We recently presented a webinar on brief interventions for preventing youth substance use. Because it was a completely filled session, I wanted to provide a description of the main points covered in the webinar for those who had not had an opportunity to attend it.
Introduction
Brief prevention interventions, particularly those that are just one-session in length, have the critical advantage of being more widely accepted for implementation in busy settings such as schools and can therefore reach a larger and broader youth population than lengthier or more intensive programs.
Brief interventions that also integrate substance use prevention with the promotion of healthy lifestyles are likely to be of greater interest and therefore have greater participation by youth, parents, schools, communities and funding agencies than more narrowly targeted and risk-based only prevention programs.
Brief Intervention Models
Brief interventions are considered evidence-based practices by the Substance Abuse and Mental Health Services Administration (SAMHSA: https://www.integration.samhsa.gov/clinical-practice/sbirt/brief-interventions).
Some common models of brief intervention for preventing substance use among youth include:
- SBI=Screening & Brief Intervention
- SBIRT=Screening, Brief Intervention & Referral to Treatment
- PPW=Prevention Plus Wellness programs
- BI=Brief Intervention or any short-term substance use prevention program
Examples of each of these types of brief interventions will be provided below.
Evidence-based Brief Interventions Addressing Youth Substance Use
One important question to answer is what types of brief interventions are evidence-based, and therefore have been vetted as being effective programs?
To answer this question a search was conducted of the Results First Clearinghouse Database (https://www.pewtrusts.org/en/research-and-analysis/data-visualizations/2015/results-first-clearinghouse-database).
This Clearinghouse is a meta-database of nine evidence-based programs (EBPs) registries.
EBPs were searched using the “substance use” outcomes option and “brief interventions” was included as a secondary descriptor. The focus of this search was for prevention or intervention programs for youth or young adults in non-clinical settings.
Ten evidence-based brief interventions for substance use were identified. The majority targeted alcohol use only (n=6) of which four were for college students, one was an intervention addressing alcohol and drug use among adolescents, one was aimed at stopping smokeless tobacco use among male high school baseball players, and two were single-session multi-health behavior screening and brief interventions.
The 10 evidence-based brief interventions included:
- Alcohol Brief Interventions
- Alcohol Literacy Challenge (ALC)
- Brief Alcohol Screening and Intervention for College Students (BASICS)
- STEPS Comprehensive Alcohol Screening and Brief Intervention
- College Drinker’s Check-up (CDCU)
- com
- Teen Intervene
- Spit Tobacco Intervention
- SPORT Prevention Plus Wellness (PPW) for youth
- InShape Prevention Plus Wellness (PPW) for young adults
Research Examining Youth Substance Use Brief Interventions
Recent research on brief interventions for substance use among youth was then reviewed. Key findings from this review showed that:
- SBIRT is feasible as a universal prevention strategy in high schools without health clinics: https://journals.sagepub.com/doi/full/10.1177/1178221817746668
- Alcohol brief interventions for youth and young adults show effects lasting one-year after implementation, with outcomes consistent across diverse settings, formats and populations: https://www.sciencedirect.com/science/article/pii/S0740547214001925
- SBIRT is an effective method for addressing adolescent substance use: https://www.ingentaconnect.com/content/wk/mop/2016/00000028/00000002/art00021
Youth Brief Intervention Substance Use Resources
A small number of resources are available for prevention and health specialists who wish to use brief interventions to prevent youth substance use. Some of these include:
- SBIRT: An Application for School Social Workers (Children & Schools, 2018): https://academic.oup.com/cs/article/40/4/249/5077482?guestAccessKey=3e365d02-4427-45d1-ba4f-7aa6cb34650c
- Alcohol SBI for Youth: A Practitioner’s Guide (NIAAA): https://pubs.niaaa.nih.gov/publications/Practitioner/YouthGuide/YouthGuide.pdf
- The American Academy of Pediatrics (AAP) has developed this guideto help pediatricians incorporate SBIRT for use of alcohol, tobacco, marijuana, and other drugs among adolescent patients: https://www.aap.org/en-us/Documents/substance_use_screening_implementation.pdf
Multi-health Behavior Brief Interventions
Prevention Plus Wellness (PPW) programs are brief interventions that differ from typical SBIs and SBIRT by targeting multiple health risk behaviors of youth and young adults.
One of the other main differences between PPW brief interventions and others is that PPW programs are founded on the Behavior-Image Model (BIM).
BIM is a marketing-related theoretical road map for developing brief interventions that integrate substance use prevention with mental and physical wellness promotion.
The two components of the BIM are:
- Cuing positive peer and desired future images of participants to increase motivation for avoiding substance use and increasing protective healthy behaviors.
- Using multiple behavior goal setting/contracts to increase self-regulation skills to set, monitor and achieve prevention and wellness behavior change.
Prevention Plus Wellness brief interventions consist of three steps: 1) Screen participants current health habits using a screening survey, 2) Provide feedback and positive image messages using a script and PowerPoint slides, and 3) Assist participants to set and monitor goals to avoid substance use and increase wellness behaviors.
Evidence-based Prevention Plus Wellness Brief Interventions
Two single-session evidence-based PPW brief interventions include the SPORT Prevention Plus Wellness program for youth and the InShape Prevention Plus Wellness program for young adults.
Both programs have been rigorously evaluated and are listed on a number of EBPs registries including Blueprints for Healthy Youth Development and the National Registry of Evidence-based Programs and Practices (NREPP).
SPORT and InShape Prevention Plus Wellness target the avoidance of alcohol and other drug use while increasing physical activity, healthy eating, sleep and stress control.
Both of these programs have undergone multiple evaluations showing they prevent alcohol, marijuana and other substance use behaviors, while increasing healthy habits like physical activity among participants, with some effects lasting a year after intervention.
Program manuals include scripts for implementing the brief interventions to participants individually (i.e., one-on-one) or in groups, and come with a digital download allowing unlimited reproduction of program materials. The SPORT PPW program also includes parent flyers.
Evidence-informed Prevention Plus Wellness Brief Interventions
A number of adaptations of the SPORT Prevention Plus Wellness program have been developed to address specific other substance use risks, including e-cigarettes, marijuana and opioids.
These adaptations use the same evidence-based practices screening and brief intervention format as SPORT PPW, and so they are also a single-session and address substance use prevention along with the promotion of physical activity, healthy nutrition, getting adequate sleep and controlling stress.
These include the Vaping Prevention Plus Wellness program, Marijuana Prevention Plus Wellness program and Opioid Prevention Plus Wellness program. Each of these brief interventions are designed for youth, with the Opioid PPW program also including versions for high-risk men and women.
Each of these brief interventions, like the SPORT PPW program, includes scripts with PowerPoint slides for implementing them to individual participants as well as in groups, and are founded on the Behavior-Image Model.
The Vaping, Marijuana and Opioid Prevention Plus Wellness programs also come with a program manual and digital downloads, like the SPORT and InShape Prevention Plus Wellness programs.
And just like the SPORT and InShape Prevention Plus Wellness programs, the Vaping, Marijuana and Opioid PPW programs include scannable pre-post surveys.
These surveys permit the evaluation of program effects on four critical measures of predictors of multiple health behaviors, including five substance use behaviors and four health-promoting behaviors.
In addition, free basic analysis of the scanned surveys is provided.
Conclusions
Brief prevention interventions have the advantage of being more widely accepted for implementation in busy settings like schools and can therefore reach a larger and broader youth population than typically lengthier prevention programs.
A number of models of brief intervention exist and ten evidence-based brief interventions for substance use were identified. The majority targeted alcohol use only, while two were single-session multi-health behavior screening and brief interventions.
Research on brief interventions for substance use among youth indicates that brief interventions such as SBIRT are feasible as a universal prevention strategy in schools and effective in influence adolescent substance use.
A small number of resources are available for prevention and health specialists who wish to use brief interventions to prevent youth substance use.
Prevention Plus Wellness (PPW) programs are brief interventions that differ from typical SBIs and SBIRT by targeting multiple health risk behaviors of youth and young adults and are founded on the marketing-related Behavior-Image Model.
Two single-session evidence-based PPW brief interventions include the SPORT Prevention Plus Wellness program for youth and the InShape Prevention Plus Wellness program for young adults.
A number of adaptations of the SPORT Prevention Plus Wellness program have been developed to address other substance use risks, including e-cigarettes, marijuana and opioids. These include the Vaping, Marijuana and Opioid Prevention Plus Wellness programs.
All PPW programs target increasing physical activity, healthy eating, sleep and stress control along with avoiding substance use, and include program manuals, digital downloads of reproducible materials, and built-in pre-posttest evaluation surveys and free evaluation support.
Learn more about Prevention Plus Wellness programs and training: http://preventionpluswellness.com
View the recorded webinar version of this article: https://youtu.be/HUtTjEzKysQ