Clinical trial NCT01829308: SBIRT Implementation for Adolescents in Urban Federally Qualified Health Centers
Official title: SBIRT Implementation for Adolescents in Urban Federally Qualified Health Centers
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Alcohol-induced Disorders
Drug Users
Tobacco Use Disorder
Keywords: implementation
SBIRT
alcohol screening
drug screening
Brief Intervention
Referral to Treatment
adolescents
Federally Qualified Health Centers
Lead sponsor: Friends Research Institute, Inc.
Sponsor class: OTHER
Collaborators: name: RTI International
name: National Institute on Drug Abuse (NIDA)
First posted: 2013-04-11
Enrollment: 98
Sex: ALL
Minimum age (years): 18
Maximum age (years): 99
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: HEALTH_SERVICES_RESEARCH

Brief summary: The purpose of this study is to examine the implementation of two evidence-based intervention strategies of SBIRT (Generalist vs. Specialist) for adolescent alcohol, tobacco, other drug use, and HIV risk behaviors.

Detailed description: Guided by Proctor's conceptual model of implementation research, the proposed study is a multi-site, cluster randomized trial to compare two principal strategies of SBIRT delivery within adolescent medicine. In the Generalist Strategy, the primary care provider delivers brief intervention (BI) for substance misuse. In the Specialist Strategy, BIs are delivered by behavioral health counselors. The 7 study sites, primary care clinics operated by a large, urban Federally Qualified Health Center in Baltimore, will be randomly assigned to implement SBIRT for adolescents using either the Generalist or Specialist strategies. Staff at each site will be trained in the assigned implementation strategy, and quarterly booster trainings will be provided during the implementation period. Implementation outcomes, including: penetration, costs/cost-effectiveness, acceptability, timeliness, fidelity/adherence, and patient satisfaction will be assessed during the 18-month-long implementation period using a complementary combination of administrative service encounter data, provider and patient surveys, and qualitative interviews. At the end of the active implementation period, all training and technical support activities will cease for 12 months in order to measure relative sustainability. The study will also examine the effectiveness of integrating HIV risk screening within an SBIRT model.

Eligibility criteria: Inclusion Criteria:

* clinic staff

Exclusion Criteria:

-

Primary outcomes:
measure: Penetration of BI within the Generalist and Specialist models
timeFrame: 12 months
Secondary outcomes:
measure: Referral to Treatment
timeFrame: 12 months
measure: Long term penetration of BI within the Generalist and Specialist models
timeFrame: 12 months
measure: HIV sex-risk behavior screening as part of adolescent SBIRT process
timeFrame: 12 months
Other outcomes:
Locations:
city: Baltimore
country: United States
facility: Total Health Care
state: Maryland
Study officials:
affiliation: Friends Research Institute, Inc.
name: Shannon G Mitchell, PhD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Mitchell SG, Gryczynski J, Schwartz RP, Kirk AS, Dusek K, Oros M, Hosler C, O'Grady KE, Brown BS. Adolescent SBIRT implementation: Generalist vs. Specialist models of service delivery in primary care. J Subst Abuse Treat. 2020 Apr;111:67-72. doi: 10.1016/j.jsat.2020.01.007. Epub 2020 Jan 20.
citation: Monico LB, Mitchell SG, Dusek K, Gryczynski J, Schwartz RP, Oros M, Hosler C, O'Grady KE, Brown BS. A Comparison of Screening Practices for Adolescents in Primary Care After Implementation of Screening, Brief Intervention, and Referral to Treatment. J Adolesc Health. 2019 Jul;65(1):46-50. doi: 10.1016/j.jadohealth.2018.12.005. Epub 2019 Mar 6.