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Development of the SBIRT checklist for observation in real-time (SCORe)
Janice A Vendetti1, Bonnie G McRee1, Frances K Del Boca1
1UConn Health, School of Medicine, Department of Community Medicine and Health Care, Farmington, CT, USA.
Addiction (Abingdon, England)
|January 12, 2017
Summary
This study introduces the SBIRT Checklist for Observation in Real-time (SCORe) to measure provider adherence to evidence-based Screening, Brief Intervention, and Referral to Treatment (SBIRT) services. The SCORe tool demonstrated feasibility and validity in assessing SBIRT program delivery.
Area of Science:
- Healthcare delivery research
- Behavioral health services research
Background:
- Screening, Brief Intervention, and Referral to Treatment (SBIRT) programs are widely used in medical settings.
- Assessing provider adherence to evidence-based SBIRT practices in real-world settings is crucial but underexplored.
- There is a need for reliable tools to evaluate the fidelity of SBIRT service delivery.
Purpose of the Study:
- To introduce the SBIRT Checklist for Observation in Real-time (SCORe) methodology for assessing adherence to evidence-based SBIRT.
- To provide preliminary evidence supporting the criterion validity of the SCORe.
- To demonstrate the feasibility and utility of SCORe through observations in large-scale US SBIRT programs.
Main Methods:
- Trained adherence judges evaluated SBIRT service elements using realistic video portrayals as criterion standards.
- 76 providers across four large-scale SBIRT programs were observed in emergency departments, outpatient clinics, and inpatient settings.
- A total of 388 services were observed and analyzed.
Main Results:
- Trainees achieved high accuracy in identifying screening (81%) and brief intervention (75%) elements.
- Adherence to core SBIRT components (FRAMES) ranged from 69% to 91% among judges.
- Observed adherence rates were 56% for screening, 54% for brief intervention, and 53% for referral to treatment, with significant program-level variations.
Conclusions:
- The SBIRT Checklist for Observation in Real-time (SCORe) offers a flexible method for evaluating adherence to SBIRT protocols.
- Preliminary findings support the criterion validity, feasibility, and utility of the SCORe tool.
- The SCORe can be a valuable instrument for quality improvement in SBIRT program implementation.
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