Factors that Influence Screening, Brief Intervention, and Referral to Treatment (SBIRT) Implementation in Non-Medical Settings

Screening, Brief Intervention, and Referral to Treatment (SBIRT) is an evidenced-based intervention model designed to reduce substance use. While initially used in a variety of medical settings, SBIRT is increasingly implemented in non-medical settings. Unfortunately, very little is known about SBIRT implementation in non-medical settings. Therefore, the purpose of this exploratory qualitative study is to understand if professionals recently trained in SBIRT are using it and factors that influence implementation of SBIRT from their perspective. In-depth qualitative interviews were conducted using a purposive sampling frame, comprised of practitioners recently trained in SBIRT. Interviews were recorded, and then transcribed verbatim, transcripts were then analyzed with MAXQDA software. Several rounds of coding were completed to allow for the identification of themes concerning influencers of implementation to emerge. An additional coder was used to ensure the validity identified themes. Findings indicate that participants can be divided between high and low levels of implementation, depending upon the number of SBIRT components they are using. Overall implementation in these non-medical setting is best categorized as low with a large majority of the sample using just two of the SBIRT components, with participants using two of the four SBIRT components at significantly higher rates than the others. Eight factors were identified that influence implementation of SBIRT in non-medical settings. Several implications arise from the study. First further research is urgently needed into the larger extent of SBIRT implementation and use in non-medical settings. Training implications include; the need for training to help participants to anticipate challenges in the level of compatibility between their setting and SBIRT, the need to help participants understand the impact of other implementation factors, and the development of technical assistance products to support practitioners how have completed training who seek to implement all the components especially the screening component