title: Computerized versus in-person brief intervention for drug misuse: a randomized clinical trial.
abstract: OBJECTIVE
  Several studies have found that brief interventions (BIs) for drug misuse have superior effectiveness to no-treatment controls. However, many health centers do not provide BIs for drug use consistently due to insufficient behavioral health staff capacity. Computerized BIs for drug use are a promising approach, but their effectiveness compared with in-person BIs has not been established. This study compared the effectiveness of a computerized brief intervention (CBI) to an in-person brief intervention (IBI) delivered by a behavioral health counselor.
  
  
  METHODS
  Two-arm randomized clinical trial, conducted in two health centers in New Mexico, United States. Participants were 360 adult primary care patients with moderate-risk drug scores on the Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) who were randomly assigned on a 1 : 1 basis to a computerized brief intervention (CBI) or to an in-person brief intervention (IBI) delivered by a behavioral health counselor. Assessments were conducted at baseline and 3-month follow-up, and included the ASSIST and drug testing on hair samples.
  
  
  RESULTS
  The IBI and CBI conditions did not differ at 3 months on global ASSIST drug scores [b = -1.79; 95% confidence interval (CI) = -4.37, 0.80] or drug-positive hair tests [odds ratio (OR) = 0.97; 95% CI = 0.47, 2.02]. There was a statistically significant advantage of CBI over IBI in substance-specific ASSIST scores for marijuana (b = -1.73; 95% CI = -2.91, -0.55; Cohen's d = 0.26; P = 0.004) and cocaine (b = -4.48; 95% CI = -8.26, -0.71; Cohen's d = 0.50; P = 0.021) at 3 months.
  
  
  CONCLUSIONS
  Computerized brief intervention can be an effective alternative to in-person brief intervention for addressing moderate drug use in primary care.
authors: Friends Research Institute, Baltimore, MD, USA.
authors: Robert P
authors: RP
authors: Schwartz
authors: Jan
authors: J
authors: Gryczynski
authors: Shannon Gwin
authors: SG
authors: Mitchell
authors: Arturo
authors: A
authors: Gonzales
authors: Ana
authors: A
authors: Moseley
authors: Thomas R
authors: TR
authors: Peterson
authors: Steven J
authors: SJ
authors: Ondersma
authors: Kevin E
authors: KE
authors: O'Grady
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003201:Computers / Q000706:statistics & numerical data*; D003376:Counseling / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009516:New Mexico; D016017:Odds Ratio; D011320:Primary Health Care; D019966:Substance-Related Disorders / Q000628:therapy*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult
keywords: Behavioral health counselor; SBIRT; brief intervention; computer technology; primary care; randomized clinical trial; substance abuse