Brief Motivational Interviewing for Substance Use by Medical Students Is Effective in the Emergency Department

Balbi, Alanna; Gak, Anthony E.; Kim, Esther; Park, Tennessee D.; Quinn, Joann Farrell; Colon, Manuel F.; Greenberg, Marna Rayl; Roth, Paige; Weaver, Kevin; Richardson, David M.; Burmeister, David B.; Dusza, Stephen W.; Cannon, Robert D.

doi:10.1016/j.jemermed.2019.03.032

Cited by 5 publications

(3 citation statements)

References 7 publications

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“…After the screening involvement, new physiotherapists thesis topics appeared, as the role of the physiotherapist in balancing diabetes mellitus. Evidence already existed that training health students specifically to address unhealthy behaviors is effective in reducing cardiovascular risk behaviors ( 30 ). However, health students do not feel competent in prevention tasks ( 31 ).…”

Section: Discussionmentioning

confidence: 99%

Screening for cardiovascular risk in the general population: The SPICES implementation survey

et al. 2023

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BackgroundIn 2019, cardiovascular diseases (CVD) caused 32% of deaths worldwide. The SPICES survey involved five countries in an international primary CVD prevention implementation study in the general population. The French SPICES survey was implemented in the Centre Ouest Bretagne area (COB), which is a rural, economically deprived, medically underserved territory with high cardiovascular mortality. A CVD screening in the general population was needed to select the implementation population without overburdening family practitioner (FP) workforces. The efficacy and the replicability of such a screening were unknown. The aims of this study were to identify the characteristics of the individuals undergoing CVD risk assessment with the Non-Laboratory Interheart risk score (NL-IHRS), and to identify barriers and explore facilitators when screening the general population.MethodsAn implementation study combining a cross-sectional descriptive study with qualitative interviews was undertaken. The NL-IHRS was completed by trained screeners selected from health students, pharmacists, nurses, and physiotherapists in the area with a dedicated e-tool in sport and cultural events and public places. After the screening, all screener groups were interviewed until theoretical saturation for each group. Thematic analysis was performed using double-blind coding.ResultsIn 5 months, 3,384 assessments were undertaken in 60 different places, mostly by health students. A total of 1,587, 1,309, and 488 individuals were at low, moderate, and high CVD risk. Stressed or depressed individuals were remarkably numerous (40.1 and 24.5% of the population, respectively). Forty-seven interviews were conducted. The main facilitators were willingness of the population, trust between screeners and the research team, and media publicity. The main barriers were lack of motivation of some screeners, some individuals at risk, some stakeholders and difficulties in handling the e-tool.ConclusionThe efficacy of CVD risk screening while using mostly health students was excellent and preserved the FP workforce. Replicability was highly feasible if research teams took great care to establish and maintain trust between screeners and researchers. The e-tools should be more user-friendly.

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Section: Discussionmentioning

confidence: 99%

Screening for cardiovascular risk in the general population: The SPICES implementation survey

et al. 2023

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“…4 The ED is an ideal clinical environment for brief interventions that promote sexual health because it offers flexibility during wait times for nonemergent conditions to engage at-risk populations and link patients to primary prevention strategies that promote health. 14,15,[26][27][28][29][30][31][32][33][34] We pilottested an intervention approach in the ED using vlogging to deliver a brief educational strategy to Black women aimed at increasing their knowledge of how HIV/STIs are transmitted. Pilot study findings support a future prevention intervention aimed at promoting sexual health.…”

Section: Discussionmentioning

confidence: 99%

Novel Use of Video Logs to Deliver Educational Interventions to Black Women for Disease Prevention

Hill

Coker

2022

WestJEM

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Introduction: Cisgender Black women comprise 67% of new human immunodeficiency virus (HIV) diagnoses among women in the South and are 11 times more likely to become HIV positive than White women in Texas. Optimal progress toward ending the HIV epidemic requires strategies that will interrupt transmission pathways in hotspot locations like Harris County, TX. Researchers are calling for public health interventions that can prevent HIV and sexually transmitted infections (STI) transmission; thus, we launched the first video log (vlog)-based, pilot HIV prevention intervention. Methods: In a prospective. randomized controlled trial of two educational intervention strategies delivered as vlogs eligible participants were randomized to either 1) an interactive gaming, education-based strategy, or 2) a storytelling, education-based strategy. Eligible participants were cisgender Black women being seen in the emergency department (ED) for a non-emergent condition who reported recent condomless heterosexual sex, were ages 18-45, and had social media access. Enrolled women completed a screening assessment, informed consent, randomization, and 10-item pre-and-post assessments with true/false statements before and after viewing a brief vlog on a tablet device to identify changes in knowledge before and after being educated on HIV/STI transmission. Results: Twenty-six women were randomized to the Taboo group, an interactive gaming, education-based strategy, (14 [53.8%]), or to storytelling, an education-based strategy using non-fictional and fictional case scenarios (12 [46.2%]). Taboo participants self-identified as African-American (12 [85.7%]), Black (1 [7.1%]) or “other” (1 [7.1%]), were younger (28.6% were ≥ 30 years), single (57.1%), reported a previous STI (8 [57.1%]), and were likely employed (57.2%). Storytelling participants self-identified as African-American (7 [58.3%]) or Black (5 [41.7%]), were older (49.9% were ≥ 30 years), in a relationship but not married (50%), and half were unemployed. Highest level of education and monthly income varied. The storytelling strategy increased knowledge in two areas and the Taboo strategy increased knowledge in one. No intervention effect was identified in three areas, and a significant decrease in knowledge (P < .0001) was discerned in eight areas for Taboo and six areas for storytelling. Conclusion: Further research is necessary to confirm whether delivery of HIV prevention interventions with vlogs is a useful approach for HIV-vulnerable populations. Findings suggest that vlogs are a feasible approach to brief behavioral interventions during an ED visit.

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“…Recently, MI has been used in multiple settings and with multiple populations including inpatient, emergency rooms, rural settings [48], and other ethnicities to reduce alcohol/substance use [49][50][51] and MI via text messages has been well received by adults [52,53]. MI has also been applied through digital format using text messaging to address a variety of health behaviors including tuberculosis [54], smoking [55], and alcohol use [56].…”

Section: Introductionmentioning

confidence: 99%

Women Empowered to Connect with Addiction Resources and Engage in Evidence-based Treatment (WE-CARE): A Usability and Feasibility Study of a Mobile Health Application for the Universal Screening of Alcohol, Substance Use, Depression and Anxiety. (Preprint)

Isaacs,

Shifflett,

Patel

et al. 2024

Preprint

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BACKGROUND Women of childbearing age (WOCA,18-44 years of age) face multiple barriers to receiving screening and treatment for unhealthy alcohol and substance use, depression, and anxiety, including lack of screening in the primary care setting and lack of support in accessing care. The Women Empowered to Connect with Addiction Resources and Engage in Evidence-based Treatment (WE-CARE) mobile app was developed to test universal screening with WOCA and linkage to care after an assessment for substance use disorder (SUD). OBJECTIVE In this study, we aimed to investigate the feasibility and acceptability of providing anonymous screening instruments for alcohol and substance use, as well as depression and anxiety, for women of childbearing age through mobile phones. METHODS We used Agile development principles based on prior formative research to create an alpha version of a WE-CARE mobile health application that was piloted with WOCA (N = 30) who resided in one of six counties in Central Florida. WE-CARE included screening instruments (for substance use, depression, and anxiety), a moderated discussion forum, educational micro-learning videos, an FAQ section, and resources for linkage to treatment. Individuals were recruited using flyers, academic listservs, and a commercial human subject survey company (Prolific). Upon completion of the screening instruments, women explored the educational and linkage to care features of the app and filled out a System Usability Scale (SUS) to evaluate the mobile health app’s usability and acceptability. Post-pilot semi-structured interviews (n = 4) were conducted to further explore the women’s reactions to the application. RESULTS Seventy-seven women downloaded the application and 30 completed testing. WOCA gave the WE-CARE app an excellent SUS score of 86.7 + 12.43 (SD). Out of the 30 participants (African American (N=1, 3.3%), Hispanic (N=6, 20%), more than one race (N=5,16.7%), White (N=14, 46.7%), Unknown (N=7, 23.3%)), 60% (n=18) had results indicating elevated risk for substance use, 50% of these 18 (n=9/18) indicated elevated risk also for anxiety or depression, and 61% (n=11/18) indicated elevated risk for substance use and/or anxiety or depression. Participants reported that WE-CARE was easy to navigate and use but they would like to see more screening questions and more educational content. However, linkage to care was an issue, as none of the women identified as ‘at-risk’ for SUDs contacted the free treatment clinic for further evaluation. CONCLUSIONS The mobile health application was highly rated for acceptability and usability, but participants were not receptive to seeking help at a treatment center after only a few brief encounters with the application. The linkage to care design features was likely insufficient to encourage them to seek treatment. The beta version of WE-CARE will include normative scores for participants to self-evaluate their screening status compared to their age- and gender-matched peers and enhanced linkages to care features. Future development will focus on improving engagement to change behaviors and assess readiness for change.

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Brief Motivational Interviewing for Substance Use by Medical Students Is Effective in the Emergency Department

Cited by 5 publications

References 7 publications

Screening for cardiovascular risk in the general population: The SPICES implementation survey

Screening for cardiovascular risk in the general population: The SPICES implementation survey

Novel Use of Video Logs to Deliver Educational Interventions to Black Women for Disease Prevention

Women Empowered to Connect with Addiction Resources and Engage in Evidence-based Treatment (WE-CARE): A Usability and Feasibility Study of a Mobile Health Application for the Universal Screening of Alcohol, Substance Use, Depression and Anxiety. (Preprint)

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