**University of Pittsburgh**

**Program Description**

The Substance Abuse and Mental Health Services Administration Center for Substance Abuse Treatment (SAMHSA-CSAT) is funding the University of Pittsburgh for five years to provide training for medical residents and faculty in screening, brief intervention and referral to treatment (SBIRT) skills and practices. The Pennsylvania **S**BIRT **M**edical **a**nd **R**esidency **T**raining program (**SMaRT**) is a state-wide initiative that will train approximately 750 medical residents at seven medical residency programs across three healthcare systems. The participating residencies are located at the University of Pittsburgh Medical Center and the Veterans Administration Healthcare System in Pittsburgh, Albert Einstein Medical Center in Philadelphia, and Susquehanna Health-Williamsport Hospital and Medical Center located in Williamsport, PA. The specialties of the residency programs and where the SMaRT curriculum will be implemented include family medicine, general and internal medicine, emergency medicine, obstetrics and gynecology, and pediatrics. Thus, the populations impacted by the SMaRT initiative includes both rural and urban populations and a variety of specialty populations that will include pregnant women, adolescents and patients presenting to family, general, internal and emergency medical settings across the Commonwealth of Pennsylvania. 

**Program Model**

The mission of the SMaRT initiative is to develop a training program in which medical residents and faculty will be trained in the principles of SBIRT and to increase the use of SBIRT in medical residency programs and physician practices. An evidence-based curriculum has been developed to provide the specific knowledge and skill development targets needed to perform screening, brief intervention and referral to treatment effectively. The curriculum is a multi-component, comprehensive curriculum that will include didactic training complemented with electronic learning modules and hands-on application. SBIRT practices will be advanced throughout the medical community via train-the-trainer procedures, other training events, and practice policy advocacy. The SMaRT initiative will establish the SBIRT model as an on-going training component of medical residency programs and will disseminate the model through regional and state-wide medical communities through validated dissemination mechanisms 

**Services Features**

SMaRT will conduct both a process and individual outcome evaluation. The process evaluation will include the degree to which the implementation of the program was delivered as planned ("implementation fidelity") and an assessment of the implementation in relation to its effectiveness in delivering the curriculum. The individual outcome evaluation will focus primarily on residents, but will also include survey information from participating faculty. The SMaRT resident outcome evaluation will include an assessment of knowledge, skill, attitudes and perceptions, and satisfaction with the program. Residents will be assessed for knowledge change using a pretest/posttest design. Scores will be collected, analyzed, and reported for each knowledge component. For skill acquisition, residents will be observed or supervised by responsible faculty, and proficiency in SBIRT practices will be evaluated after service provision through the use of a validated proficiency checklist. Resident attitudes and perceptions will be assessed through the use of survey developed by the SMaRT evaluation team. This survey includes a section on clinical experience with SBIRT, as well as a section pertaining to perceived confidence and competence with SBIRT practices. Additionally, the SMaRT survey includes the Alcohol and Alcohol Problem Perceptions Questionnaire, which asks question about working with persons with alcohol problems. This survey is proposed to be administered to residents at the beginning and end of the residency year, with the possibility of a 12-month follow-up (i.e., the end of the consequent residency year). Faculty will complete the SMaRT survey on attitudes and perceptions at least once, in order to compare faulty and resident responses. 

Finally, we will describe SBIRT activities within clinical practice. We will monitor the number of SBIRT interventions (e.g. number of screenings) provided by residents during their participation in the SMaRT curriculum. 

**Contact Info**

University of Pittsburgh, School of Pharmacy2100 Wharton Street, 7th Floor, Suite 720-CPittsburgh, PA 15203 

Project DirectorsJanice Pringle, Ph.D.(Ph) 412-904-6127(Fax) 412-904-6125(Email) jlp127@pitt.edu 

William Johnjulio, MD(Ph) 412-232-5955(Fax) 412-232-7827(Email) johnjuliowk2@upmc.edu 

EvaluatorMichael Melczak, Ph.D.(Ph) 412-904-6122(Fax) 412-904-6125(Email) mam142@pitt.edu