JMIR Publications

ABSTRACT

Background:

Digital screening and intervention tools have shown promise in the identification and reduction of substance use in health care settings. However, research in this area is impeded by under-reporting of substance use as well as by challenges integrating recruitment efforts into ongoing clinical workflows or staffing multiple study clinics with full-time research assistants.

Objective:

To evaluate pragmatic methods for facilitating disclosure and study recruitment in healthcare settings: first comparing disclosure in interaction with technology vs. a nurse intake interview; and second examining disclosure and recruitment rate using flyer- vs. research assistant-based methods.

Methods:

Study 1 compared alcohol use disclosure using standard practice alcohol screening during a nurse intake interview to self-screening on a tablet using the identical interview question. The second study compared disclosure of substance use and risk screener positivity under two different recruitment strategies, in person vs. via a flyer with a QR code/study website and examined recruitment rates for the two approaches.

Results:

In Study 1, among 48 patients completing a nurse-delivered pregnancy intake and answering the same question on a study tablet, disclosure was higher for the tablet-administered vs. nurse-administered screening (61.2% vs. 31.3% reporting any use). In Study 2, participants recruited via flyer were more likely to screen positive for alcohol use risk on the T-ACE than those recruited at the clinic (37.5% vs. 19.3%; χ2 [1, 121] = 4.86, p= .028).

Conclusions:

Participant recruitment via technology in perinatal health care appears to facilitate disclosure, particularly when participants can learn about the research and complete screening using their own device at a place and time convenient for them. Distribution of QR code flyers by medical staff appears to be an efficient and cost-effective method of recruitment that also facilitates disclosure while reducing impact on clinic workflows.