A qualitative process evaluation of SBIRT implementation in pediatric trauma centers using the Science to Service Laboratory implementation strategy

Abstract Background 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 tra...

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Main Authors: Kelli Scott, Michael J. Mello, Geraldine Almonte, Emely Arenas Lemus, Julie R. Bromberg, Janette Baird, Anthony Spirito, Mark R. Zonfrillo, Karla Lawson, Lois K. Lee, Emily Christison-Lagay, Stephanie Ruest, Jeremy Aidlen, Andrew Kiragu, Charles Pruitt, Isam Nasr, Robert Todd Maxson, Beth Ebel, Sara J. Becker
Format: Article
Language:English
Published: BMC 2025-01-01
Series:Implementation Science Communications
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Online Access:https://doi.org/10.1186/s43058-025-00697-x
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author Kelli Scott
Michael J. Mello
Geraldine Almonte
Emely Arenas Lemus
Julie R. Bromberg
Janette Baird
Anthony Spirito
Mark R. Zonfrillo
Karla Lawson
Lois K. Lee
Emily Christison-Lagay
Stephanie Ruest
Jeremy Aidlen
Andrew Kiragu
Charles Pruitt
Isam Nasr
Robert Todd Maxson
Beth Ebel
Sara J. Becker
author_facet Kelli Scott
Michael J. Mello
Geraldine Almonte
Emely Arenas Lemus
Julie R. Bromberg
Janette Baird
Anthony Spirito
Mark R. Zonfrillo
Karla Lawson
Lois K. Lee
Emily Christison-Lagay
Stephanie Ruest
Jeremy Aidlen
Andrew Kiragu
Charles Pruitt
Isam Nasr
Robert Todd Maxson
Beth Ebel
Sara J. Becker
author_sort Kelli Scott
collection DOAJ
description Abstract Background 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. Methods 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. Results 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. Conclusions 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. Trial registration Clinicaltrials.gov NCT03297060 . Registered 29 September 2017.
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spelling doaj-art-66886bae35994d2ca70893fe2237dca02025-02-02T12:26:59ZengBMCImplementation Science Communications2662-22112025-01-016111010.1186/s43058-025-00697-xA qualitative process evaluation of SBIRT implementation in pediatric trauma centers using the Science to Service Laboratory implementation strategyKelli Scott0Michael J. Mello1Geraldine Almonte2Emely Arenas Lemus3Julie R. Bromberg4Janette Baird5Anthony Spirito6Mark R. Zonfrillo7Karla Lawson8Lois K. Lee9Emily Christison-Lagay10Stephanie Ruest11Jeremy Aidlen12Andrew Kiragu13Charles Pruitt14Isam Nasr15Robert Todd Maxson16Beth Ebel17Sara J. Becker18Center for Dissemination and Implementation Science, Northwestern University Feinberg School of MedicineInjury 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 HealthInjury Prevention Center of Rhode Island Hospital-Hasbro Children’s HospitalInjury Prevention Center of Rhode Island Hospital-Hasbro Children’s HospitalDepartment of Emergency Medicine, Injury Prevention Center of Rhode Island Hospital-Hasbro Children’s Hospital, Alpert Medical School of Brown UniversityDepartment of Emergency Medicine, Injury Prevention Center of Rhode Island Hospital-Hasbro Children’s Hospital, Alpert Medical School of Brown UniversityDepartment of Psychiatry and Human Behavior, Alpert Medical School of Brown UniversityDepartment of Emergency Medicine, Department of Pediatrics, Injury Prevention Center of Rhode Island Hospital-Hasbro Children’s Hospital, Alpert Medical School of Brown UniversityDell Children’s Trauma and Injury Research Center, Trauma Services, Dell Children’s Medical Center of Central TexasDivision of Emergency Medicine, Boston Children’s HospitalYale Pediatric Surgery, Yale New Haven Children’s HospitalInjury Prevention Center of Rhode Island Hospital-Hasbro Children’s HospitalDivision of Pediatric Surgery, UMass Memorial Medical Center - University CampusDepartment of Pediatrics, University of Minnesota, Children’s Hospital of Minnesota, Department of Pediatrics, Division of Critical Care, Hennepin Healthcare, University of MinnesotaPediatric Emergency Medicine, Primary Children’s HospitalDivision of Pediatric Surgery, Johns Hopkins Children’s Center, The Johns Hopkins HospitalTrauma Services, Children’s Hospital of ArkansasPediatric Clinic, Harborview Medical CenterCenter for Dissemination and Implementation Science, Northwestern University Feinberg School of MedicineAbstract Background 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. Methods 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. Results 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. Conclusions 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. Trial registration Clinicaltrials.gov NCT03297060 . Registered 29 September 2017.https://doi.org/10.1186/s43058-025-00697-xSBIRTAdolescentsSubstance usePediatric traumaImplementation scienceProcess evaluation
spellingShingle Kelli Scott
Michael J. Mello
Geraldine Almonte
Emely Arenas Lemus
Julie R. Bromberg
Janette Baird
Anthony Spirito
Mark R. Zonfrillo
Karla Lawson
Lois K. Lee
Emily Christison-Lagay
Stephanie Ruest
Jeremy Aidlen
Andrew Kiragu
Charles Pruitt
Isam Nasr
Robert Todd Maxson
Beth Ebel
Sara J. Becker
A qualitative process evaluation of SBIRT implementation in pediatric trauma centers using the Science to Service Laboratory implementation strategy
Implementation Science Communications
SBIRT
Adolescents
Substance use
Pediatric trauma
Implementation science
Process evaluation
title A qualitative process evaluation of SBIRT implementation in pediatric trauma centers using the Science to Service Laboratory implementation strategy
title_full A qualitative process evaluation of SBIRT implementation in pediatric trauma centers using the Science to Service Laboratory implementation strategy
title_fullStr A qualitative process evaluation of SBIRT implementation in pediatric trauma centers using the Science to Service Laboratory implementation strategy
title_full_unstemmed A qualitative process evaluation of SBIRT implementation in pediatric trauma centers using the Science to Service Laboratory implementation strategy
title_short A qualitative process evaluation of SBIRT implementation in pediatric trauma centers using the Science to Service Laboratory implementation strategy
title_sort qualitative process evaluation of sbirt implementation in pediatric trauma centers using the science to service laboratory implementation strategy
topic SBIRT
Adolescents
Substance use
Pediatric trauma
Implementation science
Process evaluation
url https://doi.org/10.1186/s43058-025-00697-x
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