The Case for Change: Evolving the Clinician's Screening Tool: NIDA ASSIST

Background:  The mission of the National Institute on Drug Abuse (NIDA) is to bring the power of science to bear on drug abuse and addiction.  This effort first involves strategic support and cross-disciplinary research.  Second, it ensures the rapid and effective dissemination and use of research results to improve prevention, treatment, and policy significantly as they relate to drug abuse and addiction.  

Program background:  In 2007, an estimated 19.9 million Americans age 12 or older (nearly 8 percent of the U.S. population) reported using an illicit drug during the month prior to being surveyed.  Nearly one in five Americans age 18 to 25 had used illicit drugs during the month prior to the survey.  Yet very few individuals in need of drug addiction treatment receive it.  Given the scale of the problem, routine screening for drug abuse has become a priority.  In fact, the use of screening and brief intervention procedures in general medical settings can make a real difference in drug use behaviors.

Evaluation Methods and Results:  To support physicians in screening for potential drug use, the Institute designed the Alcohol, Smoking, and Substance Involvement Screening Test (NIDA ASSIST) to be used in an adult clinical setting for screening patients who are potentially at risk for drug use.  The ASSIST tool provides an opportunity for medical providers to ask patients questions related to drug use, to deliver direct advice about behavior change, to discover how open a patient may be to the change, and to make referrals as needed.  

Conclusions: Currently, the ASSIST screening tool is Web-based and takes place in a face-to-face conversation, with the doctor and patient working together through an extensive menu of questions and answers. 

Implications for research and/or practice:  Personal digital assistants (PDAs), particularly mobile phones, are perhaps one of the most cost-effective ways to facilitate the adoption of evidence-based research into practice.  More and more physicians are using their smartphones during office visits to look up clinical guidelines or research possible treatments.   Recognizing the power of mobile health to transform relations between health professionals and patients, NIDA’s Office of Science, Policy, and Communications contracted with IQ Solutions to create a mobile version of the ASSIST screening tool.  The NIDA-Modified ASSIST (NMASSIST) screening tool is being developed to work on the most popular mobile phones (iPhone and Blackberry) and to be repurposed as a widget to post to other Web sites and networks.  This new tool will allow patients to be given a PDA to respond to the screening questionnaire.  The data will then be transmitted immediately to the doctor, who can review and prepare for an informed discussion of the results with the patient.  The mobile application will reduce the time it takes a doctor to administer the test and will provide the patient with a confidential, nonthreatening mechanism for responding to the test.  Both of these conditions are likely to increase the response rate and validity of the test.  Learn how health communicators can use mobile health applications to improve provider-patient interaction, patient behavior, and health outcomes.