{
    "abstract": "Psychoactive substances contribute to numerous deaths annually, and more than 60% of the US population aged 12\u2009+\u2009years reports past-month substance use. Screening, brief intervention, and referral to treatment (SBIRT) may support identification of substance-related risks and facilitate targeted interventions, but best practices and implementation designs remain elusive. Our study examined whether a standardized SBIRT toolkit and training-of-trainers for nurse site coordinators was prospectively associated with documented performance of core SBIRT-related functions in medical-surgical hospital units.\nThis was a prospective cohort study conducted from January 2018 to May 2019 in 14 adult medical-surgical units (one/hospital). Hospitals were randomly allocated to two groups (n\u2009=\u20097 hospitals/each), which received identical interventions: an SBIRT training-of-trainers (8\u00a0h), supportive follow-up, and a toolkit containing information, resources, and guidance. However, group 1 sites were trained four months earlier than group 2 sites. At three points (baseline, 10-months, and 16-months), 61 patient records per hospital unit (n\u2009=\u2009854) were randomly selected for extraction. Inclusion criteria for random selection were age (18+) and being admitted and discharged from the selected unit. Main outcome measures were analyzed using generalized linear mixed models, including screening within 24\u00a0h of admission, using a validated screening tool, screening positive, and receiving a brief intervention or referral to treatment.\nFor groups 1 and 2, patients had 1.81 and 2.66 greater odds, respectively, of being screened for alcohol at 10-months, 1.92 and 4.68 greater odds of being screened for drugs, and 1.96 and 2.06 greater odds of being screened for tobacco. For hospital group 2, patients also had greater odds of being screened for alcohol (3.92), drugs (6.31), and tobacco (2.41) at 16-months. For both hospital groups and benchmarks, patients were hundreds of times more likely to be screened with a validated tool, reflecting a shift from near absence of such behaviors (around 1% prevalence) to prevalence rates from 24 to 56%.\nThe SBIRT intervention was associated with the initiation and sustained use of validated screening tools for alcohol and drugs, and with short-term increases in overall alcohol, tobacco, and drug screening prevalence.\nClinicalTrials.gov NCT03560076.",
    "authors": [
        {
            "affiliation": "Indiana University School of Nursing, Indiana University, 600 Barnhill Drive, NU 132, Indianapolis, IN, 46202, USA. newhouse@iu.edu.",
            "firstname": "Robin",
            "initials": "R",
            "lastname": "Newhouse"
        },
        {
            "affiliation": "Prevention Insights and Department of Applied Health Science, Indiana University School of Public Health - Bloomington, Indiana University Bloomington, 809 E. 9th St, Bloomington, IN, 47408, USA. jagley@iu.edu.",
            "firstname": "Jon",
            "initials": "J",
            "lastname": "Agley"
        },
        {
            "affiliation": "Indiana University Fairbanks School of Public Health and Indiana University School of Medicine, 410 West 10th St., Suite 3000, Indianapolis, IN, 46202, USA.",
            "firstname": "Giorgos",
            "initials": "G",
            "lastname": "Bakoyannis"
        },
        {
            "affiliation": "Indiana University Health, Fairbanks Hall, 340 West 10th St, Indianapolis, IN, 46202, USA.",
            "firstname": "Melora",
            "initials": "M",
            "lastname": "Ferren"
        },
        {
            "affiliation": "University of Maryland School of Pharmacy, Saratoga Building, 12th Floor 220 Arch Street, Baltimore, MD, 21201, USA.",
            "firstname": "C Daniel",
            "initials": "CD",
            "lastname": "Mullins"
        },
        {
            "affiliation": "Interprofessional Evidence-Based Practice and Research, Indiana University Health, 1701 N. Senate Ave, Indianapolis, IN, 46202, USA.",
            "firstname": "Alyson",
            "initials": "A",
            "lastname": "Keen"
        },
        {
            "affiliation": "Biostatistics Consulting Center, Indiana University School of Public Health - Bloomington, Indiana University Bloomington, Bloomington, IN, USA.",
            "firstname": "Erik",
            "initials": "E",
            "lastname": "Parker"
        }
    ],
    "conclusions": null,
    "copyrights": "\u00a9 2025. The Author(s).",
    "doi": "10.1186/s12912-025-03079-9",
    "journal": "BMC nursing",
    "keywords": [
        "Brief intervention",
        "Cohort",
        "Hospital",
        "Nurse",
        "Nursing",
        "Quality",
        "Referral to treatment",
        "SBIRT",
        "Screening",
        "Substance use"
    ],
    "methods": null,
    "publication_date": "2025-04-24",
    "pubmed_id": "40269928\n15703424\n34255006\n30604051\n34823736\n33358276\n39631003\n30587235\n28462268\n29199843\n20973848\n26464266\n26464318\n36848119\n37219901\n26471159\n15607841\n29437758\n25096690\n25919527\n36880902\n37276202\n21676054\n23787030\n18253987\n15201108\n21169370\n25221524\n30426596\n25889199\n29447544\n27311990\n18077300\n17938396\n31266603\n33043301\n33975614\n31607372\n33892758\n28864084\n20407272\n33044895\n18237661\n19895777\n23688769\n28074566\n26585638\n29345150\n27164025",
    "results": "For groups 1 and 2, patients had 1.81 and 2.66 greater odds, respectively, of being screened for alcohol at 10-months, 1.92 and 4.68 greater odds of being screened for drugs, and 1.96 and 2.06 greater odds of being screened for tobacco. For hospital group 2, patients also had greater odds of being screened for alcohol (3.92), drugs (6.31), and tobacco (2.41) at 16-months. For both hospital groups and benchmarks, patients were hundreds of times more likely to be screened with a validated tool, reflecting a shift from near absence of such behaviors (around 1% prevalence) to prevalence rates from 24 to 56%.",
    "title": "Effects of a structured SBIRT training program for hospital nursing leaders on utilization of SBIRT within their medical-surgical units: cohort study.",
    "xml": "<Element 'PubmedArticle' at 0x788503647330>"
}