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Project START

What is Project START?

The goals of Project START (an acronym for “Screening To Augment Referral and Treatment”) were to determine if certain referral and support strategies were more useful and successful than other types to decrease alcohol, tobacco and drug abuse, and enhance addictions treatment utilization. It was a randomized controlled trial (RCT) that compared both provider-led and computer-administered standardized screening, brief interventions, and referral to treatment (SBIRTs) approaches, as well as usual care treatment, in a reproductive health setting for pregnant and non-pregnant women who abused a range of hazardous substances.


Both the electronic-delivered and the clinician-delivered SBIRT significantly decreased days of primary substance use among women in reproductive healthcare centers compared to usual care. However, neither led to more treatment use than the enhanced usual care.


  • Martino S, Ondersma S, Forray A, Olmstead T, Gilstad-Hayden K, Howell H, Kershaw T, Yonkers KA. Randomized controlled trial of screening and brief interventions for substance misuse in reproductive health. American Journal of Obstetrics & Gynecology. 2017;218(3):322.e1-.e12.
  • Loree A, Gariepy A, Prah Ruger J, Yonkers KA. Postpartum contraceptive use and rapid repeat pregnancy among women who use substances. Substance Use and Misuse. 2018; Vol 53(1): 162-169. PMID: 28937912.

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