Dennis P Watson1, Monte D Staton2, Michael L Dennis3, Christine E Grella4, Christy K Scott4. 1. Chestnut Health Systems, 221 W Walton St, 60610, Chicago, IL, United States. dpwatson@chestnut.org. 2. Center for Dissemination and Implementation Science, Department of Medicine, College of Medicine, University of Illinois at Chicago, 818 S. Wolcott, 60612, Chicago, IL, United States. 3. Chestnut Health Systems, 448 Wylie Dr, 61761, Normal, IL, United States. 4. Chestnut Health Systems, 221 W Walton St, 60610, Chicago, IL, United States.
Abstract
BACKGROUND: Brief treatment (BT) can be an effective, short-term, and low-cost treatment option for many people who misuse alcohol and drugs. However, inconsistent implementation is suggested to result in BT that often looks and potentially costs similar to regular outpatient care. Prior research is also rife with inconsistent operationalizations regarding the measurement of BT received by patients. As such, there is a need to more explicitly identify and document variations in BT practice. METHODS: A qualitative investigation of BT in four Federally Qualified Health Centers (FQHC) was undertaken as a sub study of a larger clinical trial. Researchers interviewed 12 staff (administrators and clinicians) involved in BT oversight, referral, or delivery within the four FQHCs. Data were analyzed following an inductive approach guided by the primary research questions. RESULTS: Findings demonstrate considerable differences in how BT was conceptualized and implemented within the FQHCs. This included a variety of ways in which BT was presented and described to patients that likely impacts how they perceive the BT they receive, including potentially not understanding they received substance use disorder treatment at all. CONCLUSIONS: The findings raise questions regarding the validity of prior research, demonstrating more objective definitions of BT and fidelity checklists are needed to ensure integrity of results. Future work in this area should seek to understand BT as practiced among a larger sample of providers and the direct experiences and perspectives of patients. There is also a need for more consistent implementation, quality assurance guidelines, and standardized stage of change assessments to aid practitioners.
BACKGROUND: Brief treatment (BT) can be an effective, short-term, and low-cost treatment option for many people who misuse alcohol and drugs. However, inconsistent implementation is suggested to result in BT that often looks and potentially costs similar to regular outpatient care. Prior research is also rife with inconsistent operationalizations regarding the measurement of BT received by patients. As such, there is a need to more explicitly identify and document variations in BT practice. METHODS: A qualitative investigation of BT in four Federally Qualified Health Centers (FQHC) was undertaken as a sub study of a larger clinical trial. Researchers interviewed 12 staff (administrators and clinicians) involved in BT oversight, referral, or delivery within the four FQHCs. Data were analyzed following an inductive approach guided by the primary research questions. RESULTS: Findings demonstrate considerable differences in how BT was conceptualized and implemented within the FQHCs. This included a variety of ways in which BT was presented and described to patients that likely impacts how they perceive the BT they receive, including potentially not understanding they received substance use disorder treatment at all. CONCLUSIONS: The findings raise questions regarding the validity of prior research, demonstrating more objective definitions of BT and fidelity checklists are needed to ensure integrity of results. Future work in this area should seek to understand BT as practiced among a larger sample of providers and the direct experiences and perspectives of patients. There is also a need for more consistent implementation, quality assurance guidelines, and standardized stage of change assessments to aid practitioners.
Authors: Theresa W Kim; Judith Bernstein; Debbie M Cheng; Christine Lloyd-Travaglini; Jeffrey H Samet; Tibor P Palfai; Richard Saitz Journal: Addiction Date: 2017-02-07 Impact factor: 6.526
Authors: Joseph E Glass; Ashley M Hamilton; Byron J Powell; Brian E Perron; Randall T Brown; Mark A Ilgen Journal: Addiction Date: 2015-06-03 Impact factor: 6.526
Authors: Isabel A Barata; Jamie R Shandro; Margaret Montgomery; Robin Polansky; Carolyn J Sachs; Herbert C Duber; Lindsay M Weaver; Alan Heins; Heather S Owen; Elaine B Josephson; Wendy Macias-Konstantopoulos Journal: West J Emerg Med Date: 2017-09-21
Authors: Celia C Kamath; Sydney S Kelpin; Christi A Patten; Teresa A Rummans; Hilal Maradit Kremers; Tyler S Oesterle; Mark D Williams; Scott A Breitinger Journal: Mayo Clin Proc Date: 2022-07-19 Impact factor: 11.104