Implementing SBIRT for adolescents within community mental health organizations: A mixed methods study

Abstract

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.

Implementation science in adolescent healthcare research: an integrative review

“…Determine which processes relate to initial implementation outcomes 3. Utilise qualitative data to provide insights into the dynamic implementation processes that may underlie clinics' implementation behaviours as measured by the SIC 26 NYC school based mental health clinic sites which provide co-located school based mental health services Therapists/social workers/psychiatrist (essentially all clinicians) working in school based mental health clinics Radovic, 2019, USA [ 16 ] Mental health Two paediatric community practices Pre-implementation Mixed methods study—survey (quantitative) and focus groups Develop and investigate potential implementation strategies for the introduction of Supporting Our Valued Adolescents (SOVA) web-based technology in 2 primary care settings with the goal of translating to more effective implementation in the future 14 PCP PCPs in community practices who see/treat adolescents with depression and/or anxiety Shafran et al, 2020, UK [ 27 ] Mental health, epilepsy Child health epilepsy services Pre-implementation; implementation; post-implementation Qualitative To optimise MATCH-ADTC for use in children and young people with mental health needs in the context of epilepsy within routine epilepsy services, using implementation science methods 6 focus groups (FGs) of children and young people with epilepsy who had received treatment for epilepsy and 10 parents/carers 6 FGs of health professionals working in epilepsy services PDSA cycles with 12 patients receiving the version of the MATCH-ADTC intervention 8 parents participated in the qualitative interviews Parents and children and young people with epilepsy Health clinicians Stanhope et al, 2018, USA [ 17 ] Treatment of substance use disorders 27 community mental health organizations (CMHOs) in 6 states Post implementation, implementation monitoring Mixed methods 1) Describe the implementation of SBIRT within CMHOs; and 2) understand the self-reported barriers to implementing SBIRT and when these barriers occurred in the implementation process 2873 adolescents screened, 55.1% female, average age 16.6 years (SD = 1.61).15–22 Staff of the community mental health services Snider, 2016, Canada [ 23 ] Vio...…”

“…Recommendations and actions to improve the adaptability of interventions included modifying and streamlining processes to suit work practices [ 21 ], developing workarounds for technical issues [ 17 ], personalising interventions for the individual and context [ 27 ], and adapting how interventions were introduced to healthcare professionals [ 16 ]. Barriers to adaptability [ 16 – 20 , 24 ] related to difficulties in tailoring interventions to suit populations, contexts, and workflows [ 17 – 19 , 24 ], in training staff across broad services [ 20 ], in integrating technologies (e.g. with electronic medical records, mobile applications) [ 16 , 17 ] and confidentiality concerns [ 17 ].…”

“…Barriers to adaptability [ 16 – 20 , 24 ] related to difficulties in tailoring interventions to suit populations, contexts, and workflows [ 17 – 19 , 24 ], in training staff across broad services [ 20 ], in integrating technologies (e.g. with electronic medical records, mobile applications) [ 16 , 17 ] and confidentiality concerns [ 17 ].…”

Addressing Barriers to Primary Care Screening and Referral to Prevention for Youth Risky Health Behaviors: Evidence Regarding Potential Cost-Savings and Provider Concerns

“…The Consolidated Framework for Implementation Research (CFIR; Damschroder et al, 2009;Stanhope et al, 2018) guided our study foci because its domains span economic factors and provider readiness within a broad context of factors that are germane to SRP implementation, including factors that are external to providers' workplaces (outer setting), factors within providers' workplaces (inner setting), and characteristics of the providers themselves (Fig. 1).…”

Integration of the Screening, Brief Intervention, and Referral to Treatment Screening Instrument Into School Nurse Practice

“…Several assessment processes have been applied to assess substance use in the high school student population, including the Screening, Brief Intervention, and Referral to Treatment (SBIRT) for adolescents (Levey, 2015). The American Academy of Pediatrics has endorsed the use of the SBIRT process as a method to screen (S) for individuals at risk in developing SUD and, if warranted, initiate a brief intervention (BI) which may include referral to treatment (RT) with a mental health provider or the initiation of a substance rehabilitation plan (Stanhope et al, 2018).…”