Cited by 135Health Policy Implementation ScienceSubstance Abuse Treatment and OutcomesOpioid Use Disorder Treatment

Screening, brief intervention and referral to treatment (SBIRT): implementation barriers, facilitators and model migration

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Vendetti, Janice, Gmyrek, Amanda, Damon, Donna, Singh, Manu, McRee, Bonnie, Del Boca, Frances·2017·Addiction

Abstract

Aims: To identify barriers and facilitators associated with initial implementation of a US alcohol and other substance use Screening, Brief Intervention, and Referral to Treatment (SBIRT) grant program, and to identify modifications in program design that addressed implementation challenges. Design: A mixed‐method approach used quantitative and qualitative data, including SBIRT provider ratings of implementation barriers and facilitators, staff interview responses and program documentation. Setting: Multiple sites within the first seven programs funded in a national demonstration program in the United States. Participants: One hundred and two SBIRT providers were surveyed; 221 SBIRT stakeholders and staff were interviewed. Measurements: Mean ratings of barriers and facilitators were calculated using provider survey responses. An inductive content analysis of interview responses identified factors perceived to support and challenge implementation; program modifications that occurred over time were recorded. Findings: Providers rated pre‐selected implementation facilitators higher than barriers. Content analysis of interview responses revealed six themes: committed leaders; intra‐ and inter‐organizational communication/collaboration; provider buy‐in and model acceptance; contextual factors; quality assurance; and grant requirements. Over time, programs tended to: adopt more efficient ‘pre‐screen’ item sets; screen for risk factors in addition to alcohol/substance use; use contracted specialists to deliver SBIRT services; conduct services in high‐volume emergency department and trauma center settings; and implement on‐site and telephonic treatment delivery. Conclusions: Screening, Brief Intervention and Referral to Treatment program implementation in the United States is facilitated by committed leadership and the use of substance use specialists, rather than medical generalists, to deliver services. Many implementation challenges can be addressed by an adequate start‐up phase focused on comprehensive education and training, and on the development of intra‐ and inter‐organizational communication and collaboration; opinion leader support; and practitioner and host site buy‐in.

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  1. Whitlock E. P., Orleans T., Pender N., Allan J. Evaluating primary care behavioral counseling interventions. Am J Prev Med 2002; 22: 267-84.

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Authors
Vendetti, J., Gmyrek, A., Damon, D., Singh, M., McRee, B., & Del Boca, F.
Affiliations
  • UConn Health (US)
  • JBS International (United States) (US)
  • Department of Community Medicine and Health Care UConn Health, School of Medicine Farmington CT USA
Corresponding author
Vendetti, Janice
Venue
Addiction
Publisher
Wiley
Published
2017-01-10
Volume
112
Issue
S2
Pages
23-33
ISSN
  • 0965-2140 (ISSN-L)
  • 1360-0443
OpenAlex
W2573541319
Cited by
135
References
37
Citations by year
2026: 6 · 2025: 9 · 2024: 19 · 2023: 9 · 2022: 17 · 2021: 24 · 2020: 16 · 2019: 16 · 2018: 6 · 2017: 12
FWCI
22.16
Type
journal article
Language
en
Open access
Locations
  • Addiction (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • U.S. Department of Health and Human Services
  • Substance Abuse and Mental Health Services Administration
  • Center for Substance Abuse Treatment
Topics
  • Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
  • Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
Keywords
SBIRT, implementation barriers and facilitators, model migration, alcohol screening, substance use screening, emergency department, trauma centers, leadership, quality assurance
MeSH terms
Attitude of Health Personnel, Emergency Service, Hospital, Humans, Mass Screening, Referral and Consultation, United States, Substance-Related Disorders, Qualitative Research, Motivational Interviewing

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