‘Asking’ but Not ‘Screening’: Assessing Physicians’ and Nurses’ Substance-Related Clinical Behaviors

Jon Agley, Joan M. Carlson, Angela M. McNelis, Ruth A. Gassman, Rhonda Schwindt, David Crabb, Julie Vannerson

Research output: Contribution to journalArticle

6 Scopus citations


Background: Screening, brief intervention, and referral to treatment (SBIRT) is a promising public health approach for problematic substance use. A core component of SBIRT is the use of formal screening tools to categorize a patient's likely level of risk in order to provide an appropriately-matched service. Training in formal screening is included in many SBIRT training programs, but infrequently is emphasized. Objectives: To assess pre-training levels of SBIRT-related clinical behaviors, including screening, this study examined a secondary dataset collected from internal medicine residents and graduate nurse practitioner students. Methods: Learners (n = 117) completed 13 self-report items assessing use of SBIRT-related behaviors. Researchers used exploratory factor analysis to identify underlying concepts in the questionnaire, then used mixed ANOVA to compare mean frequency of utilization of each factor (asking, screening, and intervening) by academic program. Results: Learners reported asking about substance use frequently, intervening some of the time, and infrequently using formal screening tools. Interaction and between-academic-program effects were significant but small. Conclusions: Prior to SBIRT training, most clinical practitioners reported asking patients about substance use, but few reported regularly using formal substance use screening tools. This may have implications for the importance of SBIRT training as part of curricular work, and for the internal content foci of SBIRT curricula.

Original languageEnglish (US)
Pages (from-to)1834-1839
Number of pages6
JournalSubstance Use and Misuse
Issue number11
StatePublished - Sep 19 2018


  • alcohol
  • clinical care
  • education
  • screening
  • workforce development

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Health(social science)
  • Public Health, Environmental and Occupational Health
  • Psychiatry and Mental health

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