Substance involvement screening test (assist) symposium

Abstract

WHO ASSIST project: Background, history and recent developments WHO ASSIST was developed in response to the overwhelming public health burden associated with psychoactive substance use worldwide. The overall objective of the project is to increase the capacity of health systems and health professionals to prevent and reduce health burden attributable to psychoactive substance use by promoting screening, brief interventions and referral procedures in health care settings. The tool has evolved from its initial 12 items to the current (V3.0 and V3.1) 8 item version. The instrument screens for health risks and problems associated with any psychoactive substance use and it is designed to assess lifetime and current (past 3 months) use of a wide range of psychoactive substances and related risk. The WHO ASSIST, mainly to be used in Primary Health Care settings, has undergone in 3 sequential phases (I, II and III) signifi cant testing to ensure that it is feasible, reliable, valid, fl exible, comprehensive and crossculturally relevant, and able to be linked to brief interventions. Phase I (1997–1999); ASSIST development and International Feasibility and Reliability Study; Phase II (2000–2002); International Validity Study and Feasibility Study of Brief Interventions Linked to ASSIST; and Phase III (2003–2008): Development and testing of WHO ASSIST manuals and International study of effectiveness of brief interventions linked to ASSIST (Randomised Controlled Trial). In Phase III, an international RCT evaluating effectiveness of brief interventions linked to the screening with the WHO ASSIST for illicit drugs (cannabis, cocaine, Cocaine-type stimulants, opiods) was carried out in several participating sites (Australia, Brazil, India, USA) resulting in signifi cant reduction in drug use following ASSISTbased interventions, including signifi cant reduction in cannabis and stimulant (ATS and cocaine) use. In 2009 the WHO ASSIST project entered its Phase IV aimed at the implementation of the ASSIST-linked brief interventions in Primary Health Care and other settings. ASSIST dissemination and implementation ASSIST was developed in response to overwhelming burden of disease related to substance use. It is a reliable, valid, flexible and culturally neutral screening instrument which provides risk scores for each substance which are linked to brief intervention. The ASSIST is ready to be disseminated in health care systems after rigorous scientifi c testing. Diffusion of Innovation (Rogers 1971) draws on behavioural change and organisational theory and has implications on dissemination and diffusion of valuable innovations as ASSIST. The Diffusion of Innovation highlights the key factors that infl uence the process of diffusion. These factors include the innovation itself, the individual diffuser’s categories (Innovators, early adopters, early majority of adopters, late majority adopters and laggards), the organisation into which it is introduced and the broader environment where the innovation will be put into practice. These factors and the interplay between them determine potential enablers and disablers of adoption and behaviour change. Dissemination and implementation of the ASSIST requires focusing on the utility of the ASSIST and an analysis of the instrument’s role as an early intervention agent. Identifying barriers to uptake and different modes of administration will be a focus of this presentation. ASSIST Asia Pacifi c Roll Out Screening and Brief Intervention for psychoactive substance use with the ASSIST linked to Brief Interventions is a simple approach to identify and intervene at an early stage. The South East Asian and the Pacifi c countries belong to a region with escalating problems due to psychoactive substance use. WHO collabo rating centre at University of Adelaide has played a central role in advocacy of the ASSIST in the region. Wider dissemination and implementation of ASSIST linked to Brief Intervention (BI) entail fo...