1
|
Jones M, Seel CJ, Dymond S. Electronic-Screening, Brief Intervention and Referral to Treatment (e-SBIRT) for Addictive Disorders: Systematic Review and Meta-Analysis. SUBSTANCE USE & ADDICTION JOURNAL 2024:29767342241248926. [PMID: 38756012 DOI: 10.1177/29767342241248926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2024]
Abstract
BACKGROUND Addictive disorders are significant global public health burdens. Treatment uptake with these disorders is low and outcomes can be mixed. Electronic screening, brief intervention, and referral to treatment (e-SBIRT) programs have potential to improve uptake and treatment outcomes. To date, however, no prior review of the literature has been conducted to gauge the effectiveness of e-SBIRT for addictive disorders. METHODS We conducted a systematic review and meta-analysis of the literature concerning e-SBIRT for addictive disorders by surveying the MEDLINE, PubMed, Web of Science, Scopus, Embase, and PsycInfo databases on January 17, 2023. RESULTS Ten articles were included at analysis reporting evaluation of e-SBIRT interventions for substance use disorders including alcohol use in a variety of settings. No articles were identified regarding treatment for behavioral addictions such as disordered/harmful gambling. Meta-analysis found e-SBIRT to be effective at reducing drinking frequency in the short term only. e-SBIRT was not found to be advantageous over control conditions for abstinence or other treatment outcomes. We identified and described common components of e-SBIRT programs and assessed the quality of available evidence, which was generally poor. CONCLUSION The present findings suggest that research regarding e-SBIRT is concentrated exclusively on higher-risk substance use. There is a lack of consensus regarding the effectiveness of e-SBIRT for addictive disorders. Although common features exist, e-SBIRT designs are variable, which complicates identification of the most effective components. Overall, the quality of outcome evidence is low, and furthermore, high-quality experimental treatment evaluation research is needed.
Collapse
Affiliation(s)
- Matthew Jones
- School of Psychology, Swansea University, Swansea, UK
| | | | - Simon Dymond
- School of Psychology, Swansea University, Swansea, UK
- Department of Psychology, Reykjavík University, Reykjavík, Iceland
| |
Collapse
|
2
|
Witcraft SM, Johnson E, Eitel AE, Moreland AD, King C, Terplan M, Guille C. Listening to Black Pregnant and Postpartum People: Using Technology to Enhance Equity in Screening and Treatment of Perinatal Mental Health and Substance Use Disorders. J Racial Ethn Health Disparities 2024:10.1007/s40615-024-01989-z. [PMID: 38605223 DOI: 10.1007/s40615-024-01989-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 03/18/2024] [Accepted: 03/19/2024] [Indexed: 04/13/2024]
Abstract
Perinatal mood and anxiety disorders (PMADs), perinatal substance use disorders (PSUDs), and intimate partner violence (IPV) are leading causes of pregnancy-related deaths in the United States. Screening and referral for PMADs, PSUDs and IPV is recommended, however, racial disparities are prominent: Black pregnant and postpartum people (PPP) are less likely to be screened and attend treatment compared to White PPP. We conducted qualitative interviews to better understand the experience of Black PPP who used a text/phone-based screening and referral program for PMADs/PSUDs and IPV-Listening to Women and Pregnant and Postpartum People (LTWP). We previously demonstrated that LTWP led to a significant reduction in racial disparities compared to in-person screening and referral, and through the current study, sought to identify facilitators of PMAD/PSUD symptom endorsement and treatment attendance. Semi-structured interviews were conducted with 68 Black PPP who were or had been pregnant within the last 24 months, and who either had or did not have a PMAD or PSUD. Participants were enrolled in LTWP and provided feedback on their experience. Using a grounded theory approach, four themes emerged: usability, comfort, necessity, and recommendations. Ease of use, brevity, convenience, and comfort in discussing mental health and substance use via text were highlighted. Need for a program like LTWP in Black communities was discussed, given the reduction in perceived judgement and access to trusted information and resources for PMADs/PSUDs, which may lessen stigma. These qualitative findings illuminate how technology-based adaptations to behavioral health screening and referral can reduce perceived negative judgment and facilitate identification and referral to treatment, thereby more adequately meeting needs of Black PPP.
Collapse
Affiliation(s)
- Sara M Witcraft
- Medical University of South Carolina, Department of Psychiatry and Behavioral Sciences, 67 President Street, MSC 861, 29425, Charleston, SC, USA.
| | - Emily Johnson
- College of Nursing, Medical University of South Carolina, 99 Jonathan Lucas Street, MSC 160, 29425, Charleston, SC, USA
| | - Anna E Eitel
- College of Medicine, Medical University of South Carolina, 96 Jonathan Lucas Street, MSC 617, 29425, Charleston, SC, USA
| | - Angela D Moreland
- Medical University of South Carolina, Department of Psychiatry and Behavioral Sciences, 67 President Street, MSC 861, 29425, Charleston, SC, USA
| | - Courtney King
- Medical University of South Carolina, Department of Psychiatry and Behavioral Sciences, 67 President Street, MSC 861, 29425, Charleston, SC, USA
| | - Mishka Terplan
- Friends Research Institute, 1040 Park Avenue, Ste. 103, 21201, Baltimore, MD, USA
| | - Constance Guille
- Medical University of South Carolina, Department of Psychiatry and Behavioral Sciences, 67 President Street, MSC 861, 29425, Charleston, SC, USA
- Department of Obstetrics and Gynecology, Medical University of South Carolina, Charleston South Carolina, 171 Ashley Ave, 29425, Charleston, SC, USA
| |
Collapse
|
3
|
Koehlmoos TP, Lee E, Wisdahl J, Donaldson T. Fetal alcohol spectrum disorders prevention and clinical guidelines research-workshop report. BMC Proc 2023; 17:19. [PMID: 37580722 PMCID: PMC10426045 DOI: 10.1186/s12919-023-00272-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/16/2023] Open
Abstract
It is estimated that up to 1 in 20 people in the United States are affected by fetal alcohol spectrum disorders (FASD), an array of cognitive, emotional, physical and social disorders caused by exposure to alcohol during prenatal development. Common diagnoses encompassed within FASD include mood and behavioral disorders, memory and central nervous system deficits, attention-deficit/hyperactivity disorder (ADHD), slow growth and low body weight. While this condition affects a broad range of individuals and families, it is of particular concern in the military community, where cultural factors including an increased prevalence of alcohol misuse pose a unique set of challenges. To shed light on these issues and provide an overview of the existing research, programs, and clinical practice guidelines surrounding FASD, the Uniformed Services University of the Health Sciences (USUHS), in conjunction with FASD United, hosted the Workshop on Fetal Alcohol Spectrum Disorders Prevention and Clinical Guidelines Research on 21 September 2022 in Washington, DC. More than 50 attendees from academia, healthcare, federal agencies, and consumer advocacy organizations gathered to share research findings, lived experiences, and strategies for improving FASD prevention, diagnosis, interventions, and support.The workshop began with a series of presentations on FASD risk factors and causes, strategies for diagnosis and interventions, and impacts and lived experiences. Individuals and families affected by FASD spoke about the ways FASD, its symptoms, and the social stigma associated with it influences their daily lives, experiences at school and work, and access to healthcare. Several speakers highlighted the work of non-profit organizations and advocacy groups in supporting families affected by FASD and other challenges faced by military families more broadly. The workshop closed with a discussion of federal agency perspectives highlighting initiatives aimed at advancing research and access to care for women and families at-risk and those currently affected by FASD.
Collapse
Affiliation(s)
- Tracey Pérez Koehlmoos
- Center for Health Services Research, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814 USA
| | - Elizabeth Lee
- Department of Pediatrics, Division of Pediatric Health Systems Research and Clinical Epidemiology, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Building 61 Room E225, Bethesda, MD 20814 USA
| | - Jennifer Wisdahl
- FASD United, 1200 Eton Ct NW, 3rd Floor, Washington, DC 20007 USA
| | - Tom Donaldson
- FASD United, 1200 Eton Ct NW, 3rd Floor, Washington, DC 20007 USA
| |
Collapse
|
4
|
Parlier-Ahmad AB, Eglovitch M, Martin S, Svikis DS, Martin CE. Project BETTER: A Family-Centered, Technology-Delivered Intervention for Pregnant People with Opioid Use Disorder. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10020359. [PMID: 36832488 PMCID: PMC9955349 DOI: 10.3390/children10020359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Revised: 02/06/2023] [Accepted: 02/08/2023] [Indexed: 02/17/2023]
Abstract
Birthing people with opioid use disorder (OUD) face unique stressors during the transition from pregnancy to postpartum that can negatively impact the maternal-infant dyad. This study aimed to describe the development of a family-centered, technology-delivered intervention tailored to help pregnant people receiving medication for OUD (MOUD) prepare for this transition. Formative data from patients and providers identified intervention content: (1) recovery-oriented strategies for the pregnancy-to-postpartum transition; (2) guidance around caring for an infant with opioid withdrawal symptoms; and (3) preparation for child welfare interactions. The content was reviewed in successive rounds by an expert panel and modified. Pregnant and postpartum people receiving MOUD pre-tested the intervention modules and provided feedback in semi-structured interviews. The multidisciplinary expert panel members (n = 15) identified strengths and areas for improvement. Primary areas for improvement included adding content, providing more structure to help participants navigate the intervention more easily, and revising language. Pre-testing participants (n = 9) highlighted four themes: reactions to intervention content, navigability of the intervention, feasibility of the intervention, and recommendation of the intervention. All iterative feedback was incorporated into the final intervention modules for the prospective randomized clinical trial. Family-centered interventions tailored for pregnant people receiving MOUD should be informed by patient-reported needs and multidisciplinary perspectives.
Collapse
Affiliation(s)
- Anna Beth Parlier-Ahmad
- Department of Psychology, Virginia Commonwealth University, Richmond, VA 23284, USA
- Correspondence: ; Tel.: +804-828-8069
| | - Michelle Eglovitch
- Department of Psychology, Virginia Commonwealth University, Richmond, VA 23284, USA
| | - Sarah Martin
- School of Medicine, Virginia Commonwealth University, Richmond, VA 23298, USA
| | - Dace S. Svikis
- Department of Psychology, Virginia Commonwealth University, Richmond, VA 23284, USA
| | - Caitlin E. Martin
- Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Richmond, VA 23298, USA
- Department of Obstetrics and Gynecology, School of Medicine, Virginia Commonwealth University, Richmond, VA 23298, USA
| |
Collapse
|
5
|
Braciszewski JM, Sala-Hamrick KJ, Zelenak L, Gootee J, Elsiss F, Ottolini J, Lanier A, Colby SM, Ahmedani BK. Reducing Smoking Cessation Disparities: Capacity for a Primary Care- and Technology-Based Approach Among Medicaid Recipients. J Clin Psychol Med Settings 2022:10.1007/s10880-022-09925-1. [PMID: 36400987 DOI: 10.1007/s10880-022-09925-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/06/2022] [Indexed: 11/19/2022]
Abstract
While cigarette use among U.S adults has recently decreased, vulnerable subgroups continue to smoke at high rates, including individuals receiving Medicaid insurance. These individuals have also experienced treatment access disparities, highlighting the need for approaches that leverage their strong desire to quit. We conducted interviews with 100 adult primary care patients receiving Medicaid who were current tobacco users about their use, openness to technology-based interventions, and readiness to change. Most (92%) reported current cigarette use and readiness to change averaged 6.98 out of 10 (SD = 2.82). Nearly all were open to completing an iPad-based tobacco screening (95%) and brief intervention (90%) at their next appointment, while 91% and 88% were willing to talk with their provider or a cessation counselor, respectively, about the subsequent results. Results persisted across age, sex, and race/ethnicity. Openness to technology-based interventions in this population provides support for future work that may ultimately reduce disparities.
Collapse
|
6
|
Martin S, Parlier-Ahmad AB, Eglovitch M, Ondersma SJ, Svikis DS, Martin CE. Project BETTER: Preliminary Feasibility and Acceptability of a Technology-Delivered Educational Program for Pregnant and Postpartum People with Opioid Use Disorder. WOMEN'S HEALTH REPORTS 2022; 3:834-843. [PMID: 36340476 PMCID: PMC9629978 DOI: 10.1089/whr.2022.0046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 09/19/2022] [Indexed: 11/07/2022]
Abstract
Background: Postpartum people with opioid use disorder (OUD) report feeling underprepared for the pregnancy to postpartum transition. We developed a novel, technology-delivered educational intervention for pregnant and parenting people with OUD to address this gap. This study provides a theoretically grounded assessment of the feasibility and acceptability of a new technology-delivered educational intervention (Project BETTER) for pregnant and parenting people receiving medication for OUD (MOUD). Materials and Methods: Pregnant and postpartum people receiving MOUD were recruited from a perinatal addiction clinic research registry to pilot test the technology-delivered intervention. Participants completed one of three modules (Postpartum Transition, Neonatal Opioid Withdrawal Syndrome, or Child Welfare Interactions) and a survey assessing acceptability based on the theoretical framework of acceptability (TFA). We measured feasibility using process, resource, management, and scientific assessments. Demographics were self-reported. Clinical characteristics were abstracted from the medical record. Results: Feasibility was promising, with 17 of 28 participants approached (61%) agreeing to participate; 70% of these participants (N = 12; 58% White and 23% Black, all with public insurance) completed an intervention module and the study assessments, and all reported understanding how the modules worked. Acceptability was strong, with median ratings of 4 or 5 on a 5-point scale for all positively scored TFA domains. Compared to learning from a provider, participants also reported feeling more comfortable and less stigmatized learning from the intervention. Conclusion: Our theoretically grounded assessment suggests high feasibility and acceptability for Project BETTER, and provides justification for further evaluation in a clinical trial setting. Technology-delivered educational interventions may help reduce stigma and enhance prenatal education.
Collapse
Affiliation(s)
- Sarah Martin
- School of Medicine, Virginia Commonwealth University, Richmond, Virginia, USA
| | | | - Michelle Eglovitch
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Steven J. Ondersma
- Division of Public Health and Department of Obstetrics, Gynecology, and Reproductive Biology, Michigan State University, East Lansing, Michigan, USA
| | - Dace S. Svikis
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, USA.,Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Caitlin E. Martin
- Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Richmond, Virginia, USA.,Department of Obstetrics and Gynecology, School of Medicine, Virginia Commonwealth University, Richmond, Virginia, USA.,Address correspondence to: Caitlin E. Martin, MD, MPH, FACOG, FASAM, Department of Obstetrics and Gynecology, School of Medicine, Virginia Commonwealth University, 1101 East Marshall Street, 11th Floor, Room 11-027, Box #980034, Richmond, VA 23298, USA,
| |
Collapse
|
7
|
Ondersma SJ, Todd L, Jablonski S, Ahuja C, Gilstad-Hayden K, Goyert G, Loree A, Heffner J, Yonkers KA. Online randomised factorial trial of electronic Screening and Brief Intervention for alcohol use in pregnancy: a study protocol. BMJ Open 2022; 12:e062735. [PMID: 35922101 PMCID: PMC9352990 DOI: 10.1136/bmjopen-2022-062735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 07/19/2022] [Indexed: 12/03/2022] Open
Abstract
INTRODUCTION Approximately 1 in 7 pregnant women in the USA report past-month alcohol use. Strong evidence connects prenatal alcohol exposure with a range of adverse perinatal outcomes, including the spectrum of conditions known as fetal alcohol spectrum disorders. Screening and Brief Intervention (SBI) has been recommended for pregnant women but has proven difficult to implement. This study will test the efficacy of single-session technology-delivered SBI (electronic SBI) for alcohol use in pregnancy, while simultaneously evaluating the possible additional benefit of tailored text messages and/or booster sessions in a 3×2 factorial trial. METHOD AND ANALYSIS This full factorial trial will use online advertising and clinic-based flyers to recruit pregnant women meeting criteria for unhealthy alcohol use, and randomly assign them to one of six conditions crossing three levels of brief intervention (none, single 120-minute session and single session plus two 5-minute boosters) with two levels of tailored text messaging (none vs twice weekly messages). The primary analysis will test for dose-response effects of the brief intervention on alcohol abstinence, defined as no self-report of alcohol use in the 90 days prior to 34 weeks' gestation, and negative results for ethyl glucuronide analysis of fingernail samples. Secondary analyses will examine main and interaction effects of tailored text messaging as well as intervention effects on birth outcomes. ETHICS AND DISSEMINATION Ethical approval was provided by the Michigan State University Biomedical and Health Institutional Review Board (STUDY00005298). Results will be presented at conferences and community forums, in addition to being published in a peer-reviewed journal. Intervention content demonstrating sufficient efficacy and safety will be made publicly available. TRIAL REGISTRATION NUMBER ClinicalTrials.gov Registry (NCT04332172).
Collapse
Affiliation(s)
- Steven J Ondersma
- Division of Public Health and Department of Obstetrics, Gynecology, and Reproductive Biology, Michigan State University, Flint, Michigan, USA
| | - Lisa Todd
- Family Medicine and Public Health Sciences, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Samantha Jablonski
- Health Care Value-Business Analytics Division, Blue Cross Blue Shield of Michigan, Detroit, Michigan, USA
| | - Chaarushi Ahuja
- Department of Obstetrics, Gynecology, and Reproductive Science, Yale-New Haven Hospital, New Haven, Connecticut, USA
| | | | - Gregory Goyert
- Division of Maternal Fetal Medicine, Henry Ford Health, Detroit, Michigan, USA
| | - Amy Loree
- Center for Health Policy & Health Services Research, Henry Ford Health System, Detroit, Michigan, USA
| | - Jaimee Heffner
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Kimberly A Yonkers
- Departments of Psychiatry and Obstetrics & Gynecology, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| |
Collapse
|
8
|
Marcu G, Ondersma SJ, Spiller AN, Broderick BM, Kadri R, Buis LR. Barriers and Considerations in the Design and Implementation of Digital Behavioral Interventions: Qualitative Analysis. J Med Internet Res 2022; 24:e34301. [PMID: 35353043 PMCID: PMC9008531 DOI: 10.2196/34301] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 12/09/2021] [Accepted: 12/30/2021] [Indexed: 12/25/2022] Open
Abstract
Background Digital behavioral interventions have become increasingly popular for their ability to support patient diagnosis and treatment, chronic disease self-management, behavior change, and adherence to recommended care. However, digital intervention development is impeded by challenges such as limited technical skills, limited access to developers, and cost. The purpose of this study is to elicit in-depth qualitative feedback from intervention developers who have interest in digital behavioral interventions but lack programming skills regarding the barriers they experience and key considerations in the design and implementation of digital interventions. Objective This study aims to understand barriers in the design and implementation of digital behavioral interventions, as well as to identify key considerations for researchers who are developing these interventions. Methods We conducted semistructured qualitative interviews with 18 researchers who had experience either designing (but not coding) digital behavioral interventions or running research studies with them. Participants were a convenience sample of users of the Computerized Intervention Authoring System platform, an existing no-code development platform for building digital intervention content, and were recruited through either direct email solicitation or snowball sampling. All interviews were conducted and recorded over videoconference between February and April 2020. Recordings from interviews were transcribed and thematically analyzed by multiple coders. Results Interviews were completed with 18 participants and lasted between 24 and 65 (mean 46.9, SD 11.3) minutes. Interviewees were predominantly female (17/18, 94%) and represented different job roles, ranging from researcher to project/study staff. Three key barriers in the development of digital behavior interventions were identified during interviews: lack of cross-disciplinary understanding; variability in recipients’ technology access, infrastructure, and literacy; and the idea that evidence-based in-person interactions do not translate directly to digital interactions. Interviewees identified several key considerations that interventionists learned to prioritize, which have the potential to overcome these barriers and lead to successful interventions. Conclusions Barriers in the development of digital behavioral interventions are often created by a lack of cross-disciplinary understanding, which can lead to difficulties conceptualizing interventions, unrealistic expectations in terms of cost, and confusion about the development process. Moreover, concerns about research study participant characteristics and access to technology, as well as the translation of in-person interventions to digital, are apparent. Appropriate training in how to work with software development teams may help future digital behavior intervention creators overcome these barriers and may lead to new, exciting innovations in this space.
Collapse
Affiliation(s)
- Gabriela Marcu
- School of Information, University of Michigan, Ann Arbor, MI, United States
| | - Steven J Ondersma
- Department of Obstetrics, Gynecology, & Reproductive Biology and the Division of Public Health, Michigan State University, East Lansing, MI, United States
| | - Allison N Spiller
- School of Information, University of Michigan, Ann Arbor, MI, United States
| | | | - Reema Kadri
- Department of Family Medicine, University of Michigan, Ann Arbor, MI, United States
| | - Lorraine R Buis
- School of Information, University of Michigan, Ann Arbor, MI, United States.,Department of Family Medicine, University of Michigan, Ann Arbor, MI, United States
| |
Collapse
|
9
|
Guille C, Maldonado L, Simpson AN, Newman R, King C, Cortese B, Quigley E, Dietrich N, Kerr A, Aujla R, King K, Ford D, Brady KT. A Non-Randomized Trial of In-Person Versus Text/Telephone Screening, Brief Intervention and Referral to Treatment for Pregnant and Postpartum Women. PSYCHIATRIC RESEARCH AND CLINICAL PRACTICE 2021; 3:172-183. [PMID: 36101654 PMCID: PMC9175992 DOI: 10.1176/appi.prcp.20210027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Revised: 10/13/2021] [Accepted: 10/15/2021] [Indexed: 11/30/2022] Open
Abstract
Background Systems of care that improve mental health and substance use disorder Screening, Brief Intervention and Referral to Treatment (SBIRT) for pregnant and postpartum women are needed. Aims The aim of this study is to determine if women receiving prenatal care from January 2020 to April 2021 are more likely to be screened, screen positive, be referred for treatment and attend treatment with technology facilitated SBIRT, compared to women receiving prenatal care and in-person SBIRT January 2017 to December 2019. Materials & Methods Technology facilitated SBIRT, designated Listening to Women (LTW), includes text message-based screening, phone-based brief intervention, and referral to treatment by a remote care coordinator. A total of 3535 pregnant and postpartum women were included in the quasi-experimental study and data were collected via text message and Electronic Health Record. Results In-person SBIRT was completed by 65.2% (1947/2988) of women while 98.9% (547/553) of women approached agreed to take part in LTW and 71.9% (393/547) completed SBIRT via LTW. After controlling for potentially confounding variables, women enrolled in LTW were significantly more likely to be screened (relative risk [RR]: 1.10, 95% CI 1.03-1.16), screen positive (RR 1.91, 95% CI 1.72-2.10), referred to treatment (RR 1.55, 95% CI 1.43-1.69) and receive treatment (RR 4.95, 95% CI 3.93-6.23), compared to women receiving in-person SBIRT. Black women enrolled in LTW were significantly more likely to screen positive (RR 1.65, 95% CI 1.35-2.01), be referred to treatment (RR 1.54, 95% CI 1.35-1.76) and attend treatment (RR 5.49, 95% CI 3.69-8.17), compared to Black women receiving in-person SBIRT. Discussion LTW appears to increase the proportion of pregnant and postpartum women receiving key elements of SBIRT.
Collapse
Affiliation(s)
- Constance Guille
- Department of Psychiatry and Behavioral SciencesMedical University of South CarolinaCharleston
- Department of Obstetrics and GynecologyMedical University of South CarolinaCharleston
| | - Lizmarie Maldonado
- Department of Healthcare Leadership and ManagementMedical University of South CarolinaCharleston
| | - Annie N. Simpson
- Department of Healthcare Leadership and ManagementMedical University of South CarolinaCharleston
| | - Roger Newman
- Department of Obstetrics and GynecologyMedical University of South CarolinaCharleston
| | - Courtney King
- Department of Psychiatry and Behavioral SciencesMedical University of South CarolinaCharleston
| | - Bernadette Cortese
- Department of Psychiatry and Behavioral SciencesMedical University of South CarolinaCharleston
| | - Erin Quigley
- Biomedical Informatics CenterMedical University of South CarolinaCharleston
| | - Nicole Dietrich
- Department of Psychiatry and Behavioral SciencesMedical University of South CarolinaCharleston
| | - Anna Kerr
- Department of Obstetrics and GynecologyMedical University of South CarolinaCharleston
| | - Rubin Aujla
- Department of Psychiatry and Behavioral SciencesMedical University of South CarolinaCharleston
| | - Kathryn King
- Department of PediatricsMedical University of South CarolinaCharleston
| | - Dee Ford
- Department of PulmonologyMedical University of South CarolinaCharlestonSC
| | - Kathleen T. Brady
- Department of Psychiatry and Behavioral SciencesMedical University of South CarolinaCharleston
| |
Collapse
|
10
|
Wouldes TA, Crawford A, Stevens S, Stasiak K. Evidence for the Effectiveness and Acceptability of e-SBI or e-SBIRT in the Management of Alcohol and Illicit Substance Use in Pregnant and Post-partum Women. Front Psychiatry 2021; 12:634805. [PMID: 34025470 PMCID: PMC8131659 DOI: 10.3389/fpsyt.2021.634805] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Accepted: 03/17/2021] [Indexed: 12/12/2022] Open
Abstract
Alcohol and illicit psychoactive drug use during pregnancy have increased worldwide, putting women and their children's health and development at risk. Multiple drug use, comorbid psychiatric disorders, sexual and physical abuse are common in women who use alcohol and drugs during pregnancy. The effects on the mother include poor reproductive and life-long health, legal, family, and social problems. Additionally, the exposed child is at increased risk of long-term physical health, mental health, and developmental problems. The stigma associated with substance use during pregnancy and some clinicians' reticence to inquire about substance use means many women are not receiving adequate prenatal, substance abuse, and mental health care. Evidence for mHealth apps to provide health care for pregnant and post-partum women reveal the usability and effectiveness of these apps to reduce gestational weight gain, improve nutrition, promote smoking cessation and manage gestational diabetes mellitus, and treat depression and anxiety. Emerging evidence suggests mHealth technology using a public health approach of electronic screening, brief intervention, or referral to treatment (e-SBIRT) for substance use or abuse can overcome the typical barriers preventing women from receiving treatment for alcohol and drug use during pregnancy. This brief intervention delivered through a mobile device may be equally effective as SBIRT delivered by a health care professional in preventing maternal drug use, minimizing the effects to the exposed child, and providing a pathway to therapeutic options for a substance use disorder. However, larger studies in more diverse settings with women who have co-morbid mental illness and a constellation of social risk factors that are frequently associated with substance use disorders are needed.
Collapse
Affiliation(s)
- Trecia A Wouldes
- Department of Psychological Medicine, Faculty of Medical and Health Science, University of Auckland, Auckland, New Zealand
| | - Andi Crawford
- Department of Psychological Medicine, Faculty of Medical and Health Science, University of Auckland, Auckland, New Zealand
- Te Ara Manapou, Parenting and Pregnancy Service, Hawke's Bay District Health Board, Hastings, New Zealand
| | - Suzanne Stevens
- Department of Psychological Medicine, Faculty of Medical and Health Science, University of Auckland, Auckland, New Zealand
| | - Karolina Stasiak
- Department of Psychological Medicine, Faculty of Medical and Health Science, University of Auckland, Auckland, New Zealand
| |
Collapse
|
11
|
Hammock K, Velasquez MM, Alwan H, von Sternberg K. Alcohol Screening, Brief Intervention, and Referral to Treatment (SBIRT) for Girls and Women. Alcohol Res 2020; 40:07. [PMID: 34646716 PMCID: PMC8496756 DOI: 10.35946/arcr.v40.2.07] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Females ages 12 and older are the fastest growing segment of alcohol consumers in the United States, with the past decade showing a 16% increase in alcohol use per 12-month period and a 58% increase in high-risk drinking (i.e., > 3 drinks in a day and/or > 7 drinks in a week) per 12-month period. The increase in alcohol use and risk drinking poses unique and serious consequences for women. Women have a more rapid progression to alcohol-related problems and alcohol use disorders (AUD) than men, and if pregnant, women can potentially expose the fetus to alcohol. Screening, brief intervention, and referral to treatment (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 service settings. This article presents the current status of SBIRT among girls ages 12 and older, women of childbearing age, and older women. Screening instruments, brief interventions, and implementation issues specific to women of all ages are described. Through this review of the current literature, care providers can determine best practices for the prevention and treatment of risk drinking in women of all ages presenting in health care settings.
Collapse
Affiliation(s)
- Kyndal Hammock
- Health Behavior Research and Training Institute, University of Texas at Austin, Austin, Texas
| | - Mary M. Velasquez
- Health Behavior Research and Training Institute, University of Texas at Austin, Austin, Texas
| | - Hanan Alwan
- Health Behavior Research and Training Institute, University of Texas at Austin, Austin, Texas
| | - Kirk von Sternberg
- Health Behavior Research and Training Institute, University of Texas at Austin, Austin, Texas
| |
Collapse
|
12
|
Yonkers KA, Dailey JI, Gilstad-Hayden K, Ondersma SJ, Forray A, Olmstead TA, Martino S. Abstinence outcomes among women in reproductive health centers administered clinician or electronic brief interventions. J Subst Abuse Treat 2020; 113:107995. [PMID: 32359666 DOI: 10.1016/j.jsat.2020.02.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 02/07/2020] [Accepted: 02/20/2020] [Indexed: 10/24/2022]
Abstract
Treatment of substance use in women seeking reproductive healthcare is crucial for the health of both women and their offspring. Although abstinence from all substance use during pregnancy is optimal, it is difficult to achieve. This secondary analysis reports abstinence outcomes from a randomized clinical trial of screening, brief intervention, and referral to treatment (SBIRT) for substance use among women seeking reproductive healthcare services. Women who screened positive for substance use were randomly assigned to either clinician-administered SBIRT, an electronically-administered brief intervention (e-SBIRT), or an enhanced usual care condition. At a 6-month follow-up assessment, compared to enhanced usual care, the clinician-administered SBIRT increased 1-month point prevalence of abstinence from the primary substance by 7.7%, and e-SBIRT increased abstinence by 12.8%. Both brief interventions were more useful than enhanced usual care and could increase substance use abstinence rates among women in reproductive healthcare clinics. The electronic brief intervention is particularly attractive given that it appears as efficacious as, but requires fewer resources than, clinician-delivered brief interventions.
Collapse
Affiliation(s)
- Kimberly A Yonkers
- Department of Psychiatry, Yale School of Medicine, 300 George Street, New Haven, CT 06511, USA; Department of Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine, 333 Cedar Street, New Haven, CT 06510, USA; Department of Epidemiology and Public Health, Yale School of Medicine, 60 College Street, New Haven, CT 06510, USA.
| | - Jason I Dailey
- Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814, USA.
| | - Kathryn Gilstad-Hayden
- Department of Psychiatry, Yale School of Medicine, 300 George Street, New Haven, CT 06511, USA.
| | - Steven J Ondersma
- Wayne State University, Merrill Palmer Skillman Institute, 71 E. Ferry Ave, Detroit, MI 48202, USA.
| | - Ariadna Forray
- Department of Psychiatry, Yale School of Medicine, 300 George Street, New Haven, CT 06511, USA.
| | - Todd A Olmstead
- University of Texas at Austin, PO Box Y, Austin, TX 78713, USA.
| | - Steve Martino
- Department of Psychiatry, Yale School of Medicine, 300 George Street, New Haven, CT 06511, USA; VA Connecticut Healthcare System, 950 Campbell Avenue, West Haven, CT 06516, USA.
| |
Collapse
|