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

Area of Science:

• Implementation Science
• Pediatric Trauma Care
• Substance Use Intervention

Background:

• Screening, Brief Intervention, and Referral to Treatment (SBIRT) is an evidence-based practice for adolescent substance use.
• Pediatric trauma centers face barriers implementing SBIRT despite mandates.
• The IAMSBIRT study implemented SBIRT across 10 centers using the Science-to-Service Laboratory (SSL) strategy.

Purpose of the Study:

• To assess trauma center staff preferences and experiences with the SSL implementation strategy.
• To identify strengths and areas for improvement in SBIRT implementation support.
• To evaluate the effectiveness of didactic training, performance feedback, and coaching.

Main Methods:

• Qualitative exit interviews were conducted with nurses, social workers, and site leaders.
• Interviews were guided by the Consolidated Framework for Implementation Research.
• Data analysis involved directed content analysis and theme translation.

Main Results:

• Staff found SSL elements generally high quality and helpful for SBIRT implementation.
• Key strengths and areas for improvement were identified in the preparation and SSL elements.
• Performance feedback and coaching were often limited to leadership, hindering non-leader troubleshooting.

Conclusions:

• Discrepancies exist in SSL strategy experience between leadership and direct care staff.
• Modifications to the SSL strategy are needed to increase direct care staff engagement.
• Enhanced engagement of frontline staff is crucial for successful SBIRT implementation in pediatric trauma.