Ramos Mary M, Sebastian Rachel A, Murphy Mary, Oreskovich Kristin, Condon Timothy P
a Department of Pediatrics , University of New Mexico School of Medicine , Albuquerque , New Mexico , USA.
b Envision New Mexico , Albuquerque , New Mexico , USA.
Subst Abus. 2017 Apr-Jun;38(2):230-236. doi: 10.1080/08897077.2017.1287149. Epub 2017 Feb 8.
Recent attention has focused on the potential for school-based health centers (SBHCs) to provide access points for adolescent substance use care. In 2015, the University of New Mexico began screening, brief intervention, and referral to treatment (SBIRT) training for providers at New Mexico Department of Health (NMDOH)-funded SBHCs across the state. This study assesses baseline knowledge, attitudes, and practices of the New Mexico SBHC provider workforce regarding adolescent substance use and provision of services.
In early 2015, the NMDOH administered an SBHC provider workforce survey (N = 118) and achieved a 44.9% response rate. This descriptive analysis includes all survey respondents who self-identified as a primary care or behavioral health provider in an SBHC serving middle or high school students (n = 52).
Among respondents, the majority (57.7%) were primary care providers, including nurse practitioners, physicians, and physician assistants. The remaining 42.3% of respondents were master's-level behavioral health providers. Only 44.2% of providers reported practicing the full SBIRT model at their SBHC, and 21.2% reported having received continuing education on SBIRT within the previous 3 years. Most respondents, 84.6%, agreed that it is the responsibility of SBHC providers to screen students for substance use using a standardized tool, and 96.2% agreed that it is the responsibility of the SBHC provider to assess for students' readiness to change. A majority reported self-efficacy in helping students achieve change in their alcohol use, illicit drug use, and prescription drug misuse: 73.1%, 65.4%, and 63.5%, respectively.
These results suggest that SBIRT training for New Mexico SBHC providers is timely. The authors identified gaps between recommended SBIRT practices and SBIRT delivery as well as discrepancies between reported provider self-efficacy and actual implementation of the SBIRT model. Further study will determine the effectiveness of efforts to address substance use and implement SBIRT in SBHCs.
近期，人们的注意力集中在校立健康中心（SBHC）为青少年药物使用护理提供接入点的潜力上。2015年，新墨西哥大学开始为新墨西哥州卫生部（NMDOH）资助的全州范围内的SBHC的提供者开展筛查、简短干预及转介治疗（SBIRT）培训。本研究评估了新墨西哥州SBHC提供者队伍在青少年药物使用及服务提供方面的基线知识、态度和实践。
2015年初，NMDOH开展了一项SBHC提供者队伍调查（N = 118），回复率为44.9%。这项描述性分析包括所有自我认定为在为初中生或高中生服务的SBHC中担任初级保健或行为健康提供者的调查受访者（n = 52）。
在受访者中，大多数（57.7%）是初级保健提供者，包括执业护士、医生和医师助理。其余42.3%的受访者是硕士水平的行为健康提供者。只有44.2%的提供者报告在其SBHC实施完整的SBIRT模式，21.2%的提供者报告在过去3年内接受过关于SBIRT的继续教育。大多数受访者（84.6%）同意，使用标准化工具对学生进行药物使用筛查是SBHC提供者的责任，96.2%的受访者同意，评估学生改变的意愿是SBHC提供者的责任。大多数人报告在帮助学生改变饮酒、非法药物使用和处方药滥用方面有自我效能感：分别为73.1%、65.4%和63.5%。
这些结果表明，为新墨西哥州SBHC提供者开展SBIRT培训很及时。作者发现了推荐的SBIRT实践与SBIRT实施之间的差距，以及报告的提供者自我效能感与SBIRT模式实际实施之间的差异。进一步的研究将确定在SBHC中解决药物使用问题和实施SBIRT的努力的有效性。
