Because brief alcohol interventions have already been proven efficacious in a variety of primary care settings around the world, this QUERI study addresses the next critical step in the use of brief alcohol interventions, the effectiveness of implementation strategies for alcohol screening and intervention systems in the VHA, one of the largest health care providers in the U.S.
This study is Phase 1 of a two-phase project. The primary objectives of the Phase 1 study are to: 1) conduct a nationwide VHA survey to determine current practices and experiences regarding alcohol screening, brief intervention, and use of referrals in primary care, and perceptions of barriers to implementing such practices; and 2) conduct a feasibility study of the effectiveness of two implementation strategies: a Standard Training strategy used in many other settings, and an Enhanced Multimodal strategy that combines the use of opinion leaders and real-time reminders with Standard Training.
Two focus groups of managers and primary care providers will be used to assist in the development and refinement of the national survey. Through a random sample of VAMC facilities, the survey of the ACOSs for Ambulatory Care (N=75) and primary care providers (2 providers in the largest primary care site for each VAMC; N=150) will be conducted on current primary care practices for alcohol screening and intervention strategies, as well as perceived barriers to instituting alcohol screening, brief intervention, and referral programs in their sites. This survey provides a valuable baseline "snapshot" of current practice. The feasibility of implementing the alcohol screening, brief intervention, and referral training program will be pilot tested at the Ann Arbor VAMC primary care clinic for a Phase 2 grant to conduct the implementation phase of the project at six VA facilities around the country.
Results of this initial QUERI study will be used to inform VA policymakers, managers, and clinicians regarding current practices and needs regarding alcohol screening and brief interventions in VHA primary care, and to provide the basis for the Phase 2 grant.
Successful alcohol screening, brief intervention, and appropriate referral implementation can ultimately increase the length and quality of many veterans’ lives, decrease rates of chronic alcohol-related diseases, and reduce subsequent health care use and costs.
- Barry KL, Blow FC, Willenbring ML, McCormick R, Brockmann LM, Visnic S. Use of Alcohol Screening and Brief Interventions
in Primary Care Settings: Implementation and Barriers. Substance Abuse. 2004 Mar 1; 25(1):27-36.