Scott Kelli, Mello Michael J, Almonte Geraldine, Lemus Emely Arenas, Bromberg Julie R, Baird Janette, Spirito Anthony, Zonfrillo Mark R, Lawson Karla, Lee Lois K, Christison-Lagay Emily, Ruest Stephanie, Aidlen Jeremy, Kiragu Andrew, Pruitt Charles, Nasr Isam, Maxson Robert Todd, Ebel Beth, Becker Sara J
Center for Dissemination and Implementation Science, Northwestern University Feinberg School of Medicine, 633 N St Clair Street, Chicago, IL, USA.
Injury Prevention Center of Rhode Island Hospital-Hasbro Children's Hospital, Department of Emergency Medicine, Alpert Medical School of Brown University, Department of Health Services, Policy and Practice, Brown University School of Public Health, 55 Claverick Street, Providence, RI, USA.
Implement Sci Commun. 2025 Jan 30;6(1):13. doi: 10.1186/s43058-025-00697-x.
Screening, Brief Intervention, and Referral to Treatment (SBIRT) is an evidence-based practice that can identify adolescents who use alcohol and other drugs and support proper referral to treatment. Despite an American College of Surgeons mandate to deliver SBIRT in pediatric trauma care, trauma centers throughout the United States have faced numerous patient, provider, and organizational level barriers to SBIRT implementation. The Implementing Alcohol Misuse Screening, Brief Intervention, and Referral to Treatment Study (IAMSBIRT) aimed to implement SBIRT across 10 pediatric trauma centers using the Science-to-Service Laboratory (SSL), an empirically supported implementation strategy. This manuscript aimed to assess trauma center staff preferences and experience with the didactic training, performance feedback, and ongoing coaching elements of the SSL via a retrospective qualitative process evaluation.
Nurses, social workers, and site leaders that participated in IAMSBIRT were recruited to complete qualitative exit interviews guided by the Consolidated Framework for Implementation Research. Qualitative interviews were recorded, transcribed, and analyzed by two coders using a directed content analysis approach in NVivo software. Codes were then translated into frequently endorsed themes by the IAMSBIRT study research team.
Thirty-six exit interviews were conducted with site leaders, social workers, and nurses across the 10 IAMSBIRT pediatric trauma centers. Findings revealed key strengths as well as areas for improvement across the IAMSBIRT preparation phase and the three elements of the SSL: didactic training, performance feedback, and ongoing coaching. Trauma center staff generally reported that all three elements of the SSL were high quality and helpful for supporting SBIRT implementation. However, staff also noted that performance feedback and ongoing coaching were generally only available to center leadership or to individuals selected by leadership, making it challenging for non-leaders to troubleshoot SBIRT delivery.
Findings from the qualitative process evaluation revealed discrepancies in the experience of the SSL strategy between those in leadership roles and those involved in direct care delivery. These results suggest the need for several modifications to the SSL strategy, including increasing engagement of direct care staff in all elements of the SSL throughout the implementation process.
Clinicaltrials.gov NCT03297060 . Registered 29 September 2017.
筛查、简短干预及转介治疗（SBIRT）是一种循证实践，可识别使用酒精和其他药物的青少年，并支持其获得适当的治疗转介。尽管美国外科医师学会要求在儿科创伤护理中实施SBIRT，但美国各地的创伤中心在实施SBIRT时面临着众多患者、医护人员和组织层面的障碍。实施酒精滥用筛查、简短干预及转介治疗研究（IAMSBIRT）旨在通过科学服务实验室（SSL）这一经过实证支持的实施策略，在10个儿科创伤中心实施SBIRT。本手稿旨在通过回顾性定性过程评估，评估创伤中心工作人员对SSL的理论培训、绩效反馈和持续指导等要素的偏好和体验。
招募参与IAMSBIRT的护士、社会工作者和机构负责人，以完成由实施研究综合框架指导的定性离职访谈。定性访谈进行录音、转录，并由两名编码员使用NVivo软件中的定向内容分析方法进行分析。然后，编码被转化为由IAMSBIRT研究团队频繁认可的主题。
对10个IAMSBIRT儿科创伤中心的机构负责人、社会工作者和护士进行了36次离职访谈。研究结果揭示了IAMSBIRT准备阶段以及SSL的三个要素（理论培训、绩效反馈和持续指导）的关键优势和改进领域。创伤中心工作人员普遍报告称，SSL的所有三个要素质量都很高，有助于支持SBIRT的实施。然而，工作人员也指出，绩效反馈和持续指导通常仅提供给中心领导或由领导挑选的个人，这使得非领导人员在解决SBIRT实施问题时面临挑战。
定性过程评估的结果揭示了领导角色人员和直接护理人员在SSL策略体验上的差异。这些结果表明需要对SSL策略进行若干修改，包括在整个实施过程中增加直接护理人员对SSL所有要素的参与度。
Clinicaltrials.gov NCT03297060。于2017年9月29日注册。
