ArticleBMC health services research2024
Improving screening, brief intervention and referral to treatment for unhealthy alcohol use in diverse, low-resourced primary care clinics.
Article in BMC health services research, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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The trial behind it
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Who cites it
7 citing papers in PubMed.
- Mechanisms of practice facilitation identified using system dynamics diagramming in a tailored implementation study of unhealthy alcohol screening and treatment in primary care.Implementation science communications · 2026Article
- Tailoring implementation strategies to primary care clinic contexts through practice facilitation: lessons learned from the ANTECEDENT study.Implementation science communications · 2026Article
- Alcohol use-related problems in general hospitals and primary care settings: Screening, intervention, and referral to treatment.World journal of psychiatry · 2025Review
- Trajectories and strategies in implementing screening, brief intervention, and referral to treatment for substance use in primary care within public hospitals: a longitudinal qualitative study.Implementation science communications · 2025Article
- Challenges using electronic health records to support unhealthy alcohol use screening and intervention in primary care practices in the Pacific Northwest.Journal of the American Medical Informatics Association : JAMIA · 2025Article
- Goal alignment and unintended consequences of accountable care: How the structure of Oregon's Medicaid coordinated care model shapes health plan-clinic partnerships.Journal of clinical and translational science · 2025Article
- A Behind-the-Scenes Look at Practice Facilitation to Improve Delivery of Unhealthy Alcohol Use Screening and Management Services in Primary Care: A Qualitative Study.Journal of primary care & community healthArticle
Corrections and comments
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Authors and funding
12 authors.
Funding
Abstract
backgroundImplementation of screening brief intervention and referral to treatment (SBIRT) and medication-assisted treatment for alcohol use disorder (MAUD) remains low in primary care. ANTECEDENT (Partnerships to Enhance Alcohol Screening, Treatment, and Intervention) was a practice-facilitator led implementation study to increase SBIRT and MAUD use in diverse primary care clinics.
methodsFrom November 2019 - April 2023, we conducted a convergent parallel mixed methods evaluation. Participants were small and medium-sized primary care clinics in the Northwestern U.S. Clinics received foundational support (i.e., baseline/exit assessment, access to SBIRT Oregon website) and the option for supplemental implementation support (e.g., practice facilitation, expert consultation) over the 15-month intervention to improve SBIRT and MAUD. Qualitative and quantitative data regarding clinic characteristics, implementation strategies, and SBIRT/MAUD outcomes were collected through practice facilitator interviews, periodic reflections and clinic contact logs, interviews, pre-post surveys, and electronic health record (EHR) queries. Quantitative analyses included descriptive statistics, logistic regression, and the Wilcoxon sign-ranked test. Qualitative analysis took an immersion crystallization approach. Data were reviewed in a matrix to evaluate intervention adoption, implementation, and effectiveness.
resultsWe recruited 75 unique clinics; 66 participated and 48 (73%) completed the study. Eight participating clinics chose to receive foundational support only (12%) while 58 chose to engage in supplemental support (88%) activities. Clinics that received supplemental support and completed the intervention (n = 42) engaged in practice facilitation (Mean: 293 min, range: 75-550 min); data review (38%), HIT support (31%), expert consultation (19%), and peer-to-peer learning (5%). Pre- and post-intervention assessments showed significant improvement in self-reported SBIRT process outcomes. Performance data improved among the subset of completing clinics able to produce data (n = 17). Clinics described positive experiences with ANTECEDENT support and highlighted remaining barriers to SBIRT and MAUD implementation.
conclusionsParticipating clinics engaged in a diverse range of supportive activities. A flexible approach using practice facilitation and implementation support could be helpful for low-resourced primary care clinics in improving SBIRT and MAUD for unhealthy alcohol use.
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