Evaluating SBIRT Training and Implementation: Challenges and Solutions

In the United States, over 100,000 deaths annually are due to alcohol and drug use. Screening, Brief Intervention, Referral to Treatment (SBIRT) is an evidence-based public health approach for intervening with individuals across the continuum from low risk use to severe substance related problems. Despite strong evidence of its efficacy, SBIRT is underutilized across healthcare and social service settings, in part due to lack of awareness of the approach and implementation challenges. In the interest of fostering dissemination of SBIRT, SAMHSA has funded training and implementation projects in higher education and state agencies nationally. One core component of these projects is evaluating learning and implementation outcomes. Current and previous SBIRT grantees will discuss project evaluation with a focus on implementation challenges. Roundtable participants will discuss strategies used to evaluate learning outcomes and implementation, issues encountered in the evaluation process and strategies used to overcome challenges. The panel will also discuss future considerations for SBIRT research in light of expanding focus in this area nationally. 

Roundtable presenters will offer brief descriptions of their SBIRT projects, highlighting their current evaluation plan, process and outcome measures and implementation challenges. Each presenter will discuss specific issues. Presenter 1 will discuss their MSW SBIRT grant and measuring practice change over time among students, evaluating models of incorporating SBIRT into MSW curriculum (infused into the curriculum versus a stand-alone course), and the utility of self-report measures versus behavioral measures. Three themes will be discussed: challenges in measuring competency, assessing robustness of learning outcomes over time, and the challenge of measuring practice change. Presenters 2 and 3 will discuss similarities and differences in each of their respective institutions’ SBIRT grant (Multidisciplinary versus Interprofessional), how the background and education levels of trainees have influenced the evaluation process, if measures should be tailored to specific professional groups (i.e. MDs, SW, etc.) and implications for curriculum and practice. Presenter 4 will discuss a state implementation grant within multiple settings (ER, primary care, dental, and college campus) and the challenges that occur with differences in service delivery by healthcare setting, challenges of coordinating SBIRT activities within healthcare clinics, the impact on healthcare staff, and sustaining SBIRT services once grant funding ends. Future considerations will include a discussion around the need for utilizing billing codes, a national SBIRT certification program, building support for SBIRT in multiple settings, and growth of treatment resources.
After briefly reviewing their project evaluations, roundtable participants and attendees will discuss ways to resolve evaluation challenges and discuss avenues for future research on SBIRT training and the effectiveness of the SBIRT model in social work and interprofessional settings. Some questions to consider will include the following: What are the limitations/strengths of different implementation approaches? Is training leading to robust implementation? What are the challenges and benefits of multidisciplinary evaluation and training? How can training and implementation projects foster sustainability of both training and evaluation efforts? The distal goal of this roundtable is a dialogue about the future of SBIRT in social work research, education and practice.

See more of: Roundtables