Background This study explores the feasibility and acceptability of a computer self-administered approach to substance use screening from the perspective of primary care patients. Methods Forty-eight patients from a large safety net hospital in New York City completed an audio computer-assisted self-interview (ACASI) version of the Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) and a qualitative interview to assess feasibility and acceptability; comprehension; comfort with screening questions; and preferences for screening mode (interviewer or computer). Qualitative data analysis organized the participants’ feedback into major themes. Results Participants overwhelmingly reported being comfortable with the ACASI ASSIST. Mean administration time was 5.2 minutes (range 1.6 – 14.8). The major themes from the qualitative interviews were 1) ACASI ASSIST is feasible and acceptable to patients, 2) Social stigma around substance use is a barrier to patient disclosure, and 3) ACASI screening should not preclude personal interaction with providers. Conclusions The ACASI ASSIST is an appropriate and feasible approach to substance use screening in primary care. Because of the highly sensitive nature of substance use, screening tools must explain the purpose of screening, assure patients that their privacy is protected, and inform patients of the opportunity to discuss their screening results with their provider.

McNeely et al.: Can patients screen themselves? Pilot study of an audio-guided computer-assisted self-interview (ACASI) approach to screening for substance use in primary care. Addiction Science & Clinical Practice 2012 7(Suppl 1):A7.

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