IMPLEMENTING SBIRT IN A SCHOOL POPULATION

The Northampton Public Schools Experience

IMPLEMENTING SBIRT IN A SCHOOL POPULATION

Karen Jarvis-Vance, BSN, RN, NCSN

Director of Health Services, Health Education and Safety

Northampton Public Schools

Program Director, Northampton Prevention Coalition

SBIRT: Screening Brief Intervention and Referral to Treatment

http://www.bu.edu/bniart/sbirt-in-health-care/what-is-sbirt/

• evidence-based• gives health care providers skills to discuss

health behavior changes with their patients 

• proven to be particularly effective at motivating individuals to change harmful substance use

Based in research

• using SBIRT as an early intervention can reduce risky alcohol and drug use before it leads to more severe consequences or dependence

Proactive, not just reactive

SBIRT: Screening Brief Intervention and Referral to Treatment

http://www.bu.edu/bniart/sbirt-in-health-care/what-is-sbirt/

Screening

Determines the severity of substance use

Brief InterventionBuilds motivation through collaborative conversation using Motivational Interviewing techniques Can reduce resistance to changeHelps patients realize their own reasons and motivations to make healthy choices.

Referral to Treatment

Directly links patient with appropriate, requested servicesMinimizes outward barriers to seeking servicesCreates an environment for success

NPS PROTOCOL Universal screen-all 9th grade students Parental education, notification and opt-out Paper screen, student opt-out Non-use: positive reinforcement Score lower than 2: motivational interview Score greater than or equal to 2: referral for follow-

up Outside referral resources at the ready Issues of confidentiality and documentation

Screening Tool: CRAFFT

Part A (Pre-Screen) During the PAST 12 MONTHS, did you:

1. Drink any alcohol (more than a few sips)?

2. Smoke any marijuana or hashish?

3. Use anything else to get high? (“anything else” includes illegal drugs, over the counter and prescription drugs, and things that you sniff or “huff”)

Part B (CRAFFT)1. Have you ever ridden in a CAR driven by someone (including yourself) who was “high” or had been using alcohol or drugs?

2. Do you ever use alcohol or drugs to RELAX, feel better about yourself, or fit in?

3. Do you ever use alcohol or drugs while you are by yourself, or ALONE?

4. Do you ever FORGET things you did while using alcohol or drugs?

5. Do your FAMILY or FRIENDS ever tell you that you should cut down on your drinking or drug use?

6. Have you ever gotten into TROUBLE while you were using alcohol or drugs?

THE SCREENING TOOL

NPS SCREENING RESULTSMAY 2013

• 229 total freshman• 7 opted out by parents; 1 opted self out• 24 with positive pre-screen:(when noted) 11 for

alcohol, 5 alcohol + MJ, 1 for marijuana, 0 other• Of those screened in, 5 with positive CRAFFT• 25 brief interventions (mostly around the “C”)• 4 referrals to in-school counseling; 1 already under

care• 196 students received information and/or positive

reinforcement

NPS SCREENING RESULTSMAY 2014

•226 total freshman•6 opted out by parents•18 with positive pre-screen; (when noted) 4 for alcohol, 8 for marijuana, 6 both alcohol and MJ, 0 other•36 brief interventions (mostly around the “C”)•Of those screened in, 1 with positive CRAFFT•1 referrals to in-school counseling; already under care•191 students received information and/or positive reinforcement

POST-TEST RESULTSAfter meeting with the nurse, are you more likely or less likely to

use the nurse's office in the future?

less likely

about the same

more likely

162 STUDENTS SURVEYED ANONYMOUSLY

About the same: 83%

More likely: 11%

Less likely: 6%

POST-TEST RESULTSAfter meeting with the nurse, are you more likely or less likely to

use alcohol or other drugs?

less likely

about the same

more likely

About the same: 68%

More likely: 5%

Less likely 27%

POST-TEST RESULTS

How honest were you with the nurse?

Not at all honest

Honest some of the time

Mostly honest

Completely honest

Not at all honest: 9%

Honest some of the time: 5%

Mostly honest: 13%

Completely honest: 73%

Questions? Comments

? Thank You!