Abstract：
UNASSIGNED: With US Centers for Disease Control and Prevention funding, from 2018 to 2022, 4 large healthcare systems (n = 53 health centers across 7 states) serving people of reproductive age trained staff and provided implementation support for alcohol screening and brief intervention (SBI). This cross-site evaluation explores each healthcare system\'s implementation approach to implement SBI, reduce excessive alcohol use, and prevent prenatal alcohol exposure (PAE) and fetal alcohol spectrum disorders.
UNASSIGNED: The SBIRT (Screening, Brief Intervention, and Referral to Treatment) Program Matrix framed the multilevel strategies to implement alcohol SBI programs from 2018 to 2022. Qualitative and quantitative data sources examined outcomes, guided by one logic model, through systems-level process data and provider-level performance metrics. Data analyses utilized frequencies and means for quantitative data and themes for qualitative data according to an established framework.
UNASSIGNED: Successful approaches within systems included using electronic health records, flexible implementation and workflow protocols, customized training and technical assistance programs, quality assurance feedback loops, and stakeholder buy-in. Centralized management structures were efficient in standardizing implementation across health centers. Decentralized management structures used tailored approaches, enhancing provider/staff SBI acceptance. Across systems, 1259 staff (eg, clinicians, medical assistants) were trained to provide alcohol SBI services and reported pre-post training increases in self-efficacy in performing brief intervention; skills in PAE counseling; and confidence in screening. Fifty-three (48 providing data) health centers implemented alcohol SBI, screening 106 826 patients over the study period with most of the 10 087 patients who screened positive for excessive alcohol use receiving a BI.
UNASSIGNED: Maximizing the use of technology, employing flexibility in program delivery, and institutionalizing processes and protocols improved workflow, efficiency, and program reach. Ongoing partnership and stakeholder communication identify areas for ongoing improvement, engagement, and best practices for sustainability around substance use screening, which are essential with increases in substance use since the pandemic.
UNASSIGNED: The SBIRT (Screening, Brief Intervention, and Referral to Treatment) Program Matrix framed the multilevel strategies to implement alcohol SBI programs from 2018 to 2022. Qualitative and quantitative data sources examined outcomes, guided by one logic model, through systems-level process data and provider-level performance metrics. Data analyses utilized frequencies and means for quantitative data and themes for qualitative data according to an established framework.
UNASSIGNED: Successful approaches within systems included using electronic health records, flexible implementation and workflow protocols, customized training and technical assistance programs, quality assurance feedback loops, and stakeholder buy-in. Centralized management structures were efficient in standardizing implementation across health centers. Decentralized management structures used tailored approaches, enhancing provider/staff SBI acceptance. Across systems, 1259 staff (eg, clinicians, medical assistants) were trained to provide alcohol SBI services and reported pre-post training increases in self-efficacy in performing brief intervention; skills in PAE counseling; and confidence in screening. Fifty-three (48 providing data) health centers implemented alcohol SBI, screening 106 826 patients over the study period with most of the 10 087 patients who screened positive for excessive alcohol use receiving a BI.
UNASSIGNED: Maximizing the use of technology, employing flexibility in program delivery, and institutionalizing processes and protocols improved workflow, efficiency, and program reach. Ongoing partnership and stakeholder communication identify areas for ongoing improvement, engagement, and best practices for sustainability around substance use screening, which are essential with increases in substance use since the pandemic.
摘要：
■在美国疾病控制和预防中心的资助下，从2018年到2022年，4个大型医疗保健系统（n=7个州的53个健康中心）为育龄人员提供培训，并为酒精筛查和简短干预（SBI）提供实施支持。这项跨站点评估探讨了每个医疗保健系统实施SBI的实施方法，减少过度饮酒，预防产前酒精暴露（PAE）和胎儿酒精谱系障碍。
■SBIRT（筛选，简短干预,和转诊治疗）计划矩阵制定了从2018年至2022年实施酒精SBI计划的多层次战略。定性和定量数据源检查结果，在一个逻辑模型的指导下，通过系统级流程数据和提供商级性能指标。根据既定框架，数据分析利用频率和手段进行定量数据，并利用主题进行定性数据。
■系统内的成功方法包括使用电子健康记录，灵活的实施和工作流协议，定制的培训和技术援助计划，质量保证反馈回路，和利益相关者的买入。集中管理结构在卫生中心标准化实施方面是有效的。分散的管理结构使用了量身定制的方法，提高供应商/员工对SBI的接受度。跨系统，1259名员工(例如，临床医生,医疗助理）接受了提供酒精SBI服务的培训，并报告了培训前进行简短干预的自我效能感增加；PAE咨询技能；以及对筛查的信心。53个(48个提供数据)卫生中心实施了酒精SBI，在研究期间筛查106826名患者，其中10087名过度饮酒筛查阳性的患者中的大多数接受BI。
■最大限度地利用技术，在节目交付中运用灵活性，将流程和协议制度化，改善了工作流程，效率,和程序到达。持续的伙伴关系和利益相关者沟通确定了需要持续改进的领域，订婚,以及围绕物质使用筛查的可持续性最佳实践，这对大流行以来药物使用的增加至关重要。
■SBIRT（筛选，简短干预,和转诊治疗）计划矩阵制定了从2018年至2022年实施酒精SBI计划的多层次战略。定性和定量数据源检查结果，在一个逻辑模型的指导下，通过系统级流程数据和提供商级性能指标。根据既定框架，数据分析利用频率和手段进行定量数据，并利用主题进行定性数据。
■系统内的成功方法包括使用电子健康记录，灵活的实施和工作流协议，定制的培训和技术援助计划，质量保证反馈回路，和利益相关者的买入。集中管理结构在卫生中心标准化实施方面是有效的。分散的管理结构使用了量身定制的方法，提高供应商/员工对SBI的接受度。跨系统，1259名员工(例如，临床医生,医疗助理）接受了提供酒精SBI服务的培训，并报告了培训前进行简短干预的自我效能感增加；PAE咨询技能；以及对筛查的信心。53个(48个提供数据)卫生中心实施了酒精SBI，在研究期间筛查106826名患者，其中10087名过度饮酒筛查阳性的患者中的大多数接受BI。
■最大限度地利用技术，在节目交付中运用灵活性，将流程和协议制度化，改善了工作流程，效率,和程序到达。持续的伙伴关系和利益相关者沟通确定了需要持续改进的领域，订婚,以及围绕物质使用筛查的可持续性最佳实践，这对大流行以来药物使用的增加至关重要。
