title: Organizational attributes and screening and brief intervention in primary care.
abstract: Overconsumption of alcohol is well known to lead to numerous health and social problems. Prevalence studies of United States adults found that 20% of patients meet criteria for an alcohol use disorder. Routine screening for alcohol use is recommended in primary care settings, yet little is known about the organizational factors that are related to successful implementation of screening and brief intervention (SBI) and treatment in these settings. The purpose of this study was to evaluate organizational attributes in primary care practices that were included in a practice-based research network trial to implement alcohol SBI. The Survey of Organizational Attributes in Primary Care (SOAPC) has reliably measured four factors: communication, decision-making, stress/chaos and history of change. This 21-item instrument was administered to 178 practice members at the baseline of this trial, to evaluate for relationship of organizational attributes to the implementation of alcohol SBI and treatment. No significant relationships were found correlating alcohol screening, identification of high-risk drinkers and brief intervention, to the factors measured in the SOAPC instrument. These results highlight the challenges related to the use of organizational survey instruments in explaining or predicting variations in clinical improvement. Comprehensive mixed methods approaches may be more effective in evaluations of the implementation of SBI and treatment.
authors.affiliation: College of Nursing, Department of Nursing, Medical University of South Carolina, 99 Jonathan Lucas St MSC 160, Charleston, SC 29425, USA. nemethl@musc.edu
authors.forename: Lynne S
authors.initials: LS
authors.lastname: Nemeth
authors.forename: Peter M
authors.initials: PM
authors.lastname: Miller
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Nietert
authors.forename: Steven M
authors.initials: SM
authors.lastname: Ornstein
authors.forename: Andrea M
authors.initials: AM
authors.lastname: Wessell
authors.forename: Ruth G
authors.initials: RG
authors.lastname: Jenkins
mesh_terms: D000328:Adult; D000368:Aged; D019973:Alcohol-Related Disorders / Q000517:prevention & control*; D001291:Attitude of Health Personnel; D003142:Communication; D018592:Cross-Over Studies; D003657:Decision Making; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015279:Organizational Culture; D010348:Patient Care Team / Q000458:organization & administration; D011320:Primary Health Care / Q000458:organization & administration*; D011364:Professional Practice; D013315:Stress, Psychological / Q000209:etiology; D011795:Surveys and Questionnaires
keywords: Alcohol screening; High-risk drinkers; Organizational attributes; Primary care
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