SBIRT Implementation for Adolescents in Urban Federally Qualified Health Centers

Shannon Gwin Mitchell, Robert P. Schwartz, Arethusa S. Kirk, Kristi Dusek, Marla Oros, Colleen Hosler, Jan Gryczynski, Carolina Barbosa, Laura Dunlap, David W. Lounsbury, Kevin E. O'Grady, Barry S. Brown

Research output: Contribution to journalArticle

15 Citations (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)81-90
Number of pages10
JournalJournal of Substance Abuse Treatment
Volume60
DOIs
StatePublished - Jan 1 2016

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Referral and Consultation
Health
Therapeutics
Primary Health Care
HIV
Adolescent Medicine
Costs and Cost Analysis
Health Care Reform
Electronic Health Records
Risk-Taking
Tobacco
Cost-Benefit Analysis
Meta-Analysis
Public Health
Alcohols
Clinical Trials
Delivery of Health Care
Research
Pharmaceutical Preparations

Keywords

  • Adolescents
  • Brief intervention
  • Implementation
  • Primary care
  • SBIRT

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Clinical Psychology
  • Phychiatric Mental Health
  • Medicine (miscellaneous)

Cite this

Mitchell, S. G., Schwartz, R. P., Kirk, A. S., Dusek, K., Oros, M., Hosler, C., ... Brown, B. S. (2016). SBIRT Implementation for Adolescents in Urban Federally Qualified Health Centers. Journal of Substance Abuse Treatment, 60, 81-90. https://doi.org/10.1016/j.jsat.2015.06.011

SBIRT Implementation for Adolescents in Urban Federally Qualified Health Centers. / Mitchell, Shannon Gwin; Schwartz, Robert P.; Kirk, Arethusa S.; Dusek, Kristi; Oros, Marla; Hosler, Colleen; Gryczynski, Jan; Barbosa, Carolina; Dunlap, Laura; Lounsbury, David W.; O'Grady, Kevin E.; Brown, Barry S.

In: Journal of Substance Abuse Treatment, Vol. 60, 01.01.2016, p. 81-90.

Research output: Contribution to journalArticle

Mitchell, SG, Schwartz, RP, Kirk, AS, Dusek, K, Oros, M, Hosler, C, Gryczynski, J, Barbosa, C, Dunlap, L, Lounsbury, DW, O'Grady, KE & Brown, BS 2016, 'SBIRT Implementation for Adolescents in Urban Federally Qualified Health Centers', Journal of Substance Abuse Treatment, vol. 60, pp. 81-90. https://doi.org/10.1016/j.jsat.2015.06.011
Mitchell, Shannon Gwin ; Schwartz, Robert P. ; Kirk, Arethusa S. ; Dusek, Kristi ; Oros, Marla ; Hosler, Colleen ; Gryczynski, Jan ; Barbosa, Carolina ; Dunlap, Laura ; Lounsbury, David W. ; O'Grady, Kevin E. ; Brown, Barry S. / SBIRT Implementation for Adolescents in Urban Federally Qualified Health Centers. In: Journal of Substance Abuse Treatment. 2016 ; Vol. 60. pp. 81-90.
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