A Virtual Learning Collaborative for Alcohol Screening, Brief Intervention and Treatment in Primary Care

摘要

ABSTRACT This application builds upon previous studies by investigators at Medical University of South Carolina (MUSC) that resulted in significant improvements in alcohol screening and brief interventions, and modest improvements in adoption of pharmacotherapy for alcohol disorders in primary care practices across the United States. While PPRNet accomplished these improvements in a crossover randomized trial, effective strategies are still needed to more widely disseminate findings and approaches practices used, and develop mechanisms to make a larger national impact in the adoption of and effective implementation of the NIAAA recommended clinical guidelines. The proposed R25 education program implements an innovative virtual learning collaborative (VLC) approach to disseminating evidence, guidelines and strategies for implementation of screening, brief intervention, and referral to treatment (SBIRT) to primary care clinicians, nurses and other clinical staff nationwide that participate in PPRNet, a practice based research network with 15 years of experience in translating research into practice (TRIP). The proposed project tests the comparative effectiveness of participating in ALC-TRIP (Alcohol Learning Collaborative–Translating Research into Practice) compared to practices that have not participated in this VLC. This study will be the first use of an innovative VLC that involves learner participation in web-based discussions/planning to improve alcohol screening and intervention in primary care, with the potential to reach a large number of primary care practices throughout the US. The primary aims of this alcohol education project proposal are to: 1) Develop and implement ALC-TRIP, a multi-component VLC designed to educate primary care staff and clinicians to develop practice approaches to improve alcohol screening, brief intervention and alcohol pharmacotherapy for alcohol use disorders; 2) Compare the effectiveness of practice participation in ALC-TRIP on alcohol screening, brief intervention and use of alcohol pharmacotherapy to non-participation in this learning collaborative, in a nationwide sample of 10 practices in each group; and 3) Conduct a process evaluation of this learning collaborative to examine the strengths, weaknesses, opportunities and threats related to this approach from the perspective of the stakeholders. Findings from this project will advance the educational mission of the NIAAA and inform future dissemination and implementation programs for alcohol SBIRT. If ALC-TRIP is more effective than passive dissemination of guidelines through an educational webinar and quarterly practice reports, VLCs might play a critical role in primary care-focused alcohol and illicit drug use initiatives.