TY - JOUR
T1 - Implementing SBIRT for adolescents within community mental health organizations
T2 - A mixed methods study
AU - Stanhope, Victoria
AU - Manuel, Jennifer I.
AU - Jessell, Lauren
AU - Halliday, Teresa M.
N1 - Funding Information:
Some organizations worked with community partners such as schools to provide SBIRT in non-traditional settings, but due to the setting Medicaid reimbursement was denied. Delays in implementation occurred as organizations worked to identify the correct billing codes, prompting requests for TA in this area. Overall there were concerns about the impact of Medicaid cuts, which several states experienced during the implementation, specifically the defunding of Health Homes, which was one strategy for securing funds for SBIRT. However, by the end of the study 25 of the 27 organizations reported securing Medicaid funding for SBIRT, with some organizations also securing funding from state block grants.
Publisher Copyright:
© 2018
PY - 2018/7
Y1 - 2018/7
N2 - Objective: Many adolescents with substance use problems remain untreated, leading to increased risk for the development of substance use disorders. One response is Screening, Brief Intervention, and Referral to Treatment (SBIRT)—an evidence-based, early intervention that can be tailored for adolescents. This mixed methods study examined the implementation of SBIRT across 27 community mental health organizations (CMHOs) serving adolescents. Methods: Organizations completed surveys on the adoption of SBIRT and implementation barriers during the study period. Quantitative data were analyzed to examine the frequency of screening, brief intervention, and referrals. Qualitative data were coded using an iterative process that focused on barriers categorized according to the Conceptual Framework for Implementation Research (CFIR) constructs. Results: A total of 2873 adolescents were screened for alcohol and drug use with 1517 (52.8%) receiving a positive drug or alcohol screen. Positive screens that received brief intervention (BI)/referral to treatment (RT) had a significantly greater mean drug score and overall scores at baseline. The most salient implementation barriers were adaptability and complexity of SBIRT, policies related to funding and licensing, staff turnover, and implementation climate. Discussion: Nearly half of the adolescents scored positive for problematic substance use demonstrating the unmet need among this population. Future implementation efforts should focus on coordinating program demands, securing funding, integrating SBIRT into clinical workflows, retaining staff, and improving referral to treatment processes.
AB - Objective: Many adolescents with substance use problems remain untreated, leading to increased risk for the development of substance use disorders. One response is Screening, Brief Intervention, and Referral to Treatment (SBIRT)—an evidence-based, early intervention that can be tailored for adolescents. This mixed methods study examined the implementation of SBIRT across 27 community mental health organizations (CMHOs) serving adolescents. Methods: Organizations completed surveys on the adoption of SBIRT and implementation barriers during the study period. Quantitative data were analyzed to examine the frequency of screening, brief intervention, and referrals. Qualitative data were coded using an iterative process that focused on barriers categorized according to the Conceptual Framework for Implementation Research (CFIR) constructs. Results: A total of 2873 adolescents were screened for alcohol and drug use with 1517 (52.8%) receiving a positive drug or alcohol screen. Positive screens that received brief intervention (BI)/referral to treatment (RT) had a significantly greater mean drug score and overall scores at baseline. The most salient implementation barriers were adaptability and complexity of SBIRT, policies related to funding and licensing, staff turnover, and implementation climate. Discussion: Nearly half of the adolescents scored positive for problematic substance use demonstrating the unmet need among this population. Future implementation efforts should focus on coordinating program demands, securing funding, integrating SBIRT into clinical workflows, retaining staff, and improving referral to treatment processes.
KW - Adolescents
KW - Brief intervention
KW - Implementation
KW - Integrated health
KW - Prevention
KW - SBIRT
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U2 - 10.1016/j.jsat.2018.04.009
DO - 10.1016/j.jsat.2018.04.009
M3 - Article
C2 - 29866382
AN - SCOPUS:85046168315
VL - 90
SP - 38
EP - 46
JO - Journal of Substance Abuse Treatment
JF - Journal of Substance Abuse Treatment
SN - 0740-5472
ER -