results of the georgia basics sbirt initiative
TRANSCRIPT
Results of the Georgia BASICS SBIRT Initiative
Gabriel P. Kuperminc, Ph.DGeorgia State University22 October 2015, Atlanta, GA
Georgia BASICS
• SBIRT Demonstration Project– Routine screening in Emergency Departments– Motivational Interviewing (15-30 minutes)– Availability of therapy, referral to treatment
• Settings– Grady Health System (Atlanta)– Medical Center of Central Georgia (Macon)
Urban Emergency Patients
• Risk– Poverty, housing instability– Lack consistent health care, unmet needs– Behaviors (e.g., alcohol, drug use) linked with
health concerns
• ED visit as “Teachable Moment”– Opportunity to help patients make the connection– Change from blame for poor choices to increased
motivation for positive choices
3 Question Prescreen: 25% Pos.
Patient Enters ED
7% High Risk
BI + BT
54% Low- Moderate Risk
BI
Positve Prescreens
receive ASSIST Full Screen
7% Very High Risk
BI+ RT
BI = Brief InterventionBT = Brief TherapyRT = Referral to Treatment
10% Sample enrolled For 6 month Follow Up
Nurse
Health Educators 32% Screening Feedback
Georgia BASICS: Services Provided
Services Provided
Screening/Feedback 154,429
Brief Intervention (BI) 21,193
BI + Brief Therapy (BT) 2,790
BI + Referral to Tx (RT) 3,176
Total 181,588
Evaluation
Screening:Identify Pts. Eligible for
Services
Brief InterventionBrief Therapy
Referral to Treatment
6-Month Follow Up
INTERVENTION GROUPx x
xCONTROL GROUP
x 0x
Study SampleControl Group
(N = 1737) SBIRT Group
( N =1170)
Years of Education 11.77 11.80
Average Age 42 42
Female 34% 29%
African-American 74% 74%
Employed Full or Part Time 33% 33%
Unstably housed/Homeless 49% 48%
Average Monthly Wage $807 $571
Notes: (1) SBIRT pts enrolled in study via random selection from those receiving services.(2) Control pts received screening/assessment but no services.(3) 6-month follow-ups completed w/ 50% of Controland 65% of SBIRT pts.
SBIRT Patients Decreased Substance Use Baseline to 6-mo Follow-up
Alcohol Any Drugs Marijuana Cocaine0
2
4
6
8
10
12
Baseline Follow-Up
Greater Decreases in Binge Drinking for SBIRT vs. Control Patients
SBIRT Control0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
92%
74%
58% 58%
Mental Health Improvements in Quality of Life
SBIRT Comparison3032343638404244464850
Baseline 6-Month
Conclusions
• REDUCED Alcohol and other Drug use– Similar to findings in other SBIRT studies– Tend to be Larger for SBIRT vs. Controls– Better Evidence for Effectiveness with Alcohol
than other Drugs
• MORE THAN SUBSTANCE USE– Improved Mental Health may mark greater
sense of control, help individuals choose to reduce use of substances
Thanks toSAMHSA, #TI019545 GA Div. Behavioral Health & Developmental
DisabilitiesGSU Colleagues and StudentsGrady Health System & Medical Center of
Central Georgia
For more information, contact:Gabriel KupermincDept of PsychologyGeorgia State UniversityP.O. Box 5010Atlanta, GA [email protected]