a Adolescent Substance Abuse Program , Division of Developmental Behavioral Pediatrics, Boston Children's Hospital , Boston , Massachusetts , USA.
b Department of Pediatrics , Harvard Medical School , Boston , Massachusetts , USA.
Subst Abus. 2017 Jul-Sep;38(3):257-260. doi: 10.1080/08897077.2016.1275926. Epub 2016 Dec 27.
Screening, brief intervention, and referral to treatment (SBIRT) is recommended as a strategy to prevent or reduce adolescent substance use. Offering SBIRT in schools may provide an opportunity to reach adolescents not accessing primary care. The objective is to assess school nurses' attitudes and practices regarding adolescent SBIRT.
The authors administered electronically and in person a questionnaire including 29 items on SBIRT attitudes and practices to school nurses registered for the Northeastern University's School Health Institute Summer Program in Massachusetts (N = 168). Survey questions were adapted from a questionnaire originally developed by the American Academy of Pediatrics.
One hundred and forty-four nurses completed the survey for a response rate of 85.7%. More than three quarters of the respondents (77.0%) were in favor of universal alcohol screening in schools. None of the respondents reported screening their students on a regular basis. More than half (64.4%) of nurses reported screening students; however, they did so only when they suspected alcohol use. During these instances, only 17.9% used a validated screening tool and almost all (98.2%) used face-to-face clinical interviews. When addressing alcohol use by a student, the large majority of respondents reported including the following recommended clinical strategies: asking about problems related to alcohol use (56.3%), explaining the harms of alcohol use (70.1%), and advising abstinence (73.6%). On average, respondents spend 5 to 10 minutes discussing alcohol use with their students.
Survey respondents were supportive of universal alcohol screening in school, although few were doing so at the time. When respondents identified students using alcohol, their interventions were closely aligned with clinical recommendations for brief intervention. Implementation of SBIRT that focuses on standardized, annual screening has the potential to deliver high-quality care in this setting.
筛查、简短干预和转介治疗（SBIRT）被推荐作为预防或减少青少年药物使用的策略。在学校提供 SBIRT 可能为接触不到初级保健的青少年提供机会。目的是评估学校护士对青少年 SBIRT 的态度和实践。
作者通过电子和亲自方式向马萨诸塞州东北大学学校健康研究所暑期计划注册的学校护士（N=168）分发了一份包括 29 个 SBIRT 态度和实践问题的问卷。调查问题改编自美国儿科学会最初开发的问卷。
144 名护士完成了调查，应答率为 85.7%。超过四分之三的受访者（77.0%）赞成在学校进行普遍的酒精筛查。没有受访者报告定期对学生进行筛查。超过一半（64.4%）的护士报告对学生进行筛查；但是，只有当他们怀疑学生有饮酒行为时才进行筛查。在这些情况下，只有 17.9% 使用了经过验证的筛查工具，几乎所有（98.2%）都使用面对面的临床访谈。当处理学生的饮酒问题时，绝大多数受访者报告包括以下推荐的临床策略：询问与饮酒相关的问题（56.3%）、解释饮酒的危害（70.1%）和建议戒酒（73.6%）。受访者平均花费 5 到 10 分钟与学生讨论饮酒问题。
调查受访者支持在学校进行普遍的酒精筛查，尽管当时很少有人这样做。当受访者发现学生饮酒时，他们的干预措施与简短干预的临床建议密切一致。在这种情况下，实施以标准化、年度筛查为重点的 SBIRT 有可能提供高质量的护理。
