Direct Care Project Analysis

Community Description

Demographic Data

  • Miami Florida community as the target group;
  • Population of 470,914 people;
  • Community living in an urban setting;
  • Multi-ethnic community, great diversity;
  • A tourist destination, the population includes visitors.

Note: The community of Miami, Florida, is a multi-ethnic group that includes Whites, Hispanics, African-Americans, Asians, and Indians. It includes 470,914 people residing in a predominantly urban setting.

Epidemiologic Data

  • 7.1% of the population with a disability under 65;
  • The adult obesity rate of 22%;
  • The adult smoking rate of 16%;
  • 23% of children living in poverty;
  • 11 drug overdose deaths.

Note: There are some healthcare challenges that should be addressed in the current community setting. High levels of adult obesity and children living in poverty is a problem that needs further attention, while adult smoking and issues with drug abuse require immediate intervention.

Problem Description

Substance Abuse

  • Substance use presents a challenge for the community;
  • 26.5% of tobacco smokers and 13.2% of marijuana smokers;
  • 1.3% of the population diagnosed with marijuana use disorder;
  • 7.3% of the population diagnosed with substance use disorder;
  • Need to establish healthy lifestyle practices for problem mitigation.

Note: There is a need for creating an environment that encourages healthy lifestyles within the community to address the problem of substance use. The rates of the population diagnosed with substance abuse disorder need to be eliminated because they prevent the community from reaching the desired health outcomes.

Contributing Factors

  • Increased availability of legal and illegal substances;
  • Limited support of vulnerable communities;
  • Homelessness contributing to increased substance abuse (Murray, 2020);
  • Lacking mental health and counseling services;
  • No observed substance abuse treatment centers.

Note: Contributing factors that exasperate the problem should be eliminated as soon as possible. They include limited support of vulnerable communities, the lack of mental health and counseling services as well as high levels of homelessness that decrease the well-being of the population.

SBIRT Description

Elements

  • Screening: assessing the population for substance abuse behaviors:
  • Brief intervention: engaging the population in a conversation about health;
  • Referral to treatment: referring the population to treatment;
  • Evidence-based practice for resolving substance abuse;
  • Reducing the dependence of the population on substances.

Note: The SBIRT model is an evidence-based practice framework that identifies, reduces, and prevents the excessive use of substances within a population. It includes screening, brief intervention, and referral to treatment intended to help a population overcome the burden of abusing legal and illegal substances.

Use

  • Identify specific community members with substance abuse;
  • Assessing the barriers preventing healthy behaviors;
  • Proposing solutions for elevating substance abuse burden;
  • Reaching out to community stakeholders for support;
  • An adaptable system to fit community needs.

Note: The SBIRT model is highly flexible and can, therefore, be adjusted to the needs of the particular community. It can facilitate the development of solutions for overcoming the issue of substance abuse while also encouraging support from the community as a whole.

Example

  • Screening community for vulnerable individuals;
  • Identifying harmful and risky behaviors;
  • Implementing short-term interventions to study population’s adherence;
  • Modifying the intervention if necessary;
  • Introducing a system of community support and guidance.

Note: The SBIRT model will identify harmful and risky behaviors, such as alcohol, tobacco, and illicit drug abuse, and integrate an adaptable intervention.

Outcomes

  • Possibility to implement an assessment easily;
  • Adapting the tool to the needs of the specific community;
  • Awareness-raising and motivational support;
  • Addressing barriers in achieving positive health outcomes;
  • Reducing the reliance on substance use.

Note: To overcome the challenges of substance abuse in the community of Miami, the model will encourage the implementation of regular assessments, which will point to the limitations in existing practices.

Community Resources

  • Rehabilitative Services Division in Miami-Dade County;
  • Access through the phone and referrals from the intervention;
  • Screening and assessment services;
  • Outpatient and residential treatments;
  • Correction-based treatments (“Substance abuse treatment programs,” 2020).

Note: The Rehabilitative Services Division in Miami-Dade County provides assessment and treatment services to populations in need. The services can be reached online and through the phone, making them accessible to the general public.

4A’s

  • Affordability: The resources are predominantly free for the community in need;
  • Accessibility: It is easy to access the support resources;
  • Acceptability: The support services accept individuals with substance abuse issues;
  • Availability: The resource is available to the public in need.

Note: The Rehabilitative Services Division in Miami-Dade County fits the 4A’s criteria by being widely available to the public requiring support in overcoming the challenge of substance abuse.

Implications for Practice

  • A tool empowering care providers to identify health barriers;
  • Treating mental health problems contributing to abuse (Hargraves et al., 2017);
  • Pragmatic testing for effective intervention implementation;
  • Sustaining positive practices for health maintenance;
  • Supporting practitioners through evidence-based practice.

Note: With the help of the SBIRT tool, health practitioners identify patients with substance abuse and adverse mental health issues before further complications occur.

Conclusion

  • Need to overcome the substance abuse burden;
  • Create an environment of support for vulnerable communities;
  • Enable interventions intended for enhancing well-being in the community;
  • Address the barriers that prevent the community from reaching health;
  • Overcome the poverty and homelessness challenges.

Note: The community of Miami is challenged by the issue of substance abuse, and the SBIRT tool can be used to overcome the problem before the occurrence of further complications that would be costly to the population.

References

Hargraves, D., White, C., Frederick, R., Cinibulk, M., Peters, M., Young, A., & Elder, N. (2017). Implementing SBIRT (screening, brief intervention and referral to treatment) in primary care: Lessons learned from a multi-practice evaluation portfolio. Public Health Reviews, 38, 1-11.

Murray, K. (2020). The connection between homelessness and addiction.

Substance abuse treatment programs. (2020). Web.

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