Implementing an SBIRT Pilot Utilizing Student-mediated Screenings and Brief Interventions

Background: Excessive alcohol use is linked to numerous morbidities, in addition to the enormous economic impact on healthcare. Screening, brief intervention, referral to treatment (SBIRT) is a proven, effective tool in reducing alcohol use; however it is severely underutilized due to barriers such as provider time constraints and lack of confidence. Numerous missed opportunities exist regarding screening and early intervention, which could significantly improve patient outcomes. An SBIRT pilot utilizing student-mediated brief interventions could serve to increase provider confidence and awareness, as well as overcome time constraint barriers.

Purpose: The purpose is to implement an SBIRT pilot at a campus clinic, utilizing nurse practioner (NP) students to conduct universal alcohol screens and brief interventions (BI) as a means to overcome barriers to accepting an evidenced based practice.

Methods: Intervention group (IG) of two providers were matched with NP students to perform screens and BI’s (n=111), while a comparison group (CG) of three providers conducted usual care (n=41). Single question screens were administered universally, followed by an AUDIT (Alcohol Use Disorders Identification Test) and BI for positive screens. A pre/post pilot provider attitude survey was administered to gauge provider acceptance.

Results: Of 109 patients screened, 52% tested positive requiring a full AUDIT, 56% of AUDITS were positive requiring BI’s, 88% agreed to a BI, and 93% agreed to reduce alcohol intake. Post attitude survey revealed a 22% increase in provider acceptance. Chi square testing showed statistical significance, X²(1, N = 152) = 142.31, p < .001.

Conclusions: Utilizing students to perform universal screenings and BI’s is effective in implementing SBIRT while offering a sustainable option to overcome time constraint barriers and provider confidence as well as exposing misconceptions regarding patient acceptance.