SBIRT for Alcohol Use Disorder

Overseen By Tiffany F Haynes, PhD

Age: 18+

Sex: Male

Trial Phase: Academic

Sponsor: University of Arkansas

Disqualifiers: None

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

Compensation: Varies

Number of Visits: Unknown

600 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to assist men in rural Arkansas who struggle with unhealthy drinking habits by introducing a program called SBIRT (Screening, Brief Intervention, and Referral to Treatment) into barbershops. The goal is to determine if this approach can effectively reduce harmful drinking behaviors and improve health outcomes. The trial will also explore how to implement this type of care successfully in everyday community settings, like barbershops, where men in these areas frequently visit. Men in Arkansas who drink heavily (four or more drinks a day) may be suitable participants. As an unphased trial, this study offers participants the chance to contribute to innovative community health solutions that could benefit many others in similar situations.

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 prior data suggests that this SBIRT protocol is safe for use in barbershops?

Past research has shown that SBIRT (Screening, Brief Intervention, and Referral to Treatment) is a safe and well-accepted method for addressing substance use. Studies indicate that SBIRT effectively identifies and manages risky alcohol use in many healthcare settings, such as doctors' offices and public health centers. No strong evidence links SBIRT to safety problems or negative effects, suggesting it is generally safe for use in various community settings, including barbershops, as planned in the trial. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the SBIRT method for addressing Alcohol Use Disorder because it brings care directly into the community through familiar settings like barbershops. Unlike traditional treatments that often involve clinical settings and medication, SBIRT focuses on early intervention by screening individuals, offering brief counseling, and providing referrals to specialized treatment when needed. This approach not only makes it more accessible for individuals who might not seek help otherwise, but it also helps integrate health support into everyday environments, potentially reaching a broader audience.

What evidence suggests that SBIRT is effective for alcohol use disorder?

Research has shown that SBIRT, which stands for Screening, Brief Intervention, and Referral to Treatment, effectively reduces unhealthy alcohol use. In this trial, participants in the SBIRT arm will receive this intervention, which involves short conversations that can significantly lower alcohol consumption in those who drink excessively. Studies have found that in doctor's offices, SBIRT has helped many people reduce their drinking and access addiction support services. This method focuses not only on reducing alcohol consumption but also on connecting individuals with necessary support. Overall, SBIRT is a valuable tool for addressing substance use problems. ^{1 6 7 8 9}

Who Is on the Research Team?

Tiffany F Haynes, PhD

Principal Investigator

University of Arkansas

Are You a Good Fit for This Trial?

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

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 for a Trial Participant

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

What Are the Treatments Tested in This Trial?

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.

How Is the Trial Designed?

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+

Published Research Related to This Trial

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]

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]

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]

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]

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]

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]

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]

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]

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]

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]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC7666646/

Effect of Screening, Brief Intervention and Referral to ... To test the efficacy of a brief intervention to reduce alcohol or drug use and to promote use of addiction services among patients seeking mental health ...

2. samhsa.gov samhsa.gov/substance-use/treatment/sbirt

Screening, Brief Intervention, and Referral to Treatment ... SBIRT is a comprehensive, integrated, public health approach to the delivery of early intervention and treatment services for persons with substance use ...

3. jamanetwork.com jamanetwork.com/journals/jamanetworkopen/fullarticle/2834257

Substance Use Screening, Brief Intervention, and Referral ... This cross-sectional study used survey data of clinicians from multiple primary care specialties to evaluate screening, brief intervention, ...

4. sciencedirect.com sciencedirect.com/science/article/abs/pii/S0376871622001958

Alcohol brief intervention, specialty treatment and drinking ... Systematic ABI in adult primary care has the potential to reduce drinking among people with unhealthy drinking considerably on both an individual and ...

5. oasas.ny.gov oasas.ny.gov/screening-brief-intervention-and-referral-treatment-brochure

Screening, Brief Intervention, and Referral to Treatment | NY.Gov The National Survey on Drug Use and Health estimates that of the 22.6 million people who harbor a substance use disorder, only 10-11% are treated.

6. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC8496756/

Alcohol Screening, Brief Intervention, and Referral to ... SBIRT is an evidence-based, integrated public health approach used to identify and address risky alcohol use among women in a variety of health and social ...

7. cms.gov cms.gov/outreach-and-education/medicare-learning-network-mln/mlnproducts/downloads/sbirt_factsheet_icn904084.pdf

Screening, Brief Intervention & Referral to Treatment ( ... We pay for medically reasonable and necessary SBIRT services in both physicians' offices and outpatient hospital settings, including public health centers, ...

8. jahonline.org jahonline.org/article/S1054-139X(22)00348-2/fulltext

Substance Use Screening, Brief Intervention, and Referral ... This study evaluated the implementation and outcomes of a multisite initiative to identify and intervene in adolescent substance use across the many settings ...

9. sciencedirect.com sciencedirect.com/science/article/pii/S1054139X22003482

Substance Use Screening, Brief Intervention, and Referral ... This study evaluated the implementation and outcomes of a multisite initiative to identify and intervene in adolescent substance use across the many settings ...