TY - JOUR
KW - Humans
KW - Mass Screening/methods
KW - Primary Health Care/methods
KW - Qualitative Research
KW - Rural Population
KW - Substance-Related Disorders/diagnosis
KW - Screening
KW - implementation outcomes
KW - primary care
KW - rapid analysis
KW - rural
KW - substance use
AU - S. K. Moore
AU - E. C. Saunders
AU - E. Hichborn
AU - B. McLeman
AU - A. Meier
AU - R. Young
AU - N. Nesin
AU - S. Farkas
AU - L. Hamilton
AU - L. A. Marsch
AU - T. Gardner
AU - J. McNeely
A1 - 
AB - Background: Few primary care patients are screened for substance use. As part of a phased feasibility study examining the implementation of electronic health record-integrated screening with the Tobacco, Alcohol, and Prescription Medication Screening (TAPS) Tool and clinical decision support (CDS) in rural primary care clinics, focus groups were conducted to identify early indicators of success and challenges to screening implementation. Method: Focus groups (n = 6) were conducted with medical assistants (MAs: n = 3: 19 participants) and primary care providers (PCPs: n = 3: 13 participants) approximately one month following screening implementation in three Federally Qualified Health Centers in Maine. Rapid analysis and matrix analysis using Proctor's Taxonomy of Implementation Outcomes were used to explore implementation outcomes. Results: There was consensus that screening is being used, but use of the CDS was lower, in part due to limited positive screens. Fidelity was high among MAs, though discomfort with the CDS surfaced among PCPs, impacting adoption and fidelity. The TAPS Tool's content, credibility and ease of workflow integration were favorably assessed. Challenges include screening solely at annual visits and self-administered screening for certain patients. Conclusions: Results reveal indicators of implementation success and strategies to address challenges to screening for substance use in primary care.
AD - Center for Technology and Behavioral Health, Geisel School of Medicine at Dartmouth College, Hanover, New Hampshire, USA.; The Dartmouth Institute (TDI) for Health Policy and Clinical Practice, Lebanon, Pennsylvania, USA.; Center for Technology and Behavioral Health, Geisel School of Medicine at Dartmouth College, Hanover, New Hampshire, USA.; Center for Technology and Behavioral Health, Geisel School of Medicine at Dartmouth College, Hanover, New Hampshire, USA.; Center for Technology and Behavioral Health, Geisel School of Medicine at Dartmouth College, Hanover, New Hampshire, USA.; Center for Technology and Behavioral Health, Geisel School of Medicine at Dartmouth College, Hanover, New Hampshire, USA.; Penobscot Community Health Care (PCHC), Bangor, Maine, USA.; Department of Psychiatry, New York University School of Medicine, New York, New York, USA.; Department of Population Health, New York University School of Medicine, New York, New York, USA.; Center for Technology and Behavioral Health, Geisel School of Medicine at Dartmouth College, Hanover, New Hampshire, USA.; Penobscot Community Health Care (PCHC), Bangor, Maine, USA.; Department of Population Health, New York University School of Medicine, New York, New York, USA.
BT - Substance abuse
C5 - Education & Workforce; Healthcare Disparities; Measures; Opioids & Substance Use
CP - 4
DO - 10.1080/08897077.2020.1827125
IS - 4
JF - Substance abuse
LA - eng
M1 - Journal Article
N2 - Background: Few primary care patients are screened for substance use. As part of a phased feasibility study examining the implementation of electronic health record-integrated screening with the Tobacco, Alcohol, and Prescription Medication Screening (TAPS) Tool and clinical decision support (CDS) in rural primary care clinics, focus groups were conducted to identify early indicators of success and challenges to screening implementation. Method: Focus groups (n = 6) were conducted with medical assistants (MAs: n = 3: 19 participants) and primary care providers (PCPs: n = 3: 13 participants) approximately one month following screening implementation in three Federally Qualified Health Centers in Maine. Rapid analysis and matrix analysis using Proctor's Taxonomy of Implementation Outcomes were used to explore implementation outcomes. Results: There was consensus that screening is being used, but use of the CDS was lower, in part due to limited positive screens. Fidelity was high among MAs, though discomfort with the CDS surfaced among PCPs, impacting adoption and fidelity. The TAPS Tool's content, credibility and ease of workflow integration were favorably assessed. Challenges include screening solely at annual visits and self-administered screening for certain patients. Conclusions: Results reveal indicators of implementation success and strategies to address challenges to screening for substance use in primary care.
PY - 2021
SN - 1547-0164; 0889-7077; 0889-7077
SP - 678
EP - 691
EP - 
T1 - Early implementation of screening for substance use in rural primary care: A rapid analytic qualitative study
T2 - Substance abuse
TI - Early implementation of screening for substance use in rural primary care: A rapid analytic qualitative study
U1 - Education & Workforce; Healthcare Disparities; Measures; Opioids & Substance Use
U2 - 33264087
U3 - 10.1080/08897077.2020.1827125
VL - 42
VO - 1547-0164; 0889-7077; 0889-7077
Y1 - 2021
ER -