Citation

Sahker E, Jones D, Lancianese DA, Pro G, Arndt S. J. Racial Ethn. Health Disparities 2019; ePub(ePub): ePub.

Affiliation

Department of Biostatistics, College of Public Health, University of Iowa, Iowa City, IA, 52245-5000, USA. stephan-arndt@uiowa.edu.

Copyright

(Copyright © 2019, Holtzbrinck Springer Nature Publishing Group)

DOI

10.1007/s40615-019-00620-w

PMID

31364014

Abstract

BACKGROUND: Substance use disorders (SUDs) pose a significant public health concern. Previous findings, while equivocal, demonstrate screening, brief intervention, and referral to treatment (SBIRT) is effective in reducing substance use and improving overall health. While race/ethnic and sex differences in SBIRT outcomes exist, racial/ethnic differences within sex groups remain unclear. The present study sought to quantify differences within race/ethnicity and sex in drug and alcohol use following SBIRT screenings.

METHODS: Using health service data (N = 29,121) from a Midwestern state in four federally qualified health centers (FQHC) from 2012 to 2016, we assessed racial/ethnic and sex differences in the effect of SBIRT screening on alcohol and drug use between visits. We used McNemar's tests and multiple logistic regression to predict substance use at follow-up visits.

RESULTS: We found a significant race/ethnicity by sex interaction predicting a positive alcohol prescreening (p < 0.001), precipitating a full alcohol screening, and subsequent hazardous drinking (p < 0.001) at full alcohol screening follow-up. Black males demonstrated the largest reduction in positive alcohol prescreenings at follow-up (9.24%). Patients identifying as White, Black, or Other demonstrated a reduction in hazardous drinking, though effect sizes were small and not clinically meaningful. No interactions in our drug outcome models were significant.

CONCLUSION: SBIRT is useful in addressing health services equity among Black and male populations. Public health policy should support universal substance use screening and targeting interventions for underserved groups in clinical facilities likely to benefit the most. Resources should be directed to groups with the most pressing SUD treatment needs.

Language: en

Keywords

Federally qualified health centers; Health disparity; Substance use; Substance use services