Alinsky Rachel H, Percy Kayla, Adger Hoover, Fertsch Diana, Trent Maria
Johns Hopkins University, Baltimore, MD, USA.
Chiricahua Community Health Centers, Inc, Douglas, AZ, USA.
Clin Pediatr (Phila). 2020 May;59(4-5):429-435. doi: 10.1177/0009922820902441. Epub 2020 Jan 29.
The American Academy of Pediatrics recommends pediatric providers routinely screen for, assess, and treat substance use and substance use disorders among adolescents, a process called "Screening, Brief Intervention, and Referral to Treatment," or "SBIRT." Because there are limited data on how Maryland pediatric practices have adopted SBIRT, a quality improvement initiative was developed within the Maryland Adolescent and Young Adult Health Collaborative Improvement and Innovation Network using a "Plan/Do/Study/Act" approach. A 2-part provider training was conducted regarding screening and motivational interviewing, and the "CRAFFT" screening tool was integrated into the practice's electronic medical record. Results from evaluation demonstrated significant improvements in provider knowledge, attitudes, and screening behavior. The association between substance use and sexual behavior suggests a need for further expansion of this model with inclusion of sexual health screening. Overall, this study demonstrates that SBIRT implementation into a general pediatric practice is highly feasible, acceptable, and shows preliminary effectiveness.
美国儿科学会建议儿科医疗服务提供者对青少年的物质使用及物质使用障碍进行常规筛查、评估和治疗，这一过程称为“筛查、简短干预及转介治疗”，即“SBIRT”。由于关于马里兰州儿科医疗机构采用SBIRT的相关数据有限，因此在马里兰州青少年及青年健康协作改进与创新网络中采用“计划/执行/研究/行动”方法开展了一项质量改进计划。针对筛查和动机性访谈进行了分为两部分的医疗服务提供者培训，并将“CRAFFT”筛查工具整合到医疗机构的电子病历中。评估结果显示，医疗服务提供者在知识、态度和筛查行为方面有显著改善。物质使用与性行为之间的关联表明，需要进一步扩展该模式，纳入性健康筛查。总体而言，本研究表明，在普通儿科医疗机构中实施SBIRT是高度可行、可接受的，并且显示出初步成效。
