**Oregon Health & Sciences University SBIRT Primary Care Residency Initiative**

**Program Description**

Oregon Health & Sciences University is partnering with the Northwest Frontier ATTC and RMC Research Corporation to create, disseminate, and evaluate a new curriculum promoting substance abuse SBIRT practices in primary care. Along with the curriculum, we will incorporate systems changes in the residency clinics to facilitate carrying out of SBIRT practices.

Our project's main locations include: OHSU Family Medicine, Richmond clinic, South Waterfront clinic, and Gabriel Park clinic; OHSU Internal Medicine: Internal medicine clinic; OHSU Cascades East Rural Family Medicine: Cascades East clinic; and Providence Milwaukie Hospital Family Medicine Residency: Milwaukee clinic, Southeast Portland clinic.

Five residencies including seven primary care clinics will participate in this training grant that will directly impact more than 400 family, preventive, and internal medicine residents. This represents a significant proportion of the future primary care workforce in Oregon, including rural areas.Program Model

Role play exercises during didactic sessions, online curriculum, follow-up mentoring, and demonstration patient models will provide opportunities for "hands-on" training in screening, identification, brief intervention, and referral to treatment.

Our screening tools and methodologies consist of three steps:

· Step 1: All patients will complete a pre-screen questionnaire. Patients who are positive will receive the AUDIT and/or DAST screening tool.

· Step 2: Brief interventions will be carried out by the PCP to find ways to reduce risk for those with moderate risk, and to counsel referral for brief treatment for those with high risk. Those patients who are already dependent on drugs or alcohol will be referred for more intensive specialist services.

· Step 3: Patients will be asked to make a follow-up appointment with their PCP in order to gauge success of the brief intervention. 

**Service Features**

Our evaluation plan focuses on the following individuals: residents, physician clinic champions, nurse clinic champions, residency directors, and curriculum development team. The surveys we will employ include a Post-Training and Follow-up Training Satisfaction Surveys, Pre and Post-Training Knowledge Test, Brief Intervention Adherence & Competence Scale, Attitude and Behavior Survey, Clinical Exit Questionnaires, Clinical Supervision Survey, Client Chart Reviews, and Focus Groups.

Expected outcomes:

· Greater than 75% of new patients presenting to resident's clinics will be screened for problem alcohol and drug use.

· Greater than 75% of existing patients presenting at resident's clinics will be reassessed annually.

· Greater than 75% of patients presenting to resident's clinics identified as intermediate risk will receive brief-intervention.

· Greater than 75% of patients presenting to resident's clinics identified as having a substance abuse problem will receive brief-intervention and either brief treatment or physician follow-up if appropiate.

· Greater than 75% of patients presenting to resident's clinics identified as having a substance abuse dependence will be referred to treatment. 

We have also collaborated with officials from the Oregon Department of Addictions and Mental Health, who have provided expertise in regards to clinical reimbursement for SBIRT practices. This agency also publishes a resources guide listing alcohol and drug treatment centers in Oregon.

Our curriculum will cover sufficient numbers of residents that over time, a large proportion of primary care physicians in Oregon will have undergone the curriculum. Additionally, we will present an abbreviated version of the curriculum at two state forums popular among primary care clinicians. The first is the Scientific Assembly of the Oregon Academy of Family Physicians held annually in May. Our first presentation there will be in 2010 and we will request repeating the seminar in 2012. Similarly, the Oregon Health & Sciences University Family Practice Review course is held every February in Portland, Oregon.

**Contact Info**

Oregon Health and Science University, Portland, OregonSBIRT Primary Care Residency InitiativeWebsite: http://www.sbirtoregon.org  INCLUDEPICTURE "\\\\jbsweb2\\sbirtweb\\images\\extlink.gif" \* MERGEFORMATINET 

John Muench, MD, MPHOHSU Family Medicine-FMOHSU School of Medicine3181 SW Sam Jackson Park RoadPortland, OR 97239-3098Phone: (503) 494-3437Fax: (503) 494-7659muenchj@ohsu.edu

Project Director: Jim Winkle, MPHOHSU Family Medicine-FMOHSU School of Medicine3181 SW Sam Jackson Park RoadPortland, OR 97239-3098Phone: 503-494-1632Fax: (503) 494-7659winklej@ohsu.edu

Evaluator: Kelly Vander LeyRMC Research Corporation111 SW Columbia StreetPortland, OR 97201-5843Phone: (503) 552-5726Fax: (503) 223-8399kvanderley@rmccorp.com

Evaluator: Kelly JarvisRMC Research CorporationPhone: (503) 223-8248 x719Fax: (503) 223-8399KJarvis@rmccorp.com