Screening and Brief Intervention for Prescription Stimulant Misuse and Diversion: Refining and Piloting a Curriculum for College Health Providers - ABSTRACT Prescription stimulant diversion ([PSD] i.e., the sharing, selling, or trading of prescription stimulants) and prescription stimulant misuse ([PSM] i.e., use without a prescription, use in excess of a prescription, or use for nonmedical purposes) are inter-related and co-occurring problems on college campuses. In addition, PSD and PSM are not limited to students with a prescription for stimulants (Lam et al., 2020; Garcia et al., 2022). Thus, there is a need to universally screen and intervene upon both behaviors. Prior research has shown college health providers [CHPs] are concerned about PSM and PSD, yet feel they lack training in strategies to address these behaviors (Loskutova et al., 2020). As such, CHPs serve as ideal professionals for training and implementing PSM and PSD intervention efforts. To that end, our team has developed a research- and theory- guided PSM and PSD screening and brief intervention [SBI] curriculum to be implemented by CHPs. The purpose of the proposed, three-year, R34 study is to engage CHPs and college students in the refining and piloting of a SBI to address PSM and PSD. After completing start-up activities to promote content validity and face validity, we propose three studies to achieve our three aims. In Study 1, a geographically diverse sample of CHPs recruited from the American College Health Association member directory will assess the appropriateness and clarity of the curriculum content, as well as provide insights on potential implementation barriers and strategies to overcome barriers. The feedback provided will be used to refine the existing curriculum prior to pilot testing (AIM 1: Refine a novel PSM and PSD SBI curriculum by engaging CHPs in the development process). The pilot test will be completed at the campus health center of one diverse university where PSD and PSM are prevalent. Students will be randomized to control, e-SBI, or face-to-face SBI delivered by trained CHPs. Study 2 will focus on the CHPs; all CHPs who receive training will complete an evaluation of the curriculum, and CHPs who implement the SBI will complete indicators of feasibility, acceptability, and implementation (via the Motivational Interviewing Treatment Integrity tool, qualitative interview, and quantitative survey; AIM 2: Pilot test feasibility, acceptability, and implementation of the intervention). Study 3 will run concurrently with Study 2, and will focus on the student participants. Acceptability of the intervention will be measured immediately after participation (AIM 2) and impact on student PSM and PSD outcomes will be measured at one-month follow-up (AIM 3: Evaluate the short-term impact of the and PSD). Our goal is to apply the knowledge gained to refine a curriculum that can be widely disseminated. Attainment of this goal could be applied to reduce morbidity and mortality related to PSM and PSD. applying fundamental knowledge about behavior to promote health.
