Congratulations to RIAAP President, Susan Duffy, MD, FAAP for receiving one of five Friends of Children Healthy People 2020 AAP chapter grants that focus on substance abuse across the lifespan.

Project Summary:
A Pediatrician Learning Collaborative to Incorporate Substance Use Screening, Brief Intervention and Referral to Treatment (SBIRT) into Routine Adolescent Visits in Community Practices

The proposed initiative is to train pediatric primary care providers, pediatric residents and medical students in SBIRT (screening, brief intervention, and referral to treatment) utilizing the CRAFFT screening tool.

The project will enroll five to six practices in Rhode Island in a SBIRT learning collaborative incorporating practice-based quality improvement strategies to increase youth substance use screening rates.

Substance use by youth is wide spread, is not easily recognized, and has implications for long-term health and functioning.

The project aims to enhance pediatrician’s skills in using brief interventions and motivational interviewing to: 1) support youth in refraining from initiation of substance use, 2) motivate youth to decrease substance use, and 3) identify and refer youth at highest risk for substance use treatment.

Practices participating in the collaborative will receive focused training in SBIRT and assistance from a practice coach to perform baseline practice readiness assessments, develop workflow plans, use rapid learning cycles with real time data to implement effective change, and share their experiences with other practices with the support of experts in adolescent substance abuse treatment.

At the completion of the learning collaborative, the project team will draw upon the experience and lessons learned of the participating practices to develop state specific tip sheets and resource materials to disseminate to healthcare providers of youth statewide.

The target population includes adolescents served by participating practices. Priority will be given to recruiting practices that are interested and motivated to participate, serve significant numbers of youth, and serve a significant number of patients insured by Medicaid. We estimate that participating practices will serve approximately 15,000 youth 12-18 years old (representing 20% of the state’s 12-18 year olds) with about 30% covered by Medicaid.

The SBIRT learning collaborative will bring together five to six pediatric primary care practices in Rhode Island comprised of approximately 30 pediatricians as well as pediatric residents, medical students, and practice staff. The patient population of these practices is heterogeneous with half of the practices serving communities with significant health disparities and vulnerable sub-populations of immigrants, racial and ethnic minorities, and uninsured individuals.

One of the practices is in the states’ only pediatric hospital, which serves as the training site for the Alpert School of Medicine medical students and residents. Pediatric residents and medical students with interests in adolescent health will be recruited and paired with a participating practice.

The learning collaborative will utilize an innovative approach to engaging trainees by embedding them into practice teams and tapping into their social media and technology knowledge in the planning phase of the SBIRT training curriculum.

The objectives of the project align with the following HP2020 objectives: SA-2 (increase the proportion of adolescents never using substances), SA-4 (increase the proportion of adolescents who perceive great risk associated with substance use), and SA-8 (increase the proportion of persons who need alcohol and/or illicit drug treatment and received specialty treatment for abuse or dependence in the past year).

The chapter project team will incorporate information gathered during the project to develop TIP sheets that provide guidance on practice strategies for substance use screening as well as referral and treatment resources, which can be used by all health care providers of youth in Rhode Island.