatment for hospitalized medical patients with an alcohol use disorder: A proof-of-concept brief intervention study. [2018]

2. Ireland pubmed.ncbi.nlm.nih.gov

Impact of a computer-assisted Screening, Brief Intervention and Referral to Treatment on reducing alcohol consumption among patients with hazardous drinking disorder in hospital emergency departments. The randomized BREVALCO trial. [2022]

3. England pubmed.ncbi.nlm.nih.gov

Study protocol testing toolkit versus usual care for implementation of screening, brief intervention, referral to treatment in hospitals: a phased cluster randomized approach. [2020]

4. United States pubmed.ncbi.nlm.nih.gov

Integrating screening, brief intervention, and referral to treatment (SBIRT) into clinical practice settings: a brief review. [2022]

5. United States pubmed.ncbi.nlm.nih.gov

One million screened: Scaling up SBIRT and buprenorphine treatment in hospital emergency departments across Maryland. [2020]

6. United States pubmed.ncbi.nlm.nih.gov

Results of a Randomized Trial of Screening, Brief Intervention, and Referral to Treatment (SBIRT) to Reduce Alcohol Misuse Among Active-Duty Military Personnel. [2022]

7. United States pubmed.ncbi.nlm.nih.gov

Screening, Brief Intervention, and Referral to Treatment (SBIRT): toward a public health approach to the management of substance abuse. [2022]

8. Switzerland pubmed.ncbi.nlm.nih.gov

[Early intervention for people with alcohol related disorders or at-risk for alcohol use]. [2012]

9. United States pubmed.ncbi.nlm.nih.gov

Comfort Levels of Outpatient Health Care Professionals When Asking About Substance Use-Related Sexual Activity: A Pilot Survey. [2023]

10. United States pubmed.ncbi.nlm.nih.gov

Multidimensional Evaluation of Screening Brief Intervention and Referral to Treatment Training for Medical Students. [2023]

11. Scotland pubmed.ncbi.nlm.nih.gov

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. [2022]

12. United States pubmed.ncbi.nlm.nih.gov

Variation in SBIRT delivery among acute care facilities. [2020]