A mobile app to promote alcohol and drug SBIRT skill translation among multi-disciplinary health care trainees: Results of a randomized controlled trial

Abstract

Background

Adherence to clinical practice guidelines for alcohol and drug screening, brief intervention, and referral to treatment (SBIRT) is often inadequate. Mobile apps developed as clinical translation tools could improve the delivery of high fidelity SBIRT.

Methods: This study tested the effectiveness of an SBIRT mobile app conceptually aligned with the Theory of Planned Behavior (TPB) to support SBIRT delivery by health care trainees (nursing, social work, internal medicine, psychiatry, and psychology) working in clinical settings (N = 101). Bivariate analyses examined the rate of SBIRT delivery between trainees assigned to the experimental (app) and control (no app) study conditions; as well as the relationship between TPB-based constructs, intention to deliver SBIRT, and screening rates.

Results: No significant differences were identified between the study conditions in SBIRT delivery. Significant correlations were found between intent to screen and TPB variables including attitudes/behavioral beliefs concerning substance use treatment (r = .49, p = .01); confidence in clinical skills (r = .36, p = .01); subjective norms (r = .54, p = .01) and perceived behavioral control over appointment time constraints (r = .42, p = .01). Also significant were correlations between percent of patients screened and confidence (r = .24, p = .05); subjective norms (r = .22, p = .05) and perceived behavioral control (r = .28, p = .01).

Conclusions: The negative results of the study condition comparisons indicate the need for further investigation of strategies to optimize mobile app utilization, engagement, and effectiveness as a clinical translation tool. Findings of significant correlations between substance use screening rates and both norms and confidence support the potential value of the TPB model in explaining behavior of health care learners in SBIRT delivery.

Keywords:

• SBIRT
• clinical translation
• app development
• digital behavior change intervention

Acknowledgments

We wish to thank the faculty of San Francisco State University (Social Work and Nursing), University of California, San Francisco (Internal Medicine and Psychiatry), and University of San Francisco (Nursing and Clinical Psychology) who assisted the study team in participant recruitment. We also thank Agatha Hinman at the Kaiser Permanente Northern California Division of Research for assistance in preparing the manuscript.

Author contributions

Dr. Curtis drafted the manuscript and Dr. Satre and Dr. Sarovar conducted the analysis and participated in the manuscript development. All coauthors reviewed the manuscript and provided scientific critiques and comments. All authors attest they meet the ICMJE criteria for authorship. They agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. The authors declare no conflicts of interest.

Additional information

Funding

This study was supported by a grant from the Substance Abuse and Mental Health Services Administration [U79 TI025404]. Dr. Satre was also supported by a grant from the National Institute on Alcohol Abuse and Alcoholism [K24 AA025703]. The funding organization had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.