implementing sbirt in a school population the northampton public schools experience
TRANSCRIPT
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!