# ANTECEDENT (pArtNerships To Enhance alCohol scrEening, treatment, anD intErveNTion)

> **NIH AHRQ R18** · OREGON HEALTH & SCIENCE UNIVERSITY · 2020 · $931,642

## Abstract

PROJECT SUMMARY
Alcohol misuse is the fourth leading cause of death in the US and a contributing factor to a wide range of
health conditions across the lifespan. Oregon state ranks 8th nationally in per capita costs of unhealthy alcohol
use, at an annual cost of $919 per Oregonian. Addressing unhealthy alcohol use requires improved use of
PCOR evidence in primary care clinics – including screening and brief intervention (SBI), medication assisted
treatment (MAT), and referral to treatment (RT) – as part of routine care.
ANTECEDENT (pArtNerships To Enhance alCohol scrEening, treatment, anD intErveNTion) leverages the
established infrastructure of the Oregon Rural Practice-based Research Network (ORPRN) and SBIRT Oregon
to improve SBI and MAT in small to medium sized primary care clinics in Oregon. We partner with the Oregon
Health Authority (OHA) Transformation Center and align our approach with state and regional Medicaid reform
efforts – which in January 2019 will include SBIRT as an electronic health record reported quality incentive
metric. Implementation support will be delivered using practice facilitation as a central and unifying strategy. All
clinics will receive Foundational Support which includes access to an online implementation toolkit and 6-
months of tailored Supplemental Support designed to address clinic-specific gaps in care through strategies
such as practice facilitation, health information technology (HIT) support and peer-to-peer learning.
Our implementation process is informed by a hybrid conceptual model of the integrated Promoting Action on
Research Implementation in Health Services (i-PARIHS) framework and the Dynamic Sustainability
Framework (DSF). We use RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) to support
our evaluation. Our specific aims are to: (1) Engage, recruit, and conduct intake consultations with 150 primary
care clinics and their regional CCOs within the state of Oregon; (2) Implement and describe how practice
facilitators tailor implementation support based on context, intervention, and personal expertise using mixed
methods and systems science; and (3) Evaluate the impact of foundational and supplemental implementation
support on SBI, MAT, and QI capacity in participating primary care clinics.
ANTECEDENT bridges improvement science and implementation science – allowing for local change and the
production of generalizable knowledge. Our multi-method evaluation will support participation in the external
evaluation and enable a robust internal evaluation. ANTECEDENT addresses knowledge gaps regarding
practice facilitator expertise and leverages state context to build primary care QI capacity and increase SBI and
MAT for unhealthy alcohol use.

## Key facts

- **NIH application ID:** 9994866
- **Project number:** 5R18HS027080-02
- **Recipient organization:** OREGON HEALTH & SCIENCE UNIVERSITY
- **Principal Investigator:** Melinda Marie Davis
- **Activity code:** R18 (R01, R21, SBIR, etc.)
- **Funding institute:** AHRQ
- **Fiscal year:** 2020
- **Award amount:** $931,642
- **Award type:** 5
- **Project period:** 2019-09-30 → 2022-09-29

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9994866

## Citation

> US National Institutes of Health, RePORTER application 9994866, ANTECEDENT (pArtNerships To Enhance alCohol scrEening, treatment, anD intErveNTion) (5R18HS027080-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/9994866. Licensed CC0.

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