Evaluating Training of Screening, Brief Intervention, and Referral to Treatment (SBIRT) for Substance Use: Reliability of the MD3 SBIRT Coding Scale
Evaluating Training of Screening, Brief Intervention, and Referral to Treatment (SBIRT) for Substance Use: Reliability of the MD3 SBIRT Coding Scale
复制标题
DOI：
10.1037/adb0000022
复制
发表时间：
2015-03-01
影响因子：
3.4
通讯作者：
Welsh, Christopher
中科院分区：
文献类型：
--
作者：
DiClemente, Carlo C.;Crouch, Taylor Berens;Welsh, Christopher
筛查、简短干预和转诊治疗（SBIRT）已成为一种在初级和专科护理中得到经验支持和广泛实施的方法，用于解决药物滥用问题。因此，近年来对提供者进行的SBIRT培训呈指数级增长。然而，由于缺乏SBIRT特定的评估工具，培训方案和后续干预措施的质量和保真度在很大程度上是未知的。本研究的目的是创建一个编码量表，以评估SBIRT相互作用的质量和保真度，解决酒精，烟草，非法药物和处方药滥用。该量表是为了评估SBIRT住院医师培训计划的绩效而开发的。量表的开发是基于培训协议和能力与咨询动机面试编码专家。经过培训的住院医师在10至15分钟的录像互动中与标准化患者进行SBIRT。这项研究包括25个磁带从家庭医学计划编码的3个独特的编码器对不同程度的编码经验。通过组内相关系数评估总体量表组成部分和单个项目的评分者间信度。还评估了编码器对特异性可靠性。评分员间的信度是优秀的整体规模组成部分（>.85）和几乎所有的项目。可靠性更高，更有经验的编码器，但仍然足够的训练编码器对。描述性数据显示了广泛的依从性和技能。分量表相关支持同时效度和区分效度。数据提供的证据表明，MD3 SBIRT编码量表是一个心理测量学上可靠的编码系统，用于评估SBIRT的相互作用，并可用于评估实施技能的保真度，培训，评估和研究。改进和进一步测试的措施的建议进行了讨论。
Screening, brief intervention, and referral to treatment (SBIRT) has become an empirically supported and widely implemented approach in primary and specialty care for addressing substance misuse. Accordingly, training of providers in SBIRT has increased exponentially in recent years. However, the quality and fidelity of training programs and subsequent interventions are largely unknown because of the lack of SBIRT-specific evaluation tools. The purpose of this study was to create a coding scale to assess quality and fidelity of SBIRT interactions addressing alcohol, tobacco, illicit drugs, and prescription medication misuse. The scale was developed to evaluate performance in an SBIRT residency training program. Scale development was based on training protocol and competencies with consultation from Motivational Interviewing coding experts. Trained medical residents practiced SBIRT with standardized patients during 10- to 15-min videotaped interactions. This study included 25 tapes from the Family Medicine program coded by 3 unique coder pairs with varying levels of coding experience. Interrater reliability was assessed for overall scale components and individual items via intraclass correlation coefficients. Coder pair-specific reliability was also assessed. Interrater reliability was excellent overall for the scale components (>.85) and nearly all items. Reliability was higher for more experienced coders, though still adequate for the trained coder pair. Descriptive data demonstrated a broad range of adherence and skills. Subscale correlations supported concurrent and discriminant validity. Data provide evidence that the MD3 SBIRT Coding Scale is a psychometrically reliable coding system for evaluating SBIRT interactions and can be used to evaluate implementation skills for fidelity, training, assessment, and research. Recommendations for refinement and further testing of the measure are discussed.