PMID- 27090097 OWN - NLM STAT- MEDLINE DCOM- 20161012 LR - 20221207 IS - 1940-0640 (Electronic) IS - 1940-0632 (Print) IS - 1940-0632 (Linking) VI - 11 IP - 1 DP - 2016 Apr 18 TI - Examining multi-session brief intervention for substance use in primary care: research methods of a randomized controlled trial. PG - 8 LID - 10.1186/s13722-016-0057-6 [doi] LID - 8 AB - BACKGROUND: Brief interventions such as Screening, a single session of Brief Intervention, and Referral to Treatment (SBIRT) have shown mixed effectiveness in primary care. However, there are indications that multi-session brief interventions may demonstrate more consistently positive outcomes, and perhaps a more intensive approach would be of benefit in addressing substance use in primary care. This study compared the effectiveness of SBIRT with a single BI session (BI/RT) to a multi-session brief-treatment intervention (BI/RT+) in primary care. We also developed easy-to-use, evidence-based materials to assist clinicians in delivering these interventions. METHODS/DESIGN: This study was conducted in three Federally Qualified Healthcare Centers (FQHCs). A total of 10,935 patients were screened, and 600 individuals were recruited. The sample was primarily Black/African American (82 %) with a mean age of 40. Patients who attended a healthcare appointment were screened for substance use via the AUDIT and DAST. Patients were eligible for the study if they scored 8 or higher on the AUDIT, were using only marijuana and scored 2 or higher on the DAST, or were using other illicit drugs and scored 1 or higher on the DAST. Participants were randomly assigned to receive one-session BI/RT, or two to six sessions of brief intervention that incorporated elements of motivational enhancement therapy and cognitive-behavioral therapy (BI/RT+). Both interventions were delivered by behavioral health consultants at the FQHCs. Participants completed follow-up assessments every 3 months for 1 year. Primary outcome variables included substance use treatment sessions attended and days of substance use. Secondary outcomes included measures of health, employment, legal, and psychiatric functioning and HIV risk behaviors. Additionally, we will conduct an economic evaluation examining cost-effectiveness and will analyze outcomes from a process evaluation examining patient and provider experiences. DISCUSSION: The ability of brief interventions to impact substance use has great potential, but research findings have been mixed. By conducting a large-scale randomized controlled trial in real-world health centers, this study will answer important questions about the effectiveness of expanded BIs for patients who screen positive for risky substance use in primary care. Trial registration NCT01751672. FAU - Chambers, Jaclyn E AU - Chambers JE AD - Treatment Research Institute, 600 Public Ledger Building, 150 S. Independence Mall West, Philadelphia, PA, 19106, USA. jchambers@tresearch.org. FAU - Brooks, Adam C AU - Brooks AC AD - Treatment Research Institute, 600 Public Ledger Building, 150 S. Independence Mall West, Philadelphia, PA, 19106, USA. FAU - Medvin, Rachel AU - Medvin R AD - Treatment Research Institute, 600 Public Ledger Building, 150 S. Independence Mall West, Philadelphia, PA, 19106, USA. AD - The Institute for Graduate Clinical Psychology, Widener University, One University Place, Chester, PA, 19013, USA. FAU - Metzger, David S AU - Metzger DS AD - Treatment Research Institute, 600 Public Ledger Building, 150 S. Independence Mall West, Philadelphia, PA, 19106, USA. AD - Department of Psychiatry, University of Pennsylvania School of Medicine, 3900 Chestnut Street, Philadelphia, PA, 19104, USA. FAU - Lauby, Jennifer AU - Lauby J AD - Public Health Management Corporation, Centre Square East, 1500 Market St. 15th Floor, Philadelphia, PA, 19102, USA. FAU - Carpenedo, Carolyn M AU - Carpenedo CM AD - Treatment Research Institute, 600 Public Ledger Building, 150 S. Independence Mall West, Philadelphia, PA, 19106, USA. FAU - Favor, Kevin E AU - Favor KE AD - Lincoln University, 1570 Baltimore Pike, Lincoln University, PA, 19352, USA. FAU - Kirby, Kimberly C AU - Kirby KC AD - Treatment Research Institute, 600 Public Ledger Building, 150 S. Independence Mall West, Philadelphia, PA, 19106, USA. AD - Rowan University, 201 Mullica Hill Road, Glassboro, NJ, 08028, USA. LA - eng SI - ClinicalTrials.gov/NCT01751672 PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20160418 PL - England TA - Addict Sci Clin Pract JT - Addiction science & clinical practice JID - 101316917 SB - IM MH - Adult MH - Black or African American MH - Alcoholism/diagnosis/therapy MH - Cognitive Behavioral Therapy/*methods MH - Employment MH - Female MH - Health Status MH - Humans MH - Male MH - Marijuana Abuse/diagnosis/therapy MH - Mental Health MH - Motivational Interviewing MH - Patient Satisfaction MH - Primary Health Care/*organization & administration MH - *Research Design MH - Risk-Taking MH - Severity of Illness Index MH - Substance-Related Disorders/*diagnosis/ethnology/*therapy MH - Time Factors PMC - PMC4835884 OTO - NOTNLM OT - Brief intervention OT - Brief treatment OT - Primary care OT - SBIRT OT - Substance abuse EDAT- 2016/04/20 06:00 MHDA- 2016/10/13 06:00 PMCR- 2016/04/18 CRDT- 2016/04/20 06:00 PHST- 2015/05/29 00:00 [received] PHST- 2016/04/10 00:00 [accepted] PHST- 2016/04/20 06:00 [entrez] PHST- 2016/04/20 06:00 [pubmed] PHST- 2016/10/13 06:00 [medline] PHST- 2016/04/18 00:00 [pmc-release] AID - 10.1186/s13722-016-0057-6 [pii] AID - 57 [pii] AID - 10.1186/s13722-016-0057-6 [doi] PST - epublish SO - Addict Sci Clin Pract. 2016 Apr 18;11(1):8. doi: 10.1186/s13722-016-0057-6.