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Screening, Brief Intervention, and Referral to Treatment (SBIRT) is an approach to identify and reduce risk and harm from substance use. However, research indicates that implementing components of ...

It is our responsibility as educators to see that our students receive training to meet the present-day challenges facing our clients. The graduate programs in social work are especially suited for...

Background Suicide is the second leading cause of death for college-aged individuals worldwide and in the United States. Recent studies have identified preliminary evidence of widening disparities in suicidal behaviors across sex, sexual orientation, race/ethnicity, age, and socioeconomic status among college students. Few systematic reviews and meta-analyses offer a comprehensive understanding of on-campus and off-campus suicide interventions, nor is collated information available for different types of screening, assessment, treatment, and postvention plans. Further challenges have been identified since the COVID-19 pandemic, calling for cost-effective and innovative interventions to address increased rates of suicidal behaviors among college students facing unprecedented stressors. Objective This research protocol describes the first systematic review and meta-analysis to identify the most effective and cost-effective intervention components for universal and targeted (indicated and selected) suicide prevention among college students in a global context. Special attention will be placed on disparities in suicide prevention across sociodemographic subgroups, inclusive interventions beyond campus, global context, and intervention responses to the COVID-19 pandemic. Methods A sensitive search strategy will be executed across MEDLINE (Ovid), EMBASE, PsycINFO (EBSCO), ERIC (EBSCO), Cochrane Library, Dissertations and Theses Global (ProQuest), Scopus, Global Index Medicus, SciELO, African Journals Online, Global Health (CABI), and Google Scholar. Data extraction and evaluation will be conducted by three independent researchers. Risk of bias will be assessed. A multilevel meta-regression model and subgroup analysis will be used to analyze the data and estimate effect sizes. Results The initial search was completed in December 2020 and updated with additional other-language studies in March 2020. We expect the results to be submitted for publication in mid-2021. Conclusions Despite increasing rates of suicidal behaviors among college students, few preventative efforts have targeted this population, and fewer focus on factors that might place specific demographic groups at heightened risk. The impact of COVID-19 on suicidal behaviors among college students highlights and exacerbates the urgent need for rapid and effective interventions that might differ from traditional approaches. This equity-focused study will address these gaps and provide a valuable analysis of the effectiveness of suicide prevention programs and interventions. Findings will inform clinicians, researchers, policy makers, families, and organizations about evidence-based interventions for reducing the gaps in the suicide crisis among college students from different sociodemographic groups. Trial Registration PROSPERO CRD42020225429; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=225429 International Registered Report Identifier (IRRID) DERR1-10.2196/26948

Screening, Brief Intervention, and Referral to Treatment (SBIRT) is an evidence-based process for identification, prevention, and treatment of alcohol misuse. The purpose of this study was to examine the effects of an alcohol-focused training on first-year MSW students’ (n = 71) knowledge, attitudes, and beliefs about SBIRT. Changes in item means were assessed using repeated-measures analysis of variance (critical α = .002). Data indicated a significant and strong main effect for training; perceived competence improved immediately and remained significantly higher 30 days posttraining. Other improvements included knowing what questions to ask patients, ease making alcohol-related statements, and believing that it is rewarding to work with at-risk patients.

Background: In the United States, approximately 30% of adults drink at risky levels or meet the criteria for harmful or dependent alcohol use. Screening, brief intervention, and referral to treatment (SBIRT) in primary care settings is indicated. This study assessed whether knowledge, attitudes, and beliefs about SBIRT, evaluated after a three-part, mixed-methods training, predicted whether 21 family nurse practitioner (FNP) students screened for alcohol use during clinical patient encounters. Method: After training, students completed a survey and documented implementation of SBIRT during their clinical practice-specific management courses. Results: FNP students who reported higher levels of perceived competence in their posttraining surveys were more likely to screen for alcohol in the clinical setting. Conclusion: Screening for alcohol misuse and identifying patients engaged in hazardous drinking meet important nurse practitioner competencies. Further research is needed to explore training programs that specifically emphasize activities to increase perceived competence, knowledge, and comfort regarding SBIRT. [ J Nurs Educ . 2016;55(4):231–235.]

This article is for social work educators unfamiliar with military social work and receptive to a number of exemplars to enhance teaching strategies within their courses. Because examples of military social work are directly tied to the Council on Social Work Education competencies, this article offers a number of suggested teaching strategies regarding those competencies. By incorporating the exemplars into a range of courses as discussion points, students and faculty will become more aware of issues faced by military service members, veterans, and their families. The goal of this article is to alert social work faculty to the actuality that military social work is a rich teaching resource that can be mined to assist in most social work classes.

Screening, brief intervention, and referral to treatment (SBIRT) is a promising public health approach for problematic substance use. A core component of SBIRT is the use of formal screening tools to categorize a patient's likely level of risk in order to provide an appropriately-matched service. Training in formal screening is included in many SBIRT training programs, but infrequently is emphasized.To assess pre-training levels of SBIRT-related clinical behaviors, including screening, this study examined a secondary dataset collected from internal medicine residents and graduate nurse practitioner students.Learners (n = 117) completed 13 self-report items assessing use of SBIRT-related behaviors. Researchers used exploratory factor analysis to identify underlying concepts in the questionnaire, then used mixed ANOVA to compare mean frequency of utilization of each factor (asking, screening, and intervening) by academic program.Learners reported asking about substance use frequently, intervening some of the time, and infrequently using formal screening tools. Interaction and between-academic-program effects were significant but small.Prior to SBIRT training, most clinical practitioners reported asking patients about substance use, but few reported regularly using formal substance use screening tools. This may have implications for the importance of SBIRT training as part of curricular work, and for the internal content foci of SBIRT curricula.

Little is known about how the characteristics of college undergraduate nondaily tobacco users compare to daily tobacco users. We conducted a survey to compare the sociodemographic, tobacco use, psychological, and alcohol-related factors between nondaily versus daily tobacco users in a sample of Black and White college undergraduates aged 18–24 years (N = 1623). Of this sample, 301 (18.5%) participants reported using tobacco in the previous 30 days. Of the participants reporting tobacco use in the past 30 days, 50 (16.6%) participants reported nondaily use and 21 (7.0%) participants reported daily use. Findings revealed that nondaily tobacco users were more likely than daily tobacco users to deny that use of tobacco has had a detrimental impact on their health (p < 0.001). Additionally, nondaily cigarette smokers reported a lower level of dependence than daily smokers (p < 0.001). White racial status and daily tobacco use was associated with cigarette smoking (p < 0.05), while Black racial status and nonda...

This study assessed differences between Black and White young adults on prior attempts and motivation to help a smoker quit. A total of 1,621 undergraduates (912 Black, 709 White; 63% female) ages 18–24 years completed a cross-sectional survey. Overall, 54% reported they had previously tried to help someone else stop smoking (52% among Blacks vs. 58% among Whites, p = 0.016). Among nonsmokers who indicated they were close to a smoker whom they thought should quit, Blacks were most often concerned about a family member whereas Whites endorsed concern most often for a friend (p

Purpose Aerobic exercise training (ExTR), predominantly performed with lower extremities, has been used to reverse heart failure (HF)-related exercise intolerance. The present study determined the safety and efficacy of upper-extremity exercise in HF subjects because daily activities are performed using both upper and lower extremities and there is little cross-training effects between extremities. Methods Seven subjects underwent 36 sessions (40 minutes, 3 times per week for 12 weeks) of upper-extremity ExTR (ARM ExTR) using arm ergometers, the arm function of a NuStep device, and an Airdyne stationary cycle. Exercise intensity and duration during weeks 1 to 4 were gradually increased to achieve a 75% to 85% peak heart rate. Pre- and post-ExTR tests included arm ergometer cardiopulmonary testing with echocardiography and quality of life self-administered surveys. Results After ARM ExTR test duration increased by 22% (P = .008), respiratory exchange ratio increased by 10% (P = .02), whereas peak oxygen consumption was not improved. Echocardiographic parameters were not altered by ARM ExTR. The total scores of both the Minnesota Living With Heart Failure Questionnaire (P = .02) and the Medical Outcomes Study-36 questionnaire (P = .05) were improved, but the Functional Status Questionnaire scores were not improved. Conclusions Although this study was limited in the number of subjects and lacked a control group, results indicate that ARM ExTR is safe and well-tolerated by persons diagnosed with HF, a finding that is relevant for individuals with HF who cannot exercise with lower extremities.

This focused review highlights the role of spirituality in rehabilitation. It is part of the study guide on geriatric rehabilitation in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation. This article specifically focuses on spirituality, rehabilitation, aging, and research. OVERALL LEARNING OBJECTIVE: To identify the current state of knowledge regarding the relationships among rehabilitation, spirituality, and aging.

Explores the development of a clinical quality improvement pilot project at the University of Alberta Hospital and Stollery Children’s Hospital which aimed to establish a team of individuals that could disseminate a culture of quality improvement and develop a framework for a quality process that could be replicated and repeated. Outcomes of the clinical pilot project included improved performance as well as opportunities to learn some key lessons around team membership and involvement.

The purpose of this study was to examine first year outcomes of an alcohol preventive intervention within inner-city middle schools. Subjects consisted of 650 sixth grade students from one neighborhood inner-city school ( n = 262) and one bused school ( n = 388). At posttest, chi-square analyses showed that significantly fewer neighborhood intervention students initiated alcohol use, used alcohol during the past seven-day and thirty-day periods, drank heavily during the past thirty days, and drank over any period of time, compared to control students ( p's, < .05). Significant group × prior alcohol consequences interaction effects were found for bused students, showing those with past alcohol consequences who received the intervention had less intentions to use alcohol and less frequent use of alcohol ( p's < .05). These results suggest that a brief, stage-based preventive intervention may result in significant reductions in alcohol initiation and consumption among some inner-city youth.

The effects of a primary prevention social norm intervention on binge drinking among 1st-year residential college students were examined. Six hundred thirty-four students attending a medium-sized public university in the South were randomly assigned to receive a two-phase social norm intervention or the standard campus psychoeducational prevention program. At posttest, no differences were found between intervention and control group students on any of the alcohol use and alcohol-use risk factor measures. Significant subgroup differences were found by stage of initiating binge drinking behaviors, for frequency of alcohol use, F(3, 507) = 3.69, p = .01; quantity of alcohol use, F(3, 507) = 2.51, p = .05; and social norms, F(3, 505) = 2.53, p = .05. These findings suggest the need for tailoring social norm binge drinking interventions to students' stage of initiating heavy drinking and carefully monitoring for potential negative, as well as positive, effects of norm-based prevention messages.

This pilot study examined the feasibility and efficacy of a brief alcohol misuse preventive intervention for 178 7th-9th grade junior high school students attending sports physical examinations at three schools during the Summer of 1997. At 6-month posttest, fewer suburban intervention youth intended to use alcohol during the next 6 months (chi2 = 7.01, 1 df, p = .01), and fewer rural intervention youth used alcohol during the past 30 days (chi2 = 4.65, 1 df, p = .04), compared to control youth. When suburban and rural school samples were collapsed, intervention youth had significantly lower alcohol use on three of four measures than control subjects (p's.05).

Six-hundred and fifty 6th grade students were randomly assigned with the intervention group receiving the STARS for Families Program, an alcohol reduction program consisting of standardized health consultations provided by nurses and mailed follow-up information. The control group received minimum information. Students in the study attended either a neighborhood or a bused inner-city middle school. Students receiving the intervention had significantly less intentions to use alcohol in the future and less alcohol quantity. The study suggests that brief, provider-involved interventions may be a viable school based approach to prevention.

This study examined the effects of a brief, pilot alcohol prevention intervention for 211 disadvantaged 6th grade school children at posttest and 1-year follow-up. Process data indicated that the intervention was successfully implemented and well received by youth and parent/guardian participants. ANCOVA analyses indicated a significant difference on alcohol use frequency for drinking subjects at 1-month posttest, with less frequent use reported by intervention subjects than subjects receiving the minimal control materials, F(1,22) = 5.37, p = .03. No differences were found between intervention and control subjects on alcohol use measures at 1-year follow-up. Critical issues to be resolved related to the success of future prevention research and practice are discussed.

Objective Although few studies have examined cardiovascular disease in Asian-American subgroups separately, limited data in Asian Americans strongly suggest that some subgroups are at increased risk. The present study examined modifiable cardiovascular risk factor profiles as a function of Asian ethnicity. Methods This descriptive cross-sectional pilot study recruited Asian-American women ( N =147) in northeast Florida including Cambodians ( n =39), Chinese ( n =36), Filipinos ( n =49), and Vietnamese ( n =23). Risk factors included blood pressure, body mass index, waist circumference and blood lipids. Results Filipino participants (41%) had ≥4 risk factors compared to 21% Cambodian, 13% Vietnamese and 0% Chinese. The Chinese had significantly more participants (44%) with the absence of CVD risk factors compared to all other subgroups. Obesity rate (18%), mean BMI: 26±5kg/m 2 and mean triglycerides (173±103mg/dL) were highest in Filipinas ( n =49). The Chinese ( n =36) had a low rate (4%) of obesity with a mean BMI of 23±3kg/m 2 and the least risk factors along with the lowest triglycerides (88±44mg/dL). Cambodians ( n =39; BMI of 24±3kg/m 2 ) and Vietnamese ( n =23; BMI: 22±3kg/m 2 ) had low rates of obesity with comparable rates of unhealthy lipids and hypertension as the Filipinas. Conclusions Modifiable CVD risk factor profiles significantly differed as a function of ethnicity supporting the premise that Asian-American women cannot be categorized as one group and the traditional "one size fits all" prevention or treatment of CVD risk factors should be re-considered.

This study explored the association of alcohol and tobacco use among college students. A survey was administered in 2004 to 2,189 Black and White students from the southeastern United States. The prevalence of alcohol and tobacco use, tobacco use characteristics according to level of alcohol consumed, and percentage of students using tobacco according to type of alcoholic beverages consumed were evaluated. The interaction of race and gender with alcohol and tobacco use was explored. Our findings extend prior investigations that have found alcohol use associated with smoking and suggest attention be paid to the relation of alcohol to other forms of tobacco. Racial and gender differences are highlighted. This study was funded by Mayo Clinic. The study's limitations were noted.

This study evaluated the efficacy of a brief integrative multiple behavior intervention and assessed risk factors as mediators of behavioral outcomes among older adolescents. A randomized controlled trial was conducted with participants randomly assigned to either a brief intervention or standard care control with 3-month follow-up. A total of 479 students attending two public high schools participated. Participants receiving the intervention showed a significant reduction in quantity × frequency of alcohol use, and increases in fruit and vegetable consumption and frequency of relaxation activities, compared to those receiving the control, P’s = .01. No effects were found on cigarette and marijuana use, exercise and sleep. Effect sizes were small with alcohol use cessation effects reaching medium size. Intervention effects were mediated by changes in peer influenceability for alcohol use, and self-efficacy and self-image for health promoting behaviors. Findings suggest that the brief intervention resulted in health risk and promoting behavior improvements for adolescents, with outcomes mediated by several risk factors.

Introduction Alcohol and other substance use contribute to a major, preventable, international healthcare burden. The evidentiary bases for screening, brief intervention, and referral to treatment (SBIRT) for alcohol are well-established, while research on SBIRT for other substance use is ongoing. In the United States, funding for SBIRT education among medical professionals recently has expanded beyond physicians to include other healthcare providers such as nurses and social workers. Objectives This brief study measured characteristics of nurses, social workers, and physicians at the beginning of the first year of graduate education (nurses, social workers) or post-graduate year 1 (physician residents) to assess potential baseline differences in knowledge, attitudes, beliefs, and behaviors related to SBIRT. Aims The aim of this study was to inform targeted modification of SBIRT education programs based on baseline differences between professions. Methods Participants (n = 81 [16 physicians, 27 nurses, 38 social workers]) completed a 36-item assessment of baseline behaviors (modified from Hettema et al., 2012) and knowledge, beliefs, and attitudes predictive of SBIRT performance (Gassman et al., 2003). Differences between groups were assessed using ANOVA and the Tukey or Games-Howell post-hoc test (contingent on homogeneity of variance). Results The study identified differences among professionals for 13 of 36 measured variables across several domains: SBIRT behaviors, beliefs about time utilization, satisfaction working with at-risk clients, self-efficacy, and perceived organizational resources. Conclusions Preliminary data suggest that SBIRT training for medical professionals might be improved by attending to specific differences among nurses, physicians, and social workers in several key areas.

Objective. The purpose of this study was to compare the effects of a single drug, i.e., alcohol, against a multiple drug preventive intervention. Methods. A controlled trial was conducted with 448 8th grade students (mean age = 13 years old) from an inner-city middle school (n = 216) and a rural junior high school (n = 232) in 2000–2001. Students were randomized within school, and 3-month post-intervention follow-up data were collected. Results. Two risk/protective factors were found to differ significantly in favor of youth receiving the single drug alcohol intervention (p's = 0.03), while the frequency of alcohol use and two additional risk/protective factors approached significance (p's < 0.10). Conclusion. These findings support the potential efficacy of a brief, single drug preventive intervention over a brief, multi-drug intervention in producing short-term alcohol outcomes for adolescents, and indicate differential effects of interventions for subgroups of substance using youth.

This focused review highlights the role of spirituality in rehabilitation. It is part of the study guide on geriatric rehabilitation in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation. This article specifically focuses on spirituality, rehabilitation, aging, and research. OVERALL LEARNING OBJECTIVE: To identify the current state of knowledge regarding the relationships among rehabilitation, spirituality, and aging.

This study examined the 1-year follow-up effects of the STARS (Start Taking Alcohol Risks Seriously) for Families program, a 2-year preventive intervention based on a stage of acquisition model, and consisting of nurse consultations and parent materials. A randomized controlled trial was conducted, with participants receiving either the intervention or a minimal intervention control. Participants included a cohort of 650 sixth-grade students from two urban middle schools-one magnet (bused) and one neighborhood. Trained project staff administered questionnaires to students following a standardized protocol in the schools. For the magnet school sample, significantly fewer intervention students (5%) were planning to drink in the next 6 months than control students (18%), chi2 = 11.53, 1 d.f., P = 0.001. Magnet school intervention students also had less intentions to drink in the future, greater motivation to avoid drinking and less total alcohol risk than control students, Ps < 0.05. For the neighborhood school, intervention students (m = 7.90, SD = 1.87) had less total alcohol risk than control students (m = 8.42, SD = 1.83), F(1,205) = 4.09, P = 0.04. These findings suggest that a brief, stage and risk/protective factor tailored program holds promise for reducing risk for alcohol use among urban school youth 1 year after intervention, and has the unique advantage of greater 'transportability' over classroom-based prevention programs.

OBJECTIVE: To examine the effects of the STARS for Families program, 2-year stage-based intervention using nurse consultations and parent prevention materials. METHODS: Subjects consisted of 650 sixth-grade students from one neighborhood (n=262_ and one magnet (bused) urban school (n=388). RESULTS: At posttest, significantly fewer intervention magnet-school students initiated alcohol use, drank heavily during the past 30 days, and drank over any period of time, compared to minimal intervention control students (p's Elementary School Student Late Childhood Child Substance Use Substance Use Prevention Parent Education School Based Prevention Program Intervention Program Substance Use Intervention Alcohol Use Prevention Alcohol Use Intervention Urban School Urban Youth 08-00

This study examined recruitment within an alcohol prevention program at two diverse inner-city schools and retention of these students through follow-up at one month and one year. Subjects in Cohort 1 included 211 sixth grade students from one innercity, neighborhood school. Subjects in Cohort 2 included 650 sixth grade students from one neighborhood school (n = 388) and one magnet (bused) school (n = 262). Recruitment rates differed between the two Cohort 2 urban schools. However, when eligibility criteria were considered, recruitment rates were nearly identical. At one-month posttest, dropouts were more at risk for alcohol use initiation than nondropouts. At one-year follow-up, dropouts were more likely to initiate alcohol and smokeless tobacco, and had greater total risk factors for alcohol use. These findings indicate the need to establish eligibility requirements, conduct aggressive recruitment and follow-up to minimize subject attrition, and establish programming that targets students not recruited or retained when using standard protocols.

According to the World Health Organization (WHO) mental and substance use disorders will surpass all physical diseases as the major cause of disability by the year 2020. The abuse of alcohol results in 2.5 million deaths annually, including 320,000 young people between the age of 15 and 29, and at least 15.3 million people have drug use disorders (WHO, 2013). The Indiana University Center for Health Policy studied the economic impact of substance abuse in Indiana and found that substance abuse and addiction have a powerful impact on all sectors of our society including education, criminal justice, health, workforce and public safety. Total cost for the state in 2008 was $7.3 billion and the professional capacity for nurturing the health of our citizens is woefully inadequate. With funding from the Substance Abuse and Mental Health Services Administration, faculty at Indiana University's Schools of Nursing, Social Work, and Medicine integrated Screening Brief Intervention and Referral to Treatment (SBIRT) into our health care education systems in order to improve the health of the large number of adolescents and adults at risk for one or more substance use disorders. SBIRT training was incorporated in select courses in each of the three schools using tailored webbased educational modules and face-to-face motivational interview (MI) training to prepare participants' for clinical practica. Innovative curricular materials will be presented as well as preliminary data on participants' knowledge, skills and attitudes related to training.

This study examined the effects of brief nurse consultations in preventing alcohol use among inner-city youth. Participants included 138 sixth-eighth grade students attending an inner-city public school in Jacksonville, Florida. Subjects were randomly assigned by computer to either the intervention (STARS program) or a control group. Baseline and three-month post-tests were conducted at the target school site. A significant difference was found on heavy alcohol use with intervention subjects showing a reduction and control subjects an increase in heavy drinking (t = -2.33, 120df, p = .02). No differences were found between groups on other alcohol use measures. This study's findings indicate that a series of brief nurse consultations appear to reduce heavy alcohol consumption among urban school youth.

OBJECTIVE: To examine the effectiveness of a brief, school-based intervention for preventing alcohol use. DESIGN AND SETTING: Randomized, control trial assigning inner-city public school students to an intervention program or a comparison program. PARTICIPANTS: Sixth, seventh, and eighth grade students in Jacksonville, Fla (N=104). INTERVENTIONS: Students assigned to the intervention program were given a self-instructional module and corresponding audiotape, a health consultation with a physician or nurse, and a follow-up consultation with a trained peer health model. MAIN OUTCOME MEASURES: Alcohol consumption during the month after the intervention and students' assessments of the interventions were measured. RESULTS: Students' t tests showed participants were more satisfied with physician or nurse consultations than with peer consultations or the self-instructional module and audiotapes (P=.05). Analysis of covariance tests showed significant main effects for 30-day quantity of alcohol use (F=5.15, P=.02), with intervention students reporting less alcohol consumption at follow-up than comparison students, and for 30-day frequency of alcohol use (F=5.92,P=.01) with intervention students again showing less frequent use at follow-up. CONCLUSIONS: A multicomponent, school-based intervention using print and audiotape media, brief physician or nurse consultations, and follow-up peer contacts holds promise in altering short-term alcohol use and selected behavioral factors among inner-city youth. Language: en