Clinicians expressed concerns about competing priorities and the need for organizational leadership involvement for successful SBIRT implementation. A unique suggestion for successful implementation is to utilize existing primary care clinic-based psychologists to conduct brief intervention and facilitate referral to treatment. Patient stakeholders supported universal screening, but cultural differences in opinions and current experience were noted, indicating the importance of including this perspective when evaluating implementation potential.

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Background/Aims: Programs to translate the Diabetes Prevention Program (DPP) into effective real-life interventions are needed. In the Call-2-Health pilot study we designed and tested a telephone-based intervention modeled on the DPP. Here we present the impact of Call-2-Health on participants' report of support from friends and family for diet changes. Social support may be critical to long-term maintenance of behavioral changes. Methods: Between September 2010 and January 2011, we mailed recruitment letters to 438 overweight English-speaking non-diabetic Group Health members aged 45-74 for whom electronic health records indicated at least one elevated blood glucose or HbA1c. We followed up with phone screening and laboratory tests to confirm eligibility and willingness to participate. Eligible and consenting participants (N=47; 49% men) were randomly assigned 1:1 to usual care (UC) and intervention groups (IG) for the 24-week study. The IG received 12 weekly intervention calls plus 4 maintenance calls over the subsequent 12 weeks. The interventionist delivered a DPP-based curriculum, using motivational interviewing and behavioral techniques to encourage exercise, dietary change, and weight loss. Three UC participants failed to complete the study; IG participants completed 95% of intervention calls. Study questionnaires included the Sallis Social Support scale for eating, completed at baseline and 24 weeks. Results: At baseline, the UC group had mean scores (95%CI) of 10.82 (7.93, 13.70) on the family and 8.55 (6.43, 10.66) on the friend diet encouragement scales. Mean scores for the IG were comparable, at 10.58 (8.09, 13.08) and 7.17 (6.03, 8.30). At 24 weeks, the measures remained essentially unchanged for UC and increased by 3.71 (1.56, 5.86) (p=0.016) and 3.46 (1.93, 4.99) (p=0.003) for the IG. At 24 weeks the mean weight lost for the IG was 8.6% of baseline weight (5.6, 11.5) as compared to 1.5% (-0.8, 3.9) for UC. Intervention participants' weight loss and their reported increase in dietary support were highly correlated (family r=0.70, friends r=0.64). Discussion: As compared to the usual care group, participants in the Call-2-Health phone intervention reported at 24 weeks a significant increase in supportive behaviors from friends and family regarding dietary change, with increases in support correlating strongly with weight loss success.

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