Implementing Screening and Brief Intervention in a Family Medicine Residency Clinic
The purpose of this study was to evaluate the impact of simultaneous systems interventions and clinician training on management of hazardous and harmful drinking in a residency clinic. Systems interventions included forming a multi-disciplinary implementation team, training registration clerks to distribute health risk questionnaires using the AUDIT-C alcohol screen, and training nurses to score the AUDIT-C and administer the AUDIT to screen-positive patients. Clinicians were trained to perform brochure-based interventions on screen-positive patients. Research staff provided compliance feedback. Over 12 months, 8.0% (241/3014) of patients screened positive and 3.8% (115/3014) received brief interventions. For screen-positive patients, comparisons with baseline measurements found increased rates of alcohol assessment (50% vs. 0%, p < .0001) and intervention (48.1% vs. 9.4%, p < .0001). Clinicians intervened more often when prompted with completed AUDITs (72% vs. 23%, p < .0001). Program modifications resulted in progressive increases in numbers of patients screened. This model shows promise for use in other residency programs.
Seale, Paul J., Sylvia Shellenberger, Wanda K. Tillery, Robert L. Vogel, Barbara Barton, Megan McCauley.
"Implementing Screening and Brief Intervention in a Family Medicine Residency Clinic."
Substance Abuse, 26 (1): 23-31.