Computerized versus in-person brief intervention for drug misuse: a randomized clinical trial

Addiction. 2014 Jul;109(7):1091-8. doi: 10.1111/add.12502. Epub 2014 Mar 10.


Background and aims: Several studies have found that brief interventions (BIs) for drug misuse have superior effectiveness to no-treatment controls. However, many health centers do not provide BIs for drug use consistently due to insufficient behavioral health staff capacity. Computerized BIs for drug use are a promising approach, but their effectiveness compared with in-person BIs has not been established. This study compared the effectiveness of a computerized brief intervention (CBI) to an in-person brief intervention (IBI) delivered by a behavioral health counselor.

Methods: Two-arm randomized clinical trial, conducted in two health centers in New Mexico, United States. Participants were 360 adult primary care patients with moderate-risk drug scores on the Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) who were randomly assigned on a 1 : 1 basis to a computerized brief intervention (CBI) or to an in-person brief intervention (IBI) delivered by a behavioral health counselor. Assessments were conducted at baseline and 3-month follow-up, and included the ASSIST and drug testing on hair samples.

Results: The IBI and CBI conditions did not differ at 3 months on global ASSIST drug scores [b = -1.79; 95% confidence interval (CI) = -4.37, 0.80] or drug-positive hair tests [odds ratio (OR) = 0.97; 95% CI = 0.47, 2.02]. There was a statistically significant advantage of CBI over IBI in substance-specific ASSIST scores for marijuana (b = -1.73; 95% CI = -2.91, -0.55; Cohen's d = 0.26; P = 0.004) and cocaine (b = -4.48; 95% CI = -8.26, -0.71; Cohen's d = 0.50; P = 0.021) at 3 months.

Conclusions: Computerized brief intervention can be an effective alternative to in-person brief intervention for addressing moderate drug use in primary care.

Trial registration: NCT01131520.

Keywords: Behavioral health counselor; SBIRT; brief intervention; computer technology; primary care; randomized clinical trial; substance abuse.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Computers / statistics & numerical data*
  • Counseling / statistics & numerical data*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • New Mexico
  • Odds Ratio
  • Primary Health Care
  • Substance-Related Disorders / therapy*
  • Surveys and Questionnaires*
  • Treatment Outcome
  • Young Adult

Associated data