Feasibility and Acceptability of Integrating Digital Screening and Brief Intervention for Substance Use into Home Visiting: Lessons Learned from a Pilot Study

PURPOSE: Perinatal substance use (SU) often goes unaddressed due to stigma and lack of access to treatment. Home visiting (HV) is a promising venue for integrating brief interventions to address perinatal SU. We evaluated a digital screening and brief intervention for SU that is tailored to the HV context (e-SBI-HV). MATERIALS AND METHODS: The e-SBI-HV includes two digital sessions completed confidentially by clients plus home visitor facilitation protocols to promote e-SBI-HV integration into HV. The e-SBI-HV was pilot tested in New Jersey with 20 home visitors and 10 clients. A mixed-methods approach assessed recruitment and implementation feasibility, and program acceptability. RESULTS: Eighty-five clients were referred and 14 enrolled over 2 years. e-SBI-HV completion rates were 90% for digital Session 1, 70% for Session 2, and 72.5% for the facilitation protocols. Average acceptability ratings were 4.03/5.00 for Session 1 and 3.93/5.00 for Session 2. Qualitative interviews with home visitors and clients revealed implementation facilitators and barriers. DISCUSSION: Within the small sample that enrolled, feasibility and acceptability of the e-SBI-HV was supported. However, there were significant challenges reaching the target population. Qualitative interviews provided important feedback for refining the e-SBI-HV to improve reach within the HV setting, including the need for a prevention-oriented focus. CONCLUSION: While findings support the preliminary feasibility and acceptability of the e-SBI-HV, further research with a larger sample is needed to overcome significant implementation barriers and challenges identified in this study.