Implementation of Alcohol Screening and Brief Intervention in a Health System: Sustainability, Fidelity, and Patient Outcomes

Using a theory-driven conceptual framework, this multimethod study examines factors that facilitate or impede the successful implementation and long-term sustainability of screening, brief intervention, and referral to treatment (SBIRT) for risky alcohol use in real-world health care settings. This study will use electronic health record data, qualitative physician and staff interviews, and patient surveys, to examine: 1) What factors predict alcohol SBIRT facility- and clinician-level implementation outcomes (rates of alcohol use screening, brief intervention, follow-up screening and intervention, referral to addiction treatment, specialty alcohol treatment initiation, and SBIRT sustainability); 2) How facility- and clinician-level implementation outcomes affect patient drinking outcomes; and 3) How brief intervention fidelity and quality is related to patient drinking outcomes. Key policy implications include improving health plan structures that facilitate alcohol SBIRT implementation and SBIRT best practices and sustainability.

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