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


Source of the innovation, the strength and quality of the evidence supporting it, the relative advantages the innovation provides, and its adaptability, trial-ability, complexity, design quality and packaging, and cost.

  • Support must come from leaders who are credible to FQHCs: Impetus for integrating substance use treatment must come from the organizations and professional societies that are most salient to health centers.

  • A standard, brief behavioral health screener is needed: A common, simple screener is needed that primary care can use to assess behavioral risks, including alcohol and substance use.

  • Adapt substance use risk assessment and intervention: FQHCs should be encouraged to fit substance use screening and risk reduction interventions into their style and pace of practice. Adaptations may include the use of very brief screens, integrating behavioral health clinicians into primary care teams, reframing motivational interviewing as shared decision making, and promoting pharmacotherapy in the primary care practice rather than referring it out.

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