# IAMSBIRT: Implementing Alcohol Misuse SBIRT in a National Cohort of Pediatric Trauma Centers

> **NIH NIH R01** · RHODE ISLAND HOSPITAL · 2021 · $628,546

## Abstract

PROJECT SUMMARY
In 2006, the American College of Surgeons (ACS) adopted a requirement for certification as a level one trauma
center that mandated universal screening for alcohol misuse and delivery of a brief intervention for those
screening positive. Though this requirement has been mandated for a decade, its implementation has been
challenging, especially for pediatric trauma centers. Our research team completed a CDC funded
implementation study supporting seven pediatric trauma centers' compliance with the ACS requirement by
developing and implementing an institutional alcohol Screening, Brief Intervention and Referral to Treatment
(SBIRT) protocol for adolescent trauma patients. A mixed-methods approach indicated that SBIRT adoption
rates increased at all sites; however, providers' fidelity to the SBIRT intervention was variable, and providers
reported a number of barriers to SBIRT implementation. The goal of this application is to conduct a fully
powered Type III hybrid effectiveness-implementation trial to test the effectiveness of a comprehensive
implementation strategy in increasing the implementation of SBIRT for alcohol and other drug use in pediatric
trauma centers. Our implementation strategy is based on the Science to Service Laboratory (SSL), an
approach developed by the SAMHSA-funded Addiction Technology Transfer Centers (ATTCs) that consists of
the same three core elements (i.e., didactic training + performance feedback + leadership coaching) used in
our CDC study. Based on feedback from the CDC study, two enhancements were made to the SSL strategy:
1) integration of the intervention into the electronic medical record as a means of improving SBIRT adherence;
and 2) development of separate training tracks for nurses, social workers and organizational leaders to meet
the unique needs of each group. In addition, we integrate counseling around the use of prescription pain
relievers into the SBIRT intervention as an Exploratory Aim, since most pediatric trauma center patients are
discharged on pain medication and patients with a history of AOD use are at elevated risk of opioid misuse.
Utilizing a stepped wedge design, a national cohort of 10 pediatric trauma centers will receive the SSL
implementation strategy. Data collection for this study relies on multiple sources. At six distinct time points,
each of the 10 sites will provide data from 30 EMR charts (n = 1800 charts in total). A subset of adolescents
will also report on fidelity of intervention delivery and linkage to care (i.e., continued AOD discussion and/or
treatment with a primary care provider) 1 month post hospital discharge. In addition, nurses, social workers,
and leaders from each pediatric trauma center will report on organizational readiness for implementation at
three distinct time points. Results of this study will demonstrate that a highly scalable implementation strategy,
adapted for pediatric trauma centers from the results of our mixed-methods implementation tr...

## Key facts

- **NIH application ID:** 10223170
- **Project number:** 5R01AA025914-05
- **Recipient organization:** RHODE ISLAND HOSPITAL
- **Principal Investigator:** Michael J Mello
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $628,546
- **Award type:** 5
- **Project period:** 2017-08-01 → 2024-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10223170

## Citation

> US National Institutes of Health, RePORTER application 10223170, IAMSBIRT: Implementing Alcohol Misuse SBIRT in a National Cohort of Pediatric Trauma Centers (5R01AA025914-05). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10223170. Licensed CC0.

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