# Implementation of Alcohol Screening and Brief Intervention in a Health System: Sustainability, Fidelity and Patient Outcomes

> **NIH NIH R01** · KAISER FOUNDATION RESEARCH INSTITUTE · 2021 · $82,044

## Abstract

Project Summary/Abstract
The COVID-19 pandemic has led to a dramatic shift to virtual treatment for patients with alcohol
problems. This shift raises questions about potential disparities in access to virtual treatment,
given the existing ‘digital divide,’ where older patients, patients of color, and patients of lower
socio-economic status may have less access to broadband, computers, and other digital
devices. Patients may also face barriers such as confidentiality concerns, lack of private space
for participating in virtual sessions, and dissatisfaction with the virtual therapeutic experience. At
the same time, features of virtual treatment, such as convenience and elimination of
transportation and its costs, may increase access and use, particularly for underrepresented
patient populations. The proposed study examines disparities in virtual alcohol treatment among
patients with alcohol problems, defined as both excessive alcohol use and alcohol use disorder
(AUD) in a large, diverse, health care delivery system that was able to quickly pivot to virtual
alcohol treatment delivery during the pandemic. Using rich electronic health record and claims
data, we examine changes in alcohol problem identification, and in several treatment measures
(brief intervention, pharmacotherapy, and initiation, engagement, and retention in specialty
addiction treatment) comparing visit types (virtual/non-virtual, telephone, video) from a pre-
COVID-19 (3/2019-12/2019) to post-COVID-19 onset (3/2020-12/2020) time period. With a
large sample of 205,293 patients with alcohol problems, we will specifically explore disparities
by race/ethnicity, gender, age, and socioeconomic status, and examine different severity levels
of alcohol problems. We explore differential insurance loss during this turbulent time, as well as
health services utilization (e.g. emergency department, primary care, psychiatry, email secure
messages) by the study population. Our rigorous analytic plan incorporates interrupted time
series (ITS), and generalized estimating equation (GEE) models to address study aims. Early
evidence suggests alcohol problems have increased during the COVID-19 pandemic, and
virtual treatment will likely continue post-pandemic as an important treatment modality. Findings
have important implications for patient care, particularly for improving quality of care for
vulnerable populations. Further, the study cohort will be a valuable resource for future research
on virtual alcohol treatment, and its long-term impact on patient outcomes.

## Key facts

- **NIH application ID:** 10414232
- **Project number:** 3R01AA027477-03S1
- **Recipient organization:** KAISER FOUNDATION RESEARCH INSTITUTE
- **Principal Investigator:** Stacy Ann Sterling
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $82,044
- **Award type:** 3
- **Project period:** 2019-08-01 → 2024-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10414232

## Citation

> US National Institutes of Health, RePORTER application 10414232, Implementation of Alcohol Screening and Brief Intervention in a Health System: Sustainability, Fidelity and Patient Outcomes (3R01AA027477-03S1). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10414232. Licensed CC0.

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