Al-Anon Intensive Referral (AIR): A qualitative formative evaluation for implementation

Area of Science:

• Implementation Science
• Addiction Treatment
• Mutual-Help Programs

Background:

• Al-Anon supports families and friends of individuals with alcohol use disorders.
• Limited participation in Al-Anon highlights a need for better engagement strategies.
• Al-Anon Intensive Referral (AIR) is an intervention designed to improve engagement.

Purpose of the Study:

• To evaluate facilitators, barriers, and recommendations for implementing AIR in substance use disorder (SUD) treatment clinics.
• To inform the integration of AIR into existing clinical workflows.

Main Methods:

• Qualitative formative evaluation using semi-structured interviews.
• Interviews conducted with 31 directors and staff across 10 VA and community SUD clinics.
• Thematic analysis based on the Consolidated Framework for Implementation Research.

Main Results:

• Facilitators include AIR's perceived value, adaptability, and minimal training needs.
• Barriers involve limited staff time, resources, and client/concerned other engagement challenges.
• Recommendations include workflow integration, targeting readiness, and exploring digital formats (website/app).

Conclusions:

• AIR has significant implementation potential in SUD settings, varying with clinic capacity.
• Partial implementation is feasible for most clinics; full implementation requires adequate resources.
• Findings can guide the implementation of other interventions for concerned others.