Sustaining Screening, Brief Intervention and Referral to Treatment (SBIRT) services in health‐care settings

Singh, Manu; Gmyrek, Amanda; Hernandez, Amy; Damon, Donna; Hayashi, Susan

doi:10.1111/add.13654

Cited by 52Substance Abuse Treatment and OutcomesHealth Policy Implementation ScienceSmoking Behavior and Cessation

Sustaining Screening, Brief Intervention and Referral to Treatment (SBIRT) services in health‐care settings

Singh, Manu, Gmyrek, Amanda, Hernandez, Amy, Damon, Donna, Hayashi, Susan·2017·Addiction

DOI 10.1111/add.13654

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Abstract

Aims: To assess the sustainability of Screening, Brief Intervention and Referral to Treatment (SBIRT) services after cessation of initial start‐up funding. Design: Descriptive study with quantitative and qualitative data collected from 34 staff participants from six grantees (comprising 103 sites) funded previously through a large, federally supported SBIRT program. Setting: Primary care out‐patient clinics and hospitals in the United States. Participants: Thirty‐four grantee‐related staff members, including administrators, evaluators, key stakeholders and SBIRT service providers from six grantees. Measurements: Changes to levels and types of service delivery activities after federal funding stopped, alternative sources of funding and obstacles to delivery of services. Findings: Of the 103 original sites in the six SBIRT grantee programs, 69 sites continued providing services in some capacity (same as before, reduced, modified or expanded). Most of the 69 sites (67%) adapted and redesigned the delivery of SBIRT services post‐initial grant funding. In addition, new sites were added after grant funding ended, bringing the total number of sites to 88. Analysis of participant responses identified four primary factors that influenced SBIRT sustainability: presence of champions, funding availability, systemic change and SBIRT practitioner characteristics. Conclusions: Almost 70% of the Screening, Brief Intervention and Referral to Treatment (SBIRT) services in the United States funded initially through a federal program were able to sustain operations after federal funding ceased and some expanded SBIRT services beyond the original sites. The key factors related to sustainability were securing new funding, having champions, adapting and making system changes and managing program staffing challenges.

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Adaptation is fairly common and often necessary.
“What is currently known, though, is that although high fidelity has been associated with positive program outcomes (34), adaptation is fairly common (3, 86, 125, 150) and often necessary.”
From The Sustainability of Evidence-Based Interventions and Practices in Public Health and Health Care (2018) · cites this paper as [125]
Many sustainability studies in clinical/health care and mental health settings suggest that funding, organizational factors and support, and practitioner/workforce characteristics are particularly influential.
“Consistent with organizational contexts in community settings (e.g., schools), many of these studies, particularly those in clinics or hospitals, suggest that funding, organizational factors and support (e.g., champions, supervision), and practitioner/workforce characteristics (e.g., turnover) are particularly influential (13, 98, 125).”
From The Sustainability of Evidence-Based Interventions and Practices in Public Health and Health Care (2018) · cites this paper as [125]
All six of the cohort 1 SBIRT programs studied were still operational at the time of interview, 6 to 18 months after funding ended.
“All six remained operational at the time interviews were conducted, 6-18 months post-funding.”
From Screening, Brief Intervention and Referral to Treatment: implications of SAMHSA's SBIRT initiative for substance abuse policy and practice (2017) · cites this paper as [32]
Programs that sustained services made adaptations to SBIRT components, modified SBIRT protocols, drew on multiple funding sources, and worked to maximize facilitators and overcome barriers in order to develop new SBIRT models that fit their needs and could be supported.
“To sustain services, successful programs made a range of adaptations to SBIRT components, modified SBIRT protocols, accessed multiple funding sources and worked to maximize facilitators and overcome barriers to develop new SBIRT models that met their needs and could be supported.”
From Screening, Brief Intervention and Referral to Treatment: implications of SAMHSA's SBIRT initiative for substance abuse policy and practice (2017) · cites this paper as [32]
Of the original SBIRT performance sites, 69 (67%) adapted and redesigned their SBIRT service delivery after the initial grant funding ended.
“Sixty-nine (67%) of the original performance sites adapted and redesigned SBIRT service delivery after initial grant funding ended.”
From Screening, Brief Intervention and Referral to Treatment: implications of SAMHSA's SBIRT initiative for substance abuse policy and practice (2017) · cites this paper as [32]

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Can an Infusion of Federal Funds Result in Sustainable Projects? An Evaluation of Suicide Prevention Programs
Apsler, R., Formica, S. W., Stout, E. R., & Carr, C. M. (2017) · The Journal of Primary Prevention · doi:10.1007/s10935-017-0489-0 · Cited by 18 · see citing works

Authors: Singh, M., Gmyrek, A., Hernandez, A., Damon, D., & Hayashi, S.
Affiliations: JBS International (United States) (US)
RTI International (US)
UConn Health (US)
Corresponding author: Singh, Manu
ORCID: Singh, Manu
Venue: Addiction
Publisher: Wiley
Published: 2017-01-10
Volume: 112
Issue: S2
Pages: 92-100
ISSN: 0965-2140 (ISSN-L)
1360-0443
DOI: 10.1111/add.13654
OpenAlex: W2579597442
Cited by: 52
References: 16
Citations by year: 2026: 1 · 2025: 6 · 2024: 3 · 2023: 2 · 2022: 6 · 2021: 9 · 2020: 6 · 2019: 5 · 2018: 3 · 2017: 10
FWCI: 5.14
Type: journal article
Language: en
Open access: closed
Licence: onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations: Addiction (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
Keywords: SBIRT, program sustainability, substance use disorder screening, primary care, hospital services, funding sources, champions, systemic change, program adaptation, program staffing
MeSH terms: Emergency Service, Hospital, Humans, Mass Screening, Outpatient Clinics, Hospital, Primary Health Care, Referral and Consultation, United States, Program Evaluation, Substance-Related Disorders, Motivational Interviewing

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Sustaining Screening, Brief Intervention and Referral to Treatment (SBIRT) services in health‐care settings

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