title: South Texas Residency Screening, Brief Intervention, and Referral to Treatment (SBIRT) Training: 12-Month Outcomes.
abstract: BACKGROUND
  Screening, brief intervention, and referral to treatment (SBIRT) is an efficacious and cost-effective skill set when implemented in primary care settings regarding hazardous alcohol use. This study assesses the impact of medical resident SBIRT training across 3 specialties and identifies predictors of change in trainee behavior, attitudes, and knowledge over 12 months.
  
  
  METHODS
  This program's substance use SBIRT training was developed and tailored to fit diverse curricular objectives and settings across an array of medical residency programs in South Texas. The 329 residents training in pediatrics, family medicine, and internal medicine during 2009-2012 constituted the trainee group reported in this analysis. Surveys assessing SBIRT-related knowledge, current practice, confidence, role responsibility, attitudes, beliefs, and readiness to change were completed by 234 (71%) trainees at 3 time points: pre-training, then 30 days and 12 months post-initial training.
  
  
  RESULTS
  SBIRT-related knowledge, confidence, and practice increased from pre-training to 12-month follow-up. Residents who reported the least amount of pre-training clinical and/or prior academic exposure to substance use reported the greatest SBIRT practice increases. When controlling for demographic and prior exposure variables, the largest contributor to variance in SBIRT practice was attributed to residents' confidence in their SBIRT skills.
  
  
  CONCLUSIONS
  SBIRT training that employs diverse educational methodologies as part of customizing the training to residency specialties can similarly enhance SBIRT-related knowledge, confidence, and practice. Trainee report of limited prior clinical or academic exposure to substance use and/or low confidence regarding SBIRT skills and their professional role responsibilities related to substance use predicted trainee success and sustained SBIRT strategy application. When customizing SBIRT training, curriculum developers should consider leveraging and capacity building related to those factors predicting continued use of SBIRT practices.
authors.affiliation: a Department of Pediatrics , University of Texas Health Science Center at San Antonio , San Antonio , Texas , USA.
authors.forename: Glenn P
authors.initials: GP
authors.lastname: Malone
authors.forename: Shruthi
authors.initials: S
authors.lastname: Vale Arismendez
authors.forename: Suyen
authors.initials: S
authors.lastname: Schneegans Warzinski
authors.forename: Nancy
authors.initials: N
authors.lastname: Amodei
authors.forename: Sandra K
authors.initials: SK
authors.lastname: Burge
authors.forename: Patricia I
authors.initials: PI
authors.lastname: Wathen
authors.forename: Michelle V
authors.initials: MV
authors.lastname: Conde
authors.forename: Raymond
authors.initials: R
authors.lastname: Palmer
authors.forename: Janet F
authors.initials: JF
authors.lastname: Williams
mesh_terms: D000328:Adult; D002983:Clinical Competence; D004503:Education, Medical, Graduate; D005194:Family Practice / Q000193:education; D005260:Female; D006801:Humans; D007388:Internal Medicine / Q000193:education; D007396:Internship and Residency; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D010372:Pediatrics / Q000193:education; D011614:Psychotherapy, Brief / Q000193:education*; D012017:Referral and Consultation; D019966:Substance-Related Disorders / Q000175:diagnosis* / Q000628:therapy*; D013781:Texas
keywords: Intervention; SBIRT; medical training; referral to treatment; screening substance-related disorders; substance use detection