Massachusetts ED SBIRT Initiative
The Massachusetts ED SBIRT program brings Screening, 
Brief Intervention and Referral to Treatment (SBIRT) to seven emergency departments (EDs) in Massachusetts. Funding from the Massachusetts Department of Public Health Bureau of Substance Abuse Services (BSAS) allowed the BNI-ART Institute to disseminate the Project ASSERT model throughout the state, using health promotion advocates (HPAs) to perform SBIRT as part of routine emergency department care. ED SBIRT has screened close to 30,000 patients, provided brief interventions to over 8,000 positive screens and referred almost 6,500 to treatment.
The HPA Role: How it works
Project ASSERT HPA John Cromwell speaking with a patient.
A survey of patients’ health and safety needs provides the basis for detection of substance use problems and other health issues. Through a Brief Negotiated Interview (BNI) technique, HPA’s establish rapport, raise the subject of drugs and alcohol, and assess patients’ readiness to change.
The BNI is a collaborative conversation about health promotion that occurs between a patient and healthcare provider. Founded on the principles of motivational interviewing, the BNI strives to help patients resolve ambivalence, build motivation around reducing drinking and other substance use, and seek assessment and treatment for substance abuse if appropriate.
Emphasizing a comprehensive approach to health promotion, HPAs also refer and facilitate in areas of primary care appointments, health insurance, mental health referrals and social services, when appropriate, that will support their agenda for change.
