SBIRT in New Mexico

Principal Investigator: Robert Schwartz, M.D.
Co-Investigator: Shannon Gwin Mitchell, Ph.D.
Co-Investigator: Jan Gryczynski, M.A.
Project Director: Jan Gryczynski, M.A.
Funded By: National Institute on Drug Abuse
Grant #: R01 DA026003
Total Project Period: 9/09 – 7/14

Rigorous research is needed to test the effectiveness of screening and brief interventions that can easily be scaled-up to reduce illegal drug use and HIV risk behaviors. The few existing clinical trials of SBIRT for illicit drug use have not examined SBIRT’s impact on HIV risk behavior. The presently proposed study will address this gap in scientific knowledge through a partnership between Friends Research Institute and the Sangre de Cristo Community Health Partnership, the organization responsible for implementing the SAMHSA-funded Screening, Brief Intervention, Referral, and Treatment (SBIRT) Initiative throughout New Mexico since 2003. The study will use a randomized controlled trial to compare the effectiveness of a standardized interpersonal brief intervention (IBI) based on motivational interviewing (currently used in the New Mexico SBIRT initiative) with a promising computerized brief intervention (CBI) in reducing illegal drug use and HIV risk behaviors and their associated health consequences. In addition, the study will assess whether participants’ computer experience differentially moderates the effectiveness of the two interventions. The study will take place at two large primary care clinics in New Mexico. All patients will complete a screening for substance use via the Alcohol, Tobacco, and Substance Involvement Screening Tool (ASSIST) as part of regular clinical care. Patients who score in a moderate-risk category for illegal drug use (n = 360, 180 at each site) will be randomly assigned within their respective clinics to the IBI or CBI condition. Patients with high-risk drug use will be referred for more intensive services as per standard clinical practice. Primary outcomes include drug use levels for major substances of abuse as measured by analysis of hair samples, global illicit drug risk ASSIST scores, and HIV risk behaviors. Secondary outcomes include self-reported frequency of hospitalizations, emergency room utilization, injuries, psychological distress, arrests, missed work days, and earned income. Data analysis will be conducted using a Generalized Linear Mixed Model approach. An effective computerized brief intervention has the potential to make a substantial impact on public health by reducing drug use and HIV risk behaviors because it can be easily scaled up and implemented throughout the health care system.