Expand use of Screening, Brief Intervention, and Referral to Treatment (SBIRT) in adolescent primary care. (See SBIRT: Comprehensive Adolescent Substance Misuse Screener for more details.)
As written by SAMHSA (Substance Abuse and Mental Health Services Administration): Screening, Brief Intervention, and Referral to Treatment is an evidence-based practice used to identify, reduce, and prevent problematic use, abuse, and dependence on alcohol and illicit drugs. The SBIRT model was incited by an Institute of Medicine recommendation that called for community-based screening for health risk behaviors, including substance use:
- Screening: A health care professional assesses a patient for risky substance use behaviors using standardized screening tools. Screening can occur in any health care setting. This Dartmouth-Hitchcock project is focused on the expansion of screening within general pediatrics.
- Brief Intervention: A health care professional engages a patient showing risky substance use behaviors in a short conversation, providing feedback and advice.
- Referral to Treatment: A health care professional provides a referral to brief therapy or additional treatment to patients who screen as needing additional services.
Patients/populations impacted by this project
- Adolescents at risk for and engaged with substances
Process/systems being improved
- Integration of Pediatrics and mental health
- Screening tools and practices
- Evidence-based addiction treatment
- Alignment with community resources on shared goals
Provider teams involved
- Behavioral Health
Economics of care
- Clinic operational efficiency
- Dr. Steven Chapman, pediatrician practicing at Dartmouth-Hitchcock Medical Center, Lebanon NH. Dr. Chapman also serves as medical director of the Boyle Community Pediatrics Program at Children’s Hospital at Dartmouth-Hitchcock.
- Susanne Tanski
- Susan Pullen
- Aita Romain
- Shanon Bean
- Lisa Maheu
- Tessa Lafortune-Greenberg
- Angela Beamer
- Shazia Savul
Learning and data
Initial data collection is focused on a better understanding of adolescent panel profiles, the numbers of adolescents with behavioral health conditions, the rates of substance use screening being done with active patients, and the rates of connection with substance use counselors.
Two examples of data collection are the National Survey on Drug Use and Health (NSDUH), sponsored by SAMHSA, and the Youth Risk Behavior Surveillance System (YRBS), performed by the Centers for Disease Control and Prevention. The NSDUH survey is the primary source of information on the use of illicit drugs, alcohol, and tobacco for those aged 12 years old or older.
- Screening tools: CRAFFT
- Screen & Intervene, NH Youth SBIRT Initiative
This initiative focuses on the implementation of SBIRT in primary care throughout New Hampshire as an effective prevention, intervention and public health strategy.
- Adolescent Alcohol and Substance Use and Abuse (PDF)
An American Academy of Pediatrics Bright Futures resource document, including the CRAFFT tool.
- American Academy of Pediatrics Policy Statement on Substance Use Screening, Brief Intervention, and Referral to Treatment for Pediatricians
- American Academy of Pediatrics Policy Statement Pushes for More Screening, Treatment for Teen Substance Use
- SBIRT and Integrated care models in pediatrics
- Dartmouth-Hitchcock Powerpoint presentation on adolescent brief intervention (PDF)