Screening, Brief Intervention, and Referral to Treatment (SBIRT) for Substance Use Disorders in Title X Facilities: Assessing Barriers, Change of Provider Behavior, and Patient Outcomes

Introduction: Substance use disorders, specifically opioids, are an increasing problem in the US. Screening, brief intervention, and referral to treatment (SBIRT) is a method to identify and treat patients at risk, or currently using illicit substances. Integrating SBIRT into Title X facilities, which provide reproductive healthcare to lower income populations, may allow identification and treatment of individuals that do not seek healthcare elsewhere. Objective: We aim to assess the efficacy of a longitudinal training program in Title X facilities. The program provides a structured approach to implementing new protocols, including an educational session on SBIRT and motivational interviewing (MI). Methods: We conducted a trial of assessments during the first of two cohorts to determine their value as assessments for learner outcomes based on SBIRT/MI training. One assessment measured SBIRT/MI knowledge, while the other measured attitudes about substance users. Data was collected using electronic forms with personalized and de-identified codes. Results: 3 of 35 providers responded, representing 3 of 5 facilities. All respondents thought the assessments were ‘Very relevant’ to their training, the knowledge assessment was ‘Appropriately difficult’ (mean score of 8/10 ± 1), and the training program improved their skills to identify and address patients with concerns of substance use. Conclusion: Despite limitations, results suggest the knowledge and attitude assessments were appropriate for our population. In the second cohort, we will conduct pre- and post-testing. These measures will be used to assess the efficacy of training, as well as compare the attitude outcomes with values in the literature