Screening, Brief Intervention and Referral to Treatment (SBIRT): An examination of health disparities

Abstract

Risky substance use can lead to a variety of negative health outcomes, yet treatment is often underutilized by historically minoritized racial/ethnic groups. Screening, Brief Intervention and Referral to Treatment (SBIRT) is effective in changing substance use patterns across diverse settings and for diverse demographic groups. However, few studies have focused on whether individuals receive the appropriate level of care based on screening criteria. The purpose of this study was to investigate intervention match/mismatch and factors (e.g., service site, gender, race, ethnicity, age, socio-economic status) that predicted the likelihood of being matched/mismatched to an intervention. A sample of N = 3412 were available for analyses and logistic regressions were performed to examine the relationship between matching/mismatching to an intervention and other factors. Of participants, 2222 (65%) were matched to an intervention and 1190 (35%) were mismatched to an intervention. Being older, Hispanic, and receiving SBIRT by health-teams designed to reduce health disparities was related to increased odds of being mismatched. Exploratory results suggested that across predictors, individuals were more likely to receive a lesser intervention than their screening score indicated. Most clients were matched well to intervention as based on screening score. When mismatch occurred, a lower level of care was given. Staff may benefit from attending to more client engagement so that clients return for more intensive interventions; and agencies may need more resources to facilitate client access to services.

Keywords:

• SBIRT
• intervention matching/mismatching
• health disparities
• ethnicity
• substance use

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The datasets analyzed during the current study are not publicly available due to them containing information that could compromise research participants’ privacy/consent but are available from the corresponding author on reasonable request.

Additional information

Funding

This work was supported by the Rhode Island Department of Behavioral Healthcare, Developmental Disabilities & Hospitals (BHDDH; Project Director, Catherine Hunter) via a grant from the Substance Abuse & Mental Health Services Administration (SAMHSA; 1H79TI026664-01); Site Principal Investigator-LAR Stein, University of Rhode Island. The funding source had involvement in the collection of data (provided assessment instrument and web-based platform for data entry).