Background
Unhealthy use of alcohol and drugs poses a significant health problem on college campuses,[1] and student health centers are an under-utilized resource for offering substance use screening and interventions.[2, 3] As a strategy for increasing screening rates, we tested the feasibility of incorporating tablet computer self-administered screening into routine care at one university health clinic.
Materials and methods
During the 3-week study period, all patients presenting for a visit with a participating primary care provider were asked by the receptionist to fill out a ‘health screener’ in the clinic waiting area Screening tools were the 4-item Substance Use Brief Screen (SUBS),[4] followed by the ASSIST for those who screened positive.[5] Patients gave informed consent and completed screening on a tablet computer, then viewed their results and were given the option of delivering this information to the medical provider.
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Results
Half of the patients presenting for an appointment received the tablet, of which 337 (90%) consented and completed screening. Rates of past-year unhealthy use were 73% for alcohol, 43% for illicit drugs, and 8% for prescription drugs. Among participants who screened positive for alcohol, 45 (21%) had moderate-risk use, and 4 (2%) had high-risk use, based on ASSIST scores. Of those screening positive for drugs, 53 (35%) had moderate-risk use, and one had high-risk use. Overall, 49% of all participants elected to disclose results to their primary care provider. Rates of disclosure were significantly lower for those with moderate-high risk drug or alcohol use (31%) than in those with low-risk use (59%), (P<0.01).
Conclusions
Our findings suggest that university health centers are a good venue for substance use screening and interventions, but there is also a need for interventions that can be delivered outside the health center, or that increase patient motivation to discuss substance use during the primary care visit.
Acknowledgements
This research was funded by the Center for Drug Use and HIV Research (P30 DA011041).
This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.