Implementation Barriers to and Facilitators of Screening, Brief Intervention, Referral, and Treatment (SBIRT) in Federally Qualified Health Centers (FQHCs). Characteristics of Individuals


Knowledge and beliefs about the intervention, self-efficacy, individual readiness to change, individual identification with the organization, and other personal attributes.

Clinicians are unsure of how to screen and counsel adolescents about substance use. Nearly half of primary care clinicians who treat adolescent patients believe they are insufficiently trained to deal with patients' substance use.322 Many rely on informal screening for risky substance use rather than using validated screening tools. Compared with other health issues among their adolescent patients, providers report less knowledge about substance use treatment and less certainty about their skills and abilities to address their patients' substance use. Surveys of providers suggest that they are reluctant to ask about substance use because they are unsure about what to do with the information, they lack the skills to intervene with risky use, and they are unprepared to diagnose alcohol or drug use disorders.322, 324, 325, 326

On the other hand, providers are likely to implement teen SBI if they believe that routine screening for alcohol use should begin early, that adolescent alcohol consumption is a significant health problem, that treatment resources are available should their patients need them, and that primary care settings are good places for identifying risky use and counseling risk reduction.319, 322, 327

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