# Practice Facilitation to Promote Evidence-based Screening and Management of Unhealthy Alcohol Use in Primary Care

> **NIH AHRQ R18** · VIRGINIA COMMONWEALTH UNIVERSITY · 2020 · $851,874

## Abstract

Practice Facilitation to Promote Evidence-based Screening and Management of Unhealthy Alcohol Use in
 Primary Care
PROJECT SUMMARY
Unhealthy alcohol use is the third leading cause of preventable death in the US. Evidence shows that
screening for unhealthy alcohol use and providing persons engaged in risky drinking with brief behavioral
counseling interventions improves health outcomes, collectively termed screening and brief intervention (SBI).
For moderate or severe alcohol use disorder (AUD), medication assistance therapy (MAT) is effective. Despite
clear evidence of effectiveness, only 13% of primary care patients are screened with a standard instrument
and only 6.7% of adults with AUD receive treatment. We believe that underutilization of SBI and MAT are
driven by both a misunderstanding of the role and effectiveness of primary care in addressing unhealthy
alcohol and limited practice resource and infrastructure. To promote the dissemination and implementation of
evidence-based strategies to address unhealthy alcohol use throughout Virginia, we have extended our
EvidenceNow collaboration to include addiction medicine experts at Virginia Commonwealth University, the
Virginia Ambulatory Care Outcomes Research Network (ACORN), our state's family medicine residency
training programs, and our state's Community Service Boards. We propose a practice-level cluster randomized
trial with wait list control. 125 primary care practices in five regions throughout the state, each centered around
a residency site for educational support, will receive a practice facilitation intervention to implement screening,
counseling, and treatment for unhealthy alcohol at intervention start or 6-month delay. Guided by the identified
EvidenceNow key drivers for change, practice support will include practice facilitation, education and training,
shared learning and best practices, screening and counseling toolkits, data support, and assessment with
feedback. Each practice will identify a clinician, nurse, and administrator champion to locally lead efforts and
participate in learning collaboratives. Practices will design and implement screening, counseling, and treatment
processes and operational changes, adapting their implementation strategy based on experiences and findings
from other sites. We will conduct a mixed methods analysis. Primary outcomes will include the increase in
screening for unhealthy alcohol use, increase in provision of brief counseling interventions and MAT, and
reduction in alcohol intake for patients after practices receive practice facilitation. We will use the consolidated
framework for implementation research to code and rate practice facilitation (e.g. dose, mode, reach) and
practice implementation strategies (e.g. SBI and MAT strategies and tools implemented) on outcomes. Data
sources will include practice facilitator field notes and interviews, chart reviews, patient survey, clinician survey,
All Payer Claims Data, and qualitative interviews....

## Key facts

- **NIH application ID:** 9994863
- **Project number:** 5R18HS027077-02
- **Recipient organization:** VIRGINIA COMMONWEALTH UNIVERSITY
- **Principal Investigator:** Alexander H Krist
- **Activity code:** R18 (R01, R21, SBIR, etc.)
- **Funding institute:** AHRQ
- **Fiscal year:** 2020
- **Award amount:** $851,874
- **Award type:** 5
- **Project period:** 2019-09-30 → 2022-09-29

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9994863

## Citation

> US National Institutes of Health, RePORTER application 9994863, Practice Facilitation to Promote Evidence-based Screening and Management of Unhealthy Alcohol Use in Primary Care (5R18HS027077-02). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/9994863. Licensed CC0.

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