Implementing SBIRT in a Culturally Competent Manner

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Implementing SBIRT in a Culturally Competent
Manner

• One projects experience

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What is SBIRT?

• Screening
• Brief
• Intervention
• Referral to
• Treatment

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Where Does SBIRT Come From?

• OASAS Health Intervention Service model
• Health care, primary care settings
• No wrong door
• Meet people where they are
• Trauma settings see almost half of their patients
  with positive BAC levels.
• BI reduces chances of seeing the patient again in
  the trauma setting by as much as 50

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Why Use SBIRT?

• BI reduces chances of seeing the patient again in
  the trauma setting by as much as 50
• Increases name recognition of your clinic
• Identifies people who need services who would
  otherwise be missed
• Normalizes, and de-stigmatizes the issue of
  substance abuse

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Getting Started

• Screening Choose a screening instrument
• Consider your population
• How much time in general will you have to
  complete the screening
• Where will these screening be taking place
• Prepare for all levels of need

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Screening Instruments
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Screening Instruments Continued
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Screening Instruments Continued
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Taking Your Instrument IntoThe Real World

• OUTREACH
• Who is your community?
• Where are they?
• What topics are they comfortable discussing?

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ISAAC Examples

• Critical Care Facilities
• Churches
• Schools, elementary through college
• Senior Centers
• Health Fairs
• Parks, on the street, playgrounds
• Cultural parades and festivals

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ISAAC Project Projected Numbers

• Goals for the project over the 3 year project
  period
• Screening To screen 6,000 Asian-Americans for
  substance abuse issues.
• Brief Interventions That 960 individuals would
  receive a brief or full intervention.
• Referral to Treatment of those 960 individuals
  360 of them would be referred and admitted to
  treatment.

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ISAAC Project Numbers

• Screening Results
• 3,165 screened negative
• 381 screened positive
• 54 screened negative but were referred to
  treatment

Is this normal?
What is normal?
The general population has approximately a 10
percent positive screening rate
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Screening Vs. Reality

• Positive Screening Results
• 30 declined intervention
• 179 received a brief intervention
• 226 received a full intervention

• Be prepared to meet resistance, and have a
  response for it.
• Have brief intervention materials ready to go.
• Have contact information cards ready to hand out,
  if possible get the persons contact information
  so you can call them.

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What Do Our Clients Look Like?
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Clients Breakdown Continued
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Our Clients Continued

• Age Demographics
• Mean 47.5
• Median 46
• Range18 95
• Gender Breakdown
• 40.6 Male
• 59.4 Female

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Screening Location Makes a Difference

• Try to find positive screens trauma care
  locations, high risk populations
• Be persistent when trying to get your foot in the
  door, not everyone will welcome you with open
  arms, know the change leader
• General screening is beneficial, it reduces
  stigma, promotes name recognition, and gets
  information to those who may know someone who
  needs help

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Clients in Treatment

• Clients who were screened positive, and
  successfully referred to and engaged in treatment
  are encouraged to participate in GPRA Government
  Performance Results Act.
• What is GPRA?
• Our tale of woe regarding GPRA, the cultural
  competence implications.
• Take home ADVOCATE for your population

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Results From GPRA Data

• 80 of GPRA clients were Men
• 7 were 18-24 years old
• 26 were 25-34 years old
• 37 were 35-44 years old
• 24 were 45-54 years old
• 6 were 55 or older
• Does this look like the population being
  screened?

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This Project Was Made Possible

• By a Targeted Capacity Expansion grant from the
  Substance Abuse Mental Health Services Agency
• SAMHSA will be announcing several TCE, and SBIRT
  driven funding opportunities this fall, for more
  information go tohttp//www.samhsa.gov/Grants/2
  008/fy2008opps.aspx

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Grand Finale

• If you would like this presentation, or any
  additional information regarding SBIRT or the
  Increasing Services to Asian Americans in NYC
  project please e-mail me atluciaclark_at_oasas.stat
  e.ny.us