Electronic Screening and Brief Intervention for Unhealthy Alcohol use in Primary Care Waiting Rooms – a Pilot Project

Abstract

Background: In primary care, electronic self-administered screening and brief interventions for unhealthy alcohol may overcome some of the implementation barriers of face-to-face intervention. We developed an anonymous electronic self-administered screening brief intervention device for unhealthy alcohol use and assessed its feasibility and acceptability in primary care practice waiting rooms. Two modes of delivery were compared: with or without the presence of a research assistant (RA) to make patients aware of the device's presence and help users. Using the device was optional. Methods: The devices were placed in 10 participating primary care practices waiting rooms for 6 weeks, and were accessible on a voluntary basis. Number of appointments by each practice during the course of the study was recorded. Access to the electronic brief intervention was voluntary among those who screened positive. Screening and brief intervention rates and characteristics of users were compared across the modes of delivery. Results: During the study, there were 7270 appointments and 1511 individuals used the device (20.8%). Mean age of users was 45.3 (19.5), and 57.9% screened positive for unhealthy alcohol use. Of them, 53.8% accessed the brief intervention content. The presence of the RA had a major impact on the device's usage (59.6% vs 17.4% when absent). When the RA was present, participants were less likely to screen positive (49.4% vs 60.7%, P = 0.0003) but more likely to access the intervention (62.7% vs 51.4%, P = 0.009). Results from the satisfaction survey indicated that users found the device easy to use (93.5%), questions useful (89–95%) and 77.2% reported that their friends would be willing to use it. Conclusions: This pilot project indicates that the implementation of an electronic screening and brief intervention device for unhealthy alcohol is feasible and acceptable in primary care practices but that, without human support, its use is rather limited.

The efficacy of Personalized Normative Feedback interventions across addictions: A systematic review and meta-analysis

“…Social norms approaches are a potentially powerful and cost-effective way to promote behavior change [ 30 ] and may be incorporated into SBIs to help address the burden of addictive behaviors [ 31 , 32 ]. Social norms approaches include various distinct interventions, operationalized from different aspects of social norms theory e.g., social marketing, fear-based methods, and personalized normative feedback (PNF) [ 30 ].…”

Identifying available substance use disorder screening tests feasible for use in primary care: A systematic review

“…Different methods were used to study the feasibility of addictive disorder screening tests. Satisfaction questionnaires or a brief survey were the most commonly used methods ( Adam et al, 2019 , Bertholet et al, 2019 , Chan-Pensley, 1999 , Christoff et al, 2016 , Dyches et al, 1999 ; N. A. Johnson et al, 2013 , Nguyen et al, 2001 , Ríos-Bedoya and Hay, 2013 , Smith et al, 2011 , Wu et al, 2016 ).…”

“…The computer version of AUDIT (Alcohol Use Disorders Identification Test) was considered easy-to-use and to understand ( Chan-Pensley, 1999 , Mulvaney-Day et al, 2018 ). The touchpad versions of SUBS (Substance Use Brief Screen) ( Bertholet et al, 2019b ) and TAPS (Tobacco, Alcohol, Prescription medication and other Substance use) (MyTAPS) were acceptable and easy-to-use but elderly people found this MyTAPS format more difficult ( Adam et al, 2019 ).…”

“…The term ease of use was commonly used but some studies analyzed the ease of response and the need for assistance with technical problems. Only ASSIST, AUDIT-C, CAGE (Cut-down, Annoyed, Guilty, Eye-opener), SUBS and TAPS were specifically studied and were considered easy-to-use ( Adam et al, 2019 , Bertholet et al, 2019 , Christoff et al, 2016 , Farrell et al, 2009a , Spear et al, 2016 , WHO Assist Working Group, 2002 ).…”

Digital Health Screening in People With HIV in Uganda to Increase Alcohol Use Reporting: Qualitative Study on the Development and Testing of the Self-administered Digital Screener for Health

“…The use of tablets for self-completion of clinic intake forms is increasing in many resource-rich settings; for instance, several clinical settings in the United States and Sweden have examined the use of digital screening and found that reporting of risk behaviors was comparable with more traditional screening methods [34,[47][48][49][50][51][52][53][54][55][56][57], and the digital screening over a wide range of patient characteristics was acceptable [58][59][60][61][62]. Audio computer-assisted self-interviewing (ACASI) has been associated with increased reporting of stigmatized behaviors such as forced sex, especially in Africa and rural settings [63].…”