Assessing the effectiveness of Screening, Brief Intervention, and Referral to Treatment (SBIRT) to reduce polysubstance impaired driving among emerging adults aged 18-30 in Washington State.

PROJECT SUMMARY Screening, Brief Intervention, and Referral to Treatment (SBIRT) is an evidence-based comprehensive approach that can 1) quickly screen individuals for at-risk alcohol and other substance use and mental health issues, 2) utilize in-the-moment delivery of brief (i.e., 5-10 minute) intervention with motivational interviewing techniques and 3) when needed, provide referral to treatment. Regarding alcohol-impaired driving, SBIRT has been shown to be efficacious in reducing self-reports of drinking and alcohol-impaired driving, reports of alcohol-related vehicle crashes, and increasing referrals to treatment. Given the success of SBIRT for alcohol- impaired driving it may also be impactful for polysubstance-impaired driving. However, to date there has been limited evaluations of SBIRT regarding its effects for polysubstance-impaired driving. Despite the potential of SBIRT to reduce polysubstance-impaired driving, reported barriers include competing priorities for staff to provide SBIRT, staff turnover, and availability of treatment options. Brief motivational interventions (BMI) have evidence for reducing alcohol and cannabis use and consequences among young adults with additional previous support for reducing impaired driving. Web-based personalized feedback intervention (PFI) adapted from these in-person BMI may also be effective in reducing impaired driving and would address limitations within the SBIRT framework. Our team is contracted to roll out SBIRT training with 200 facilitators between Jan 2025-Sept 2025, which will include updated material specific to alcohol- and polysubstance-impaired driving. The proposed project would leverage this newly trained network and provide a web-PFI (SBIRT+PFI) to their young adult clients who screen at moderate or moderate to high risk or have any reports of impaired driving. Consented young adults would be randomized to receive the PFI or waitlist control and be assessed at enrollment and 3 months later. We also will collect data from the SBIRT facilitators to garner information on sustainability and barriers of implementing SBIRT. Thus, the objectives of this project will be to 1) examine the changes in polysubstance-impaired driving among young adults among those who receive the expanded SBIRT+PFI, and 2) using both qualitative and quantitative approaches, document real-word successes and difficulties in sustaining SBIRT models including: a) barriers to implementing with fidelity and b) percentage of staff turnover. Findings of the project can help inform decisionmakers and policymakers on the value of SBIRT and SBIRT+PFI for polysubstance-impaired driving as well as considerations for continued sustainability.