Grantees

Michigan

Michigan Sustained Patient-centered Alcohol-Related Care (MI-SPARC) Trial

Principal Investigators: Katharine Bradley, Kaiser Foundation Research Institute, and Anya Day, Altarum Institute

Specific Aims:

1. Test whether the MI-SPARC model increases alcohol screening and brief intervention (SBI) in primary care patients and medication treatment of patients with alcohol use disorders (AUDs), in a stepped-wedge trial with six waves, and
2. Test whether adding a novel patient decision aid for AUDs to the MI-SPARC model increases alcohol SBI and medication treatment of patients with AUDs, in a nested two-arm cluster randomized trial.

Website: Michigan Sustained Patient-centered Alcohol-Related Care (MI-SPARC)

Publications:

• Altarum. Alcohol and Health Implementation Guide for Primary Care. 2023. https://michigansparc.org/src/assets/pdf/MISPARC_Implementation_Guide.pdf

Virginia

Practice Facilitation to Promote Evidence-based Screening and Management of Unhealthy Alcohol Use in Primary Care

Principal Investigator: Alexander Krist, Virginia Commonwealth University

Specific Aims:

1. Screening: Evaluate whether practice facilitation increases screening rates for unhealthy alcohol use in primary care.
2. Treatment: Evaluate whether practice facilitation increases treatment for unhealthy alcohol use in primary care.
3. Practice Implementation and Support Moderators: Understand the practice implementation strategies and practice support factors that influence the effectiveness of the intervention in promoting routine screening for unhealthy alcohol use.

Website: Unhealthy Alcohol Use - Virginia (https://uauvirginia.squarespace.com)

Publications:

• Huffstetler AN, Epling J, Krist AH. The Need for Electronic Health Records to Support Delivery of Behavioral Health Preventive Services. JAMA. 2022. https://doi.org/10.1001/jama.2022.13391
• Huffstetler, A.N., Kuzel, A.J., Sabo, R.T. et al. Practice Facilitation to Promote Evidence-based Screening and Management of Unhealthy Alcohol Use in Primary Care: A Practice-level Randomized Controlled Trial. BMC Family Practice 21, 93, 2020. https://doi.org/10.1186/s12875-020-01147-4

North Carolina

Screening and Management of Unhealthy Alcohol Use in Primary Care: Dissemination and Implementation of PCOR Evidence

Principal Investigator: Daniel Jonas, University of North Carolina at Chapel Hill

Specific Aims:

1. Evaluate the effect of primary care practice facilitation on uptake of evidence-based SBI for unhealthy alcohol use.
2. Evaluate the effect of primary care practice facilitation on uptake of evidence-based counseling and medication-assisted treatment (MAT) for AUD.
3. For practices with slower uptake, evaluate the effect of providing embedded telehealth services on use of evidence-based SBI for unhealthy alcohol use and counseling and MAT for AUD.

Publications:

• Balio CP, Riley SR, Grammer D, Weathington C, Barclay C, & Jonas DE. Barriers to recruiting primary care practices for implementation research during COVID-19: A qualitative study of practice coaches from the Stop Unhealthy (STUN) Alcohol Use Now trial. Implementation Research and Practice, 3, 2022. https://doi.org/10.1177/26334895221094297
• Jonas DE, Barclay C, Grammar D. et al. The STUN (STop UNhealthy) Alcohol Use Now trial: study protocol for an adaptive randomized trial on dissemination and implementation of screening and management of unhealth alcohol use in primary care. Trials 22, 810 (2021). https://doi.org/10.1186/s13063-021-05641-7

Colorado

Facilitating Alcohol Screening and Treatment (FAST), Colorado

Principal Investigator: Perry Dickinson, University of Colorado, Denver

Specific Aims:

1. Conduct a cluster randomized trial to examine the Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) and relative value of two approaches to supporting primary care practices to implement PCOR findings. The focus is on improving identification and treatment of unhealthy alcohol use among adults, including SBI, MAT, and referral to treatment. This trial will investigate the noninferiority from an effectiveness perspective and the superiority from a cost perspective of a virtual practice facilitation intervention. This intervention will feature a practice facilitator working with practices in virtual group sessions using an alcohol use e-learning module to guide and focus the process and content. It will be compared with an in-person practice facilitation intervention.
2. Identify key practice characteristics (e.g., practice size, organization type, level of behavioral integration, setting, and level of experience with practice redesign efforts) and other contextual factors that affect the response of practices to the two practice transformation interventions.
3. Compare the adaptability, trialability, and scalability of the two interventions to plan dissemination of the findings to key local, regional, and national stakeholders, including sharing ongoing lessons learned and resources with other programs supporting practice transformation.

Websites:

• Practice Innovation Website
• 9 UAU eLearning Modules
  • Note: To register for these eLearning Modules, please use "FASTUAU" as the registration code.

Publications: None at this time.

Oregon

ANTECEDENT (pArtNerships To Enhance alCohol scrEening, treatment, anD intErveNTion)

Principal Investigators: Melinda Davis and John Muench, Oregon Health & Science University

Specific Aims:

1. Engage, recruit, and conduct intake consultations with 150 primary care clinics and their regional coordinated care organizations within Oregon.
2. Implement and describe how practice facilitators tailor implementation support based on context, intervention, and personal expertise using mixed methods and systems science.
3. Evaluate the impact of foundational and supplemental implementation support on SBI, MAT, and quality improvement capacity in participating primary care clinics.

Website: ANTECEDENT - SBIRT Oregon

Publications:

• Holtrop JS and Davis MM. Primary Care Research is Hard to Do During COVID-19: Challenges and Solutions. The Annals of Family Medicine. November 2022, 20(6); https://pubmed.ncbi.nlm.nih.gov/36443077/
• Singh AN, Sanchez V, Kenzie ES, McCormack JL, Larson JH, Robbins A, Weekley T, Hatch BA, Dickinson C, Elder NC, Muench JP, Davis MM. Improving screening, treatment, and intervention for unhealthy alcohol use in primary care through clinic, practice-based research network, and health plan partnerships: Protocol of the ANTECEDENT study. PLOS ONE. June 28, 2022. https://doi.org/10/1371/journal.pone.0269635

Illinois and Wisconsin

INtervention in Small Primary care practices to Implement Reduction in unhealthy alcohol usE (INSPIRE)

Principal Investigators: Abel Kho and Theresa Walunas, Northwestern University

Specific Aims:

1. Develop and deploy a robust online and in-person learning collaborative to support in-clinic implementation of Screening, Brief Intervention, and Referral to Treatment (SBIRT) and MAT for people with unhealthy alcohol use and identify patients who may benefit from further referral.
2. Conduct and assess implementation of a practice-randomized stepped wedge trial in small primary care practices to determine the adoption and efficacy of an electronic health record (EHR)-based workflow to improve screening and treatment for people with unhealthy alcohol use.
3. Evaluate the ability of small practices in the region to participate in practice education programs and implement and sustain standard screening and treatment protocols adapted for documentation in the EHR. In addition, identify the factors that facilitated or hindered improvement and sustainability using quantitative and qualitative analysis methods.

Website: INSPIRE: Center for Health Information Partnerships

Publications: None at this time.

Resource Center and Evaluation Contractor

NORC at the University of Chicago; Principal Investigator: Tracy McPherson