Online Military Screening, Brief Intervention, and Referral to Treatment (SBIRT) Training Program

Kognito Solutions, Llc, New York NY

Investigators

Abstract

? DESCRIPTION (provided by applicant): Alcohol is the most commonly used substance among soldiers and has a long history as part of the military culture to promote unit cohesion and reduce stress. As military deployments to Iraq and Afghanistan have increased within the past 10-12 years, risky alcohol use among military personnel has also increased. Untreated, binge and heavy drinking can endanger the health and well-being of military personnel and their families; impact military unit readiness; and increase the risk of alcohol-related harmful behaviors and consequences (e.g., driving while intoxicated, work productivity loss, accidental injury, misconduct, separation from military service, domestic and other types of violence, illicit drug use, and suicide). Evidence demonstrates the efficacy and cost-effectiveness of alcohol-related screening, brief intervention, and referral to treatment (SBIRT) for adults. The Veterans Affairs (VA) and Department of Defense (DoD) Clinical Practice Guideline for Management of Substance Use Disorders (SUDs) recommends universal alcohol SBIRT. However, a 2012 Institute of Medicine (IOM) report, prepared for DoD, Substance Use Disorders in the U.S. Armed Forces, found little evidence of its implementation within the branches. Studies have found that only a small percentage of military personnel who screen positive are referred to treatment. To improve screening and treatment rates, IOM calls for implementation of routine SBIRT in medical settings and standardized annual training for clinicians serving the military. This aligns with the 2011 National Drug Control Strategy requirement that DoD provide training to military health professionals in evidence-based SBI for alcohol and other drug use, and the recommendation that training be available online. Over the last 8 years, Drs. McPherson (PI) and Goplerud (Co-I), have facilitated the Brief Intervention Group, a consortium of all major managed behavioral health (BH) and employee assistance organizations, employers, professional associations, SBIRT and motivational interviewing experts, researchers, trainers, and federal and state representatives, with the goal of making SBIRT for alcohol problems routine practice. Our collaborating BH organizations see the critical need for a low cost, competency-based training in alcohol SBIRT designed specifically for practitioners serving military personnel, veterans, and family members. The proposed Military Alcohol SBI program will be developed as a stand-alone virtual patient simulation training with content based on the DoD's Clinical Practice Guideline for Management of SUDs. Phase 1 will develop one virtual patient simulation between a military BH professional and military patient (1 hour). It will be evaluated in a pretest-posttest randomized trial with military BH practitioners (N = 60). The Phase 2 program will include 4-6 virtual patient simulations (4-6 hours). This project will continue development of a series of programs to train BH and medical practitioners in conducting alcohol SBIRT. We are currently developing a virtual patient simulation for integrating adolescent SBIRT into schools of social work and nursing education.