Addressing adolescent substance use through the integration of SBIRT into a primary care clinic:A quality improvement project

Background and Objective: Adolescent substance use is a serious public health problem. Negative consequences include risky sexual behaviors, violence, mental health risks, and lifelong consequences including substance use disorders, unemployment, and lower life satisfaction. Outpatient clinical providers may not consistently utilize evidence-based screening tools, such as the CRAFFT, for adolescent substance use. Providers identify barriers to implementation of Screening, Brief Intervention, and Referral to Treatment (SBIRT). Methods: This quality improvement project used a mixed-methods design. Quantitative statistics included CRAFFT completion rates and pre- and post-provider readiness, comfort, and knowledge constructs of SBIRT. Qualitative data included provider comments about the DNP project. Results: Quarterly CRAFFT screening completion rates fluctuated but trended upward during the last quarter toward the goal of 75%. Data analyses indicated no statistical significance between baseline and completion for provider readiness, comfort, and knowledge of SBIRT. Conclusions: While there was not statistical significance with seven providers, there was clinical significance screening 80 adolescents and no negative outcomes. Despite challenging circumstances during the Coronavirus-19 pandemic, providers successfully engaged in SBIRT. Future implementation would include a SBIRT nurse navigator and use of an electronic device for adolescents to complete screening tool.