SBIRT Implementation within Primary Care Clinics in King County Washington – Implementation Outcomes during the First Three Years

PRESENTATION TYPE: Individual Paper

 

CATEGORY/THEME: Dissemination and Implementation Science

 

TITLE: SBIRT implementation within primary care clinics in King County Washington – Implementation outcomes during the first three years.

 

ABSTRACT BODY:

Introduction: Consistent with increasing efforts to address substance use within primary care settings, Washington State and King County secured a five-year SAMHSA grant to implement SBIRT (screening, brief intervention and referral to treatment) within primary care settings (WA-SBIRT project). Guided by Proctor and colleagues conceptual framework for implementation research (Proctor et al., 2009, 2011), this presentation will focus on characterizing several key implementation outcomes (i.e., penetration, implementation costs, and sustainment) during the WA-SBIRT project’s first three years. 

 

Methods: A total of 13 primary care clinics have participated in the SAMHSA-funded
WASBIRT project to date.  Using administrative data collected during the first three years of this project, this presentation will describe results related: (a) client prescreening penetration (CPSP; i.e.,. the number of individuals who were prescreened, divided by the total number of individuals eligible to be screened), (b) full screen penetration (FSP, i.e., the number full screens completed divided by the total number of individuals prescreening positive; (c) brief intervention penetration (BIP; i.e., the number of individuals who received a brief intervention, divided by the total number of individuals who screened eligible to receive the brief intervention), (d) implementation costs (i.e., unit costs for above implementation outcomes [CPSP, FSP and BIP]) and (e) early sustainment (ES; i.e., the number of clinics continuing to implement SBIRT 6-months following the completion of the initial implementation phase.

Results: Examination of key implementation outcomes (e.g., CSP, FSP, BIP) during the first three years of the WASBIRT project found the following results.  In terms of penetration, overall CPSP was 53.4%%, overall FSP was 55.8%% and overall BIP was 44.1%%.  With an overall cost of $1,691,812 during the first three years, the implementation costs for these outcomes were $93.63; finally, of the 7 primary care clinics that have had 12 months pass since they completed the initial implementation phase, four (57.1%) have continued SBIRT implementation.

Conclusions: Implementation outcomes show mixed success. Measures of penetration show a declining ability to capture those needing further screening or intervention. Cost per SBIRT (prescreen, full screen, brief intervention, referral to treatment) is higher than will be compensated. Sustainment is inconclusive due do to number clinics Further implementation evaluation guided by Proctor and colleagues conceptual framework is a solid next step.