# Implementation Facilitation of Screening, Brief Intervention, and Referral to Treatment for Pain Management for Veterans Separating from Military Service

> **NIH NIH UG3** · YALE UNIVERSITY · 2023 · $674,464

## Abstract

Project Summary
Fully half of post-9/11 Veterans eventually receive service-connected disability for musculoskeletal disorder.
These Veterans often go on to develop chronic pain and are at high risk for substance misuse. Early
intervention, connecting Veterans to multimodal pain treatment, is important for Veterans transitioning from
military to civilian healthcare to arrest worsening pain and the initiation or exacerbation of risky substance use.
Screening, Brief Intervention and Referral to Treatment for Pain Management (SBIRT-PM) has been shown to
be useful for this purpose; and case managers in the Post-9/11 Military2VA (M2VA) program are perfectly
positioned to deliver it. M2VA Programs are at each VA medical center and are charged with coordinating VA
health care for all service members separating from the military. The implementation of SBIRT-PM by M2VA
likely requires facilitation because the social workers and nurses who provide case management are not
otherwise directed to specific training in multimodal pain care or addiction services, and they are not routinely
provided facility support for this effort that requires coordination across pain treatment modalities and systems.
In collaboration with the national leadership of the M2VA program, we propose a 2-cohort, cluster randomized,
type 2 hybrid trial to test the effectiveness, cost effectiveness and patient-level effects of an implementation
facilitation strategy for SBIRT-PM. Informed by a 1-year planning phase, we will randomly assign 28 VA
medical centers to one of two conditions. M2VA case managers in sites within the experimental condition will
receive training in SBIRT-PM followed by implementation facilitation (case finding report, consultation groups,
audit and feedback, and technical assistance and problem-solving support) delivered by an external facilitation
team (with pain, addiction, case management, and implementation science expertise) and internal facilitators
at each medical center. A Relational Coordination framework will guide facilitation efforts. Comparator sites
will receive SBIRT-PM training-as-usual. A formative evaluation before, during, and after the trial will iteratively
inform the adjustment of the implementation facilitation strategy to best fit this project. From the full cohort of
Veterans who are seeking service-connection for musculoskeletal disorders, we will recruit and follow 1848
Veterans for more detailed phone assessments at baseline, 3 and 9 months after enrollment. We hypothesize
that adding implementation facilitation to training-as-usual for SBIRT-PM will result in a higher proportion of
Veterans who receive SBIRT-PM (Reach), higher proportion of case managers who attend training and use
SBIRT-PM with at least three Veterans (Adoption), and better adherence to the SBIRT-PM protocol
(Implementation). We further hypothesize that implementation facilitation of SBIRT-PM will improve Veterans
clinical outcomes (pain, risky substance use) and inc...

## Key facts

- **NIH application ID:** 10592726
- **Project number:** 1UG3AT012262-01
- **Recipient organization:** YALE UNIVERSITY
- **Principal Investigator:** Steve Martino
- **Activity code:** UG3 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2023
- **Award amount:** $674,464
- **Award type:** 1
- **Project period:** 2023-07-01 → 2024-09-15

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10592726

## Citation

> US National Institutes of Health, RePORTER application 10592726, Implementation Facilitation of Screening, Brief Intervention, and Referral to Treatment for Pain Management for Veterans Separating from Military Service (1UG3AT012262-01). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10592726. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*