# Screening and Management of Unhealthy Alcohol Use in Primary Care: Dissemination and Implementation of PCOR Evidence

> **NIH AHRQ R18** · UNIV OF NORTH CAROLINA CHAPEL HILL · 2020 · $745,416

## Abstract

Project Summary/Abstract
Background: Unhealthy alcohol use is the third leading cause of preventable deaths in the US
and is associated with many societal and health problems. It is a key contributor to recent
declines in US life expectancy, especially among middle-aged white Americans and those living
in rural areas. Despite the burden of illness and recommendations to screen for unhealthy
alcohol use, relatively few people who visit primary care providers in the US are asked about
alcohol use or ever discuss alcohol use with a health professional. Practices often lack a formal
process for screening and subsequent delivery of appropriate interventions.
Objectives: The objectives are (1) to determine if primary care practice facilitation (PF) can
achieve rapid dissemination and implementation of evidence-based screening, counseling, and
medication assisted therapy (MAT) for unhealthy alcohol use and (2) for practices with slower
uptake, to compare whether providing embedded telehealth services accelerates the
dissemination and implementation of screening, counseling, and MAT.
Methods: STUN Alcohol Use Now is an adaptive randomized, controlled trial to evaluate the
effect of primary care PF and providing embedded telehealth services on evidence-based
screening, counseling, and MAT in 135 primary care practices with 10 or fewer providers. Each
enrolled practice will receive the PF intervention. After 6 months of receiving the PF
intervention, practices in the lower 50th percentile (based on performance) will be randomized to
continued PF or to embedded telehealth services plus PF for the next 12 months. The PF
intervention includes onsite QI facilitation, EHR support, training, and academic detailing.
Potential Impact: A successful intervention would significantly reduce the burden of disease
from unhealthy alcohol use. The study will produce fundamentally important evidence about the
effect of practice facilitation on uptake of evidence-based SBI and MAT for unhealthy alcohol
use when delivered on a large scale to small to medium-size primary care practices. It will also
generate scientific knowledge about whether embedded telehealth services can improve use of
evidence-based screening and interventions for practices with slower uptake. The results of this
rigorously conducted evaluation are expected to have a positive impact by supplying AHRQ with
the evidence it needs to effectively and efficiently accelerate the dissemination and
implementation of evidence related to unhealthy alcohol use into primary care practices.

## Key facts

- **NIH application ID:** 9994865
- **Project number:** 5R18HS027078-02
- **Recipient organization:** UNIV OF NORTH CAROLINA CHAPEL HILL
- **Principal Investigator:** DARREN A DEWALT
- **Activity code:** R18 (R01, R21, SBIR, etc.)
- **Funding institute:** AHRQ
- **Fiscal year:** 2020
- **Award amount:** $745,416
- **Award type:** 5
- **Project period:** 2019-09-30 → 2022-09-29

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9994865

## Citation

> US National Institutes of Health, RePORTER application 9994865, Screening and Management of Unhealthy Alcohol Use in Primary Care: Dissemination and Implementation of PCOR Evidence (5R18HS027078-02). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/9994865. Licensed CC0.

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