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Published in: Addiction Science & Clinical Practice 1/2013

Open Access 01-12-2013 | Study Protocol

Randomized controlled trial to evaluate screening and brief intervention for drug-using multiethnic emergency and trauma department patients

Authors: Kimberly Eisenberg, Susan I Woodruff

Published in: Addiction Science & Clinical Practice | Issue 1/2013

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Abstract

Background

Screening and brief intervention (SBI) is a comprehensive, integrated public health approach to identify and deliver a spectrum of early detection and intervention services for substance use in general medical care settings. Although the SBI approach has shown promise for alcohol use, relatively little is known about its effectiveness for illicit drug use. We are evaluating the SBI approach for drug use using a rigorous randomized controlled trial. The purpose of the report is to describe the overall trial and its programmatic and methodological strengths with a focus on health educator (HE) selection and training. In addition, the baseline characteristics of the recently enrolled multiethnic cohort are described.

Methods/design

A randomized two-group repeated measures design is being used in which drug-related outcomes of an intervention group will be compared with those of an attention-placebo control group. Selection of bicultural paraprofessional HEs—their training in research concepts, comorbid mental health issues, special treatment of marijuana use, and nonscripted enhanced motivational interviewing as well as their ongoing monitoring and evaluation—are among the features described. The HEs enrolled, consented, and conducted an intervention among 700 illicit drug users in two large hospital emergency departments/trauma units. To be eligible, a participant needed to be an adult (age ≥18 years), an English or Spanish speaker, awake and able to give consent, and reachable by telephone to schedule a six-month follow-up interview.

Discussion

A comprehensive HE training protocol combined with rigorous, ongoing process measurement resulted in skill mastery in many areas and a successful participant recruitment period. Strengths and limitations of the study protocol are discussed as well as the characteristics of those recruited. This trial will be among the first to provide information about the effectiveness of SBI for illicit drug use. Outcome analysis has not yet been completed, but demonstrated programming and design successes have implications for future research and service delivery.

Trial registration

Appendix
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Literature
1.
go back to reference Longabaugh R, Woolard RF, Nirenberg TD: Evaluating the effects of a brief motivational intervention for injured drinkers in the emergency department. J Stud Alcohol. 2001, 62: 806-816.CrossRefPubMed Longabaugh R, Woolard RF, Nirenberg TD: Evaluating the effects of a brief motivational intervention for injured drinkers in the emergency department. J Stud Alcohol. 2001, 62: 806-816.CrossRefPubMed
2.
go back to reference Wilk AI, Jensen NM, Havinghurst TC: Meta-analysis of randomized control trials addressing brief alcohol intervention in heavy alcohol drinkers. J Gen Intern Med. 1997, 5: 274-283.CrossRef Wilk AI, Jensen NM, Havinghurst TC: Meta-analysis of randomized control trials addressing brief alcohol intervention in heavy alcohol drinkers. J Gen Intern Med. 1997, 5: 274-283.CrossRef
3.
go back to reference D’Onofrio G, Degutis LC: Preventive care in the emergency department: screening and brief intervention for alcohol problems in the emergency department: a systematic review. Acad Emerg Med. 2002, 9: 627-638. 10.1111/j.1553-2712.2002.tb02304.x.CrossRefPubMed D’Onofrio G, Degutis LC: Preventive care in the emergency department: screening and brief intervention for alcohol problems in the emergency department: a systematic review. Acad Emerg Med. 2002, 9: 627-638. 10.1111/j.1553-2712.2002.tb02304.x.CrossRefPubMed
4.
go back to reference Saitz R: Screening and brief intervention enter their 5th decade. Subst Abuse. 2007, 28 (3): 3-6. 10.1300/J465v28n03_02.CrossRef Saitz R: Screening and brief intervention enter their 5th decade. Subst Abuse. 2007, 28 (3): 3-6. 10.1300/J465v28n03_02.CrossRef
5.
go back to reference Bernstein E, Bernstein JA, Stein JB, Saitz R: SBI in emergency care settings: are we ready to take it to scale?. Acad Emerg Med. 2009, 16: 1072-1077. 10.1111/j.1553-2712.2009.00549.x.CrossRefPubMed Bernstein E, Bernstein JA, Stein JB, Saitz R: SBI in emergency care settings: are we ready to take it to scale?. Acad Emerg Med. 2009, 16: 1072-1077. 10.1111/j.1553-2712.2009.00549.x.CrossRefPubMed
6.
go back to reference Humeniuk R, Ali R, Babor T, Souze-Formigoni ML, de Lacerda RB, Ling W: A randomized controlled trial of a brief intervention for illicit drugs linked to the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) in clients recruited from primary health settings in four countries. Addiction. 2012, 107: 957-966. 10.1111/j.1360-0443.2011.03740.x.CrossRefPubMed Humeniuk R, Ali R, Babor T, Souze-Formigoni ML, de Lacerda RB, Ling W: A randomized controlled trial of a brief intervention for illicit drugs linked to the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) in clients recruited from primary health settings in four countries. Addiction. 2012, 107: 957-966. 10.1111/j.1360-0443.2011.03740.x.CrossRefPubMed
7.
go back to reference Madras BK, Compton WM, Avula D, Stegbauer T, Stein JB, Clark HW: Screening, brief interventions, referral to treatment (SBI) for illicit drug and alcohol use at multiple healthcare sites: Comparison at intake and 6 months later. Drug Alcohol Depend. 2009, 99: 280-295. 10.1016/j.drugalcdep.2008.08.003.PubMedCentralCrossRefPubMed Madras BK, Compton WM, Avula D, Stegbauer T, Stein JB, Clark HW: Screening, brief interventions, referral to treatment (SBI) for illicit drug and alcohol use at multiple healthcare sites: Comparison at intake and 6 months later. Drug Alcohol Depend. 2009, 99: 280-295. 10.1016/j.drugalcdep.2008.08.003.PubMedCentralCrossRefPubMed
8.
go back to reference Bernstein J, Bernstein E, Tassiopoulos K, Heeren T, Levenson S, Hingson R: Brief motivational intervention at a clinic visit reduces cocaine and heroin use. Drug Alcohol Depend. 2005, 77: 49-59. 10.1016/j.drugalcdep.2004.07.006.CrossRefPubMed Bernstein J, Bernstein E, Tassiopoulos K, Heeren T, Levenson S, Hingson R: Brief motivational intervention at a clinic visit reduces cocaine and heroin use. Drug Alcohol Depend. 2005, 77: 49-59. 10.1016/j.drugalcdep.2004.07.006.CrossRefPubMed
9.
go back to reference Babor TF, Higgins-Biddle JC, Saunders JB, Monteiro MG: AUDIT—the Alcohol Use Disorders Identification Test: Guidelines for Use in Primary Care. 2001, Geneva, Switzerland: World Health Organization, Department of Mental Health and Substance Dependence, 2 Babor TF, Higgins-Biddle JC, Saunders JB, Monteiro MG: AUDIT—the Alcohol Use Disorders Identification Test: Guidelines for Use in Primary Care. 2001, Geneva, Switzerland: World Health Organization, Department of Mental Health and Substance Dependence, 2
10.
go back to reference Skinner HA: The Drug Abuse Screening Test. Addict Behav. 1982, 7 (4): 363-371. 10.1016/0306-4603(82)90005-3.CrossRefPubMed Skinner HA: The Drug Abuse Screening Test. Addict Behav. 1982, 7 (4): 363-371. 10.1016/0306-4603(82)90005-3.CrossRefPubMed
11.
go back to reference McLellan AT, Luborsky L, Woody GE, O’Brien CP: An improved diagnostic evaluation instrument for substance abuse patients: the Addiction Severity Index. J Nerv Ment Dis. 1980, 168 (1): 26-33. 10.1097/00005053-198001000-00006.CrossRefPubMed McLellan AT, Luborsky L, Woody GE, O’Brien CP: An improved diagnostic evaluation instrument for substance abuse patients: the Addiction Severity Index. J Nerv Ment Dis. 1980, 168 (1): 26-33. 10.1097/00005053-198001000-00006.CrossRefPubMed
12.
go back to reference Woodruff SI, Eisenberg K, McCabe C, Clapp JD, Hohman M: Evaluation of California’s alcohol and drug screening and brief intervention project for emergency department patients. West J Emerg Med. 2013, 10.5811/westjem.2012.9.11551. (in press) Woodruff SI, Eisenberg K, McCabe C, Clapp JD, Hohman M: Evaluation of California’s alcohol and drug screening and brief intervention project for emergency department patients. West J Emerg Med. 2013, 10.5811/westjem.2012.9.11551. (in press)
14.
go back to reference Vaca FE, Winn D: The basics of alcohol screening, brief intervention and referral to treatment in the emergency department. West J Emerg Med. 2007, 8 (3): 88-92.PubMedCentralPubMed Vaca FE, Winn D: The basics of alcohol screening, brief intervention and referral to treatment in the emergency department. West J Emerg Med. 2007, 8 (3): 88-92.PubMedCentralPubMed
15.
go back to reference Babor TF, McRee BG, Kassebaum PA, Grimaldi PL, Ahme K, Bray J: Screening, brief intervention, and referral to treatment (SBI): toward a public health approach to the management of substance abuse. Subst Abuse. 2007, 28 (3): 7-30. 10.1300/J465v28n03_03.CrossRef Babor TF, McRee BG, Kassebaum PA, Grimaldi PL, Ahme K, Bray J: Screening, brief intervention, and referral to treatment (SBI): toward a public health approach to the management of substance abuse. Subst Abuse. 2007, 28 (3): 7-30. 10.1300/J465v28n03_03.CrossRef
16.
go back to reference Bray JW, Zarkin GA, Hinde JM, Mills MJ: Costs of alcohol screening and brief intervention in medical settings: a review of the literature. J Stud Alcohol Drugs. 2012, 73: 911-919.PubMedCentralCrossRefPubMed Bray JW, Zarkin GA, Hinde JM, Mills MJ: Costs of alcohol screening and brief intervention in medical settings: a review of the literature. J Stud Alcohol Drugs. 2012, 73: 911-919.PubMedCentralCrossRefPubMed
17.
go back to reference Sise MJ, Sise CB, Kelley DM, Simmons CW, Kelso DJ: Implementing screening, brief intervention and referral for alcohol and drug use: the trauma service perspective. J Trauma. 2005, 59 (Suppl 3): S112-S133.CrossRefPubMed Sise MJ, Sise CB, Kelley DM, Simmons CW, Kelso DJ: Implementing screening, brief intervention and referral for alcohol and drug use: the trauma service perspective. J Trauma. 2005, 59 (Suppl 3): S112-S133.CrossRefPubMed
18.
go back to reference Mules T, Taylor J, Prince R, Walker L, Singh B, Newsam P: Addressing patient alcohol use: a view from general practice. J Prim Health Care. 2012, 4 (3): 217-222.PubMed Mules T, Taylor J, Prince R, Walker L, Singh B, Newsam P: Addressing patient alcohol use: a view from general practice. J Prim Health Care. 2012, 4 (3): 217-222.PubMed
19.
go back to reference American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders (Revised). 2000, Washington, DC: APA American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders (Revised). 2000, Washington, DC: APA
20.
go back to reference Dresser R: Irrational basis: the legal status of medical marijuana. Hastings Cent Rep. 2009, 39 (6): 7-8. 10.1353/hcr.0.0207.CrossRef Dresser R: Irrational basis: the legal status of medical marijuana. Hastings Cent Rep. 2009, 39 (6): 7-8. 10.1353/hcr.0.0207.CrossRef
24.
go back to reference Clark R, Samnalie M, McGovern MP: Treatment for co-occurring mental and substance use disorders in five state Medicaid programs. Psych Serv. 2007, 58 (7): 942-948. 10.1176/appi.ps.58.7.942.CrossRef Clark R, Samnalie M, McGovern MP: Treatment for co-occurring mental and substance use disorders in five state Medicaid programs. Psych Serv. 2007, 58 (7): 942-948. 10.1176/appi.ps.58.7.942.CrossRef
25.
go back to reference Estroff SE, Penn DL, Toporek JR: From stigma to discrimination: An analysis of community efforts to reduce the negative consequences of having a psychiatric disorder and label. Schizophrenia Bull. 2004, 30 (3): 493-509. 10.1093/oxfordjournals.schbul.a007097.CrossRef Estroff SE, Penn DL, Toporek JR: From stigma to discrimination: An analysis of community efforts to reduce the negative consequences of having a psychiatric disorder and label. Schizophrenia Bull. 2004, 30 (3): 493-509. 10.1093/oxfordjournals.schbul.a007097.CrossRef
27.
go back to reference Raghunathan TE, Lepkowski JM, van Hoewyk J, Solenberger P: A multivariate technique for multiply imputing missing values using a sequence of regression models. Surv Methodol. 2001, 27: 85-95. Raghunathan TE, Lepkowski JM, van Hoewyk J, Solenberger P: A multivariate technique for multiply imputing missing values using a sequence of regression models. Surv Methodol. 2001, 27: 85-95.
28.
go back to reference Rubin RB: Multiple Imputation for Nonresponse in Surveys. 1987, New York: John Wiley and SonsCrossRef Rubin RB: Multiple Imputation for Nonresponse in Surveys. 1987, New York: John Wiley and SonsCrossRef
29.
go back to reference Schafer JL: Analysis of Incomplete Multivariate Data. 1997, London: Chapman and HallCrossRef Schafer JL: Analysis of Incomplete Multivariate Data. 1997, London: Chapman and HallCrossRef
30.
go back to reference Van Buuren S: Multiple imputation of discrete and continuous data by fully conditional specification. Stat Methods Med Res. 2007, 16: 219-242. 10.1177/0962280206074463.CrossRefPubMed Van Buuren S: Multiple imputation of discrete and continuous data by fully conditional specification. Stat Methods Med Res. 2007, 16: 219-242. 10.1177/0962280206074463.CrossRefPubMed
31.
go back to reference Yudko E, Lozhkina O, Fouts A: A comprehensive review of the psychometric properties of the Drug Abuse Screening Test. J Subst Abuse Treat. 2007, 32: 189-198. 10.1016/j.jsat.2006.08.002.CrossRefPubMed Yudko E, Lozhkina O, Fouts A: A comprehensive review of the psychometric properties of the Drug Abuse Screening Test. J Subst Abuse Treat. 2007, 32: 189-198. 10.1016/j.jsat.2006.08.002.CrossRefPubMed
32.
go back to reference Martin GW, Wilkinson DA, Poulo CX: The drug avoidance self-efficacy scale. J Subst Abuse. 1995, 7: 151-163. 10.1016/0899-3289(95)90001-2.CrossRefPubMed Martin GW, Wilkinson DA, Poulo CX: The drug avoidance self-efficacy scale. J Subst Abuse. 1995, 7: 151-163. 10.1016/0899-3289(95)90001-2.CrossRefPubMed
33.
go back to reference Marin G, Sabogal F, Marin BV, Otero-Sabogal R, Perez-Stable E: Development of a short acculturation scale for Hispanics. Hispanic J Behav Sci. 1987, 9: 183-205. 10.1177/07399863870092005.CrossRef Marin G, Sabogal F, Marin BV, Otero-Sabogal R, Perez-Stable E: Development of a short acculturation scale for Hispanics. Hispanic J Behav Sci. 1987, 9: 183-205. 10.1177/07399863870092005.CrossRef
34.
go back to reference Davoudi M, Rawson RA: Screening, brief intervention, and referral to treatment (SBIRT) initiatives in California: notable trends, challenges, and recommendations. J Psychoactive Drugs. 2010, 9 (Suppl 6): 239-248.CrossRef Davoudi M, Rawson RA: Screening, brief intervention, and referral to treatment (SBIRT) initiatives in California: notable trends, challenges, and recommendations. J Psychoactive Drugs. 2010, 9 (Suppl 6): 239-248.CrossRef
35.
go back to reference Krohn MD, Thornberry TP: Retention of minority populations in panel studies of drug use. Drugs Soc. 1999, 14: 185-207.CrossRef Krohn MD, Thornberry TP: Retention of minority populations in panel studies of drug use. Drugs Soc. 1999, 14: 185-207.CrossRef
36.
go back to reference Hunt JR, White E: Retaining and tracking cohort study members. Epidemiol Rev. 1998, 20: 57-70. 10.1093/oxfordjournals.epirev.a017972.CrossRefPubMed Hunt JR, White E: Retaining and tracking cohort study members. Epidemiol Rev. 1998, 20: 57-70. 10.1093/oxfordjournals.epirev.a017972.CrossRefPubMed
37.
go back to reference Magura S: Validating self-reports of illegal drug use to evaluate national drug control policy: a reanalysis and critique. Eval Program Plann. 2010, 33: 234-237. 10.1016/j.evalprogplan.2009.08.004.CrossRefPubMed Magura S: Validating self-reports of illegal drug use to evaluate national drug control policy: a reanalysis and critique. Eval Program Plann. 2010, 33: 234-237. 10.1016/j.evalprogplan.2009.08.004.CrossRefPubMed
Metadata
Title
Randomized controlled trial to evaluate screening and brief intervention for drug-using multiethnic emergency and trauma department patients
Authors
Kimberly Eisenberg
Susan I Woodruff
Publication date
01-12-2013
Publisher
BioMed Central
Published in
Addiction Science & Clinical Practice / Issue 1/2013
Electronic ISSN: 1940-0640
DOI
https://doi.org/10.1186/1940-0640-8-8

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