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. Author manuscript; available in PMC: 2017 Jan 1.
Published in final edited form as: J Subst Abuse Treat. 2015 Jun 26;60:81–90. doi: 10.1016/j.jsat.2015.06.011

Table 1.

Implementation strategies used for Generalist and Specialist approaches.

Implementation
Strategy
Description Target Audience Schedule
Electronic
Medical Record
(EMR)
Modification
Substance use screening (CRAFFT)
and documentation fields addressing
follow-up services provided (e.g., BI
provided) were added to the EMR.
Administrators,
Primary Care
Providers,
Behavioral Health
Counselors,
Nurses, Medical
Assistants
Prior to
Implementation
Phase and repeated
when the new EMR
was adopted
Initial Staff
Trainings
In-person trainings addressing
adolescent substance use prevalence
and incidence, SBIRT overview, items
and scoring of CRAFFT, service
delivery protocol, and EMR
documentation. A list of adolescent
substance use providers in the
community was also provided.
Trainings were conducted at each site
for all staff. BHCs were trained as a
group, independent of site.
Primary Care
Providers,
Behavioral Health
Counselors,
Nurses, Medical
Assistants
Start of
Implementation
Phase
Bi-monthly
Feedback
De-identified encounter data from the
EMR were aggregated by site and
summarized into a single page
overview. Feedback compared the
site’s rates of screening and BI
completion over time and in
comparison to the other clinics
completion rates.
Administrators Repeated every
other month for
duration of
Implementation
Phase
Quarterly
Booster
Trainings
On-site quarterly boosters provided
the site’s EMR data for screening and
BI completion and presented an
opportunity to clarify confusion
regarding service delivery processes
by Implementation Approach, identify
and overcome barriers to screening,
BI/BA delivery, and warm handoff
completion.
Primary Care
Providers, Nurses,
Medical Assistants
Repeated every 3
months for duration
of Implementation
Phase
Quarterly
Feedback to
Providers
EMR data for each adolescent patient
seen by each provider were
summarized and provided in a
quarterly single page letter to
demonstrate performance trends and
offer reminders for adherence to their
assigned Implementation Approach.
Primary Care
Providers
Repeated every 3
months for duration
of Implementation
Phase