The Status of SBIRT Training in Health Professions Education: A Cross-Discipline Review and Evaluation of SBIRT Curricula and Educational Research.

PURPOSE: To assess the quality of curricular research on the Screening Brief Intervention and Referral to Treatment (SBIRT) approach and determine the presence of useful training modalities, particularly motivational interviewing (MI) training, across health care training curricula. METHOD: The authors conducted a systematic review of published, peer-reviewed studies in PubMed, ERIC, CINAHL, Ovid HealthSTAR, and PsycINFO databases through March 2021 for English-language studies describing SBIRT, a curriculum for health care trainees, and curricular intervention outcomes. After the records were independently assessed, data were extracted and 20% of the studies were double-coded for interrater reliability. RESULTS: Of 1,856 studies, 95 were included in the review; 22 had overlapping samples and were consolidated into 10 nested studies, leaving 83 total. Interrater reliability ranged from moderate (κ = .74, P < .001) to strong (κ = .91, P < .001) agreement. SBIRT training was delivered to trainees across many professions, including nursing (n = 34, 41%), medical residency (n = 28, 34%), and social work (n = 24, 29%). Nearly every study described SBIRT training methods (n = 80, 96%), and most reported training in MI (n = 54, 65%). On average, studies reported 4.06 (SD = 1.64) different SBIRT training methods and 3.31 (SD = 1.59) MI training methods. Their mean design score was 1.92 (SD = 0.84) and mean measurement score was 1.89 (SD = 1.05). A minority of studies measured SBIRT/MI skill (n = 23, 28%), and 4 studies (5%) set a priori benchmarks for their curricula. CONCLUSIONS: SBIRT training has been delivered to a wide range of health care trainees and often includes MI. Rigor scores for the studies were generally low due to limited research designs and infrequent use of objective skill measurement. Future work should include predefined training benchmarks and validated skills measurement.

Young adult use, dual use, and simultaneous use of alcohol and marijuana: An examination of differences across use status on marijuana use context, rates, and consequences.

Objective: Co-use of alcohol and marijuana has increased among college students, though comparisons among simultaneous (i.e., use of both substances such that effects overlap), dual (i.e., use of both substances within a similar time period but without overlapping effects), and marijuana-only use are limited. This study aimed to understand differences between simultaneous, dual, and marijuana-only users on marijuana use rates, consequences, and context of use in a multi-university study. Method: College students (N = 4,764; Mage = 19.9 years) who were mainly female (70.6%) and White (67.9%) completed an online survey. The Marijuana Use Grid captured marijuana use quantity/frequency, and the Brief Marijuana Consequences Questionnaire and the Cannabis Use Disorders Identification Test-Revised assessed problem use. Location, method of consumption, and social context of use also were assessed. Results: Fifty-five percent of the sample endorsed lifetime use of alcohol and marijuana. Of these students, 36.1% endorsed past-month simultaneous use, 10.8% endorsed past-month dual use, and 6.4% endorsed past-month marijuana-only use. Simultaneous users reported more marijuana use and problems than dual users. Marijuana-only users did not differ from simultaneous users on marijuana use indices, though they reported greater use than dual users as well. Simultaneous users used marijuana in plant form, at parties, and with unknown others a greater percentage of the time than dual users, while dual users used edibles and ingested marijuana a greater percentage of the time. Conclusions: Given their greater levels of marijuana use and marijuana-related problems, screening and interventions for simultaneous alcohol-marijuana use are needed in college students. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Screening for alcohol use disorders in college student drinkers with the AUDIT and the USAUDIT: a receiver operating characteristic curve analysis.

Background: The Alcohol Use Disorders Identification Test (AUDIT) and its consumption subscale (AUDIT-C) are international gold standard screeners for identifying at-risk drinkers. Items have been modified to reflect United States low-risk drinking guidelines in the USAUDIT and USAUDIT-C, which also perform well in identifying at-risk drinkers. The USAUDIT may also be used to screen for potential AUD, an important first step to identify individuals needing diagnostic testing and treatment referrals. Objectives: The present study sought to evaluate the sensitivity and specificity of each measure in predicting potential AUDs via diagnostic criteria from the Diagnostic and Statistical Manual of Mental Disorders, 5th edition in a college sample. Methods: Participants were 382 college student drinkers (Mage = 20.2, SD = 1.5; 68.7% female) who completed online surveys assessing alcohol use, at-risk drinking, and AUD symptom endorsement. Receiver operating curves provide optimal cutoff scores for each measure in overall, male, and female samples. Results: Results indicated the AUDIT and USAUDIT are equally superior in detecting potential AUD in the current sample. Recommended cutoff scores for detecting likely AUD with the USAUDIT are 12 for males (sensitivity = 62.0%, specificity = 86.6%) and 8 for females (sensitivity = 65.3%, specificity = 87.7%). Conclusions: Whereas prior work supports the USAUDIT-C in detecting at-risk drinking, the current study supports the AUDIT and USAUDIT in detecting potential AUD. Based on prior work, and in an effort to be consistent with standard US drinking guidelines, we recommend using the USAUDIT in screening and brief interventions across college campuses.

Identifying At-Risk College Student Drinkers With the AUDIT-US: A Receiver Operating Characteristic Curve Analysis.

The Alcohol Use Disorders Identification Test (AUDIT) is the gold standard screening measure. Recently, there has been increasing call to update the measure to reflect harmful drinking standards in the United States. The purpose of this study was to use receiver operating characteristic curve analysis to evaluate the AUDIT and the United States version (AUDIT-US). Participants were 382 traditional age (M = 20.2, SD = 1.5) college students (68.7% female, 64.9% White) who had consumed alcohol at least once in the 30 days prior to participating. Although results provide evidence for the AUDIT and the AUDIT-US as valid screening tools, the Consumption subscale of the AUDIT-US performed the best in predicting at-risk college drinkers. The Consumption subscale of the AUDIT-US with a single cutoff score of four appears to be the optimal and most parsimonious method of identifying at-risk college drinkers.