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J Subst Abuse Treat. 2016 Jan;60:81-90. doi: 10.1016/j.jsat.2015.06.011. Epub 2015 Jun 26.

SBIRT Implementation for Adolescents in Urban Federally Qualified Health Centers.

Author information

1
Friends Research Institute, Baltimore, MD USA. Electronic address: smitchell@friendsresearch.org.
2
Friends Research Institute, Baltimore, MD USA.
3
Total Health Care, Baltimore, MD USA.
4
Mosaic Group, Baltimore, MD USA.
5
RTI International, Chicago, IL USA.
6
RTI International, Research Triangle Park, NC USA.
7
Yeshiva University, Bronx, NY USA.
8
University of Maryland, College Park, Department of Psychology, College Park, MD USA.
9
Friends Research Institute, Baltimore, MD USA; University of North Carolina at Wilmington, Wilmington, NC USA.

Abstract

BACKGROUND:

Alcohol, tobacco, and other drug use remains highly prevalent among US adolescents and is a threat to their well-being and to the public health. Evidence from clinical trials and meta-analyses supports the effectiveness of Screening, Brief Intervention and Referral to Treatment (SBIRT) for adolescents with substance misuse but primary care providers have been slow to adopt this evidence-based approach. The purpose of this paper is to describe the theoretically informed methodology of an on-going implementation study.

METHODS:

This study protocol is a multi-site, cluster randomized trial (N=7) guided by Proctor's conceptual model of implementation research and comparing two principal approaches to SBIRT delivery within adolescent medicine: Generalist vs. Specialist. In the Generalist Approach, the primary care provider delivers brief intervention (BI) for substance misuse. In the Specialist Approach, BIs are delivered by behavioral health counselors. The study will also examine the effectiveness of integrating HIV risk screening within an SBIRT model. Implementation Strategies employed include: integrated team development of the service delivery model, modifications to the electronic medical record, regular performance feedback and supervision. Implementation outcomes, include: Acceptability, Appropriateness, Adoption, Feasibility, Fidelity, Costs/Cost-Effectiveness, Penetration, and Sustainability.

DISCUSSION:

The study will fill a major gap in scientific knowledge regarding the best SBIRT implementation strategy at a time when SBIRT is poised to be brought to scale under health care reform. It will also provide novel data to inform the expansion of the SBIRT model to address HIV risk behaviors among adolescents. Finally, the study will generate important cost data that offer guidance to policymakers and clinic directors about the adoption of SBIRT in adolescent health care.

KEYWORDS:

Adolescents; Brief intervention; Implementation; Primary care; SBIRT

PMID:
26297321
PMCID:
PMC4548813
DOI:
10.1016/j.jsat.2015.06.011
[Indexed for MEDLINE]
Free PMC Article

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