title: From Policy to Practice: Implementation of Treatment for Substance Misuse in Québec Primary Healthcare Clinics.
abstract: OBJECTIVE
  In 2007, the Québec Ministry of Health issued a policy document that specifically mandated the development of addiction treatment services including screening, brief interventions and referral (SBIR) to be delivered by primary healthcare clinics throughout Québec. The current study examined the level of implementation of SBIR one year following the end of the mandate (2007-2012).
  
  
  METHODS
  Semi-structured interviews were conducted with 45 participants from 21 primary health and social service centres throughout the province. Qualitative analysis was used to evaluate the level of success each centre had in implementing SBIR and to identify organizational measures that contributed to successful implementation.
  
  
  RESULTS
  The results show that Québec primary health and social service centres had limited success in their efforts to integrate SBIR into their services. A comparative analysis of the centres, categorized according to their level of implementation, revealed the presence of significant organizational- and staff-level factors, including the creation of formal action plans that were conducive to the successful implementation of SBIR in primary care.
  
  
  CONCLUSIONS
  The findings highlight the importance of offering support and guidance, as well as a menu of specific practices that are likely to assist primary health and social services centres to implement SBIR. At the organizational level, the adoption of local action plans and formal service trajectories offers a framework that allows for horizontal and vertical integration of new practices.
authors.affiliation: Research Coordinator, Addictions Unit, McGill University Health Centre, Montréal, QC.
authors.forename: Serge
authors.initials: S
authors.lastname: Maynard
authors.affiliation: Research Coordinator, Addictions Unit, McGill University Health Centre, Montréal, QC.
authors.forename: Emily
authors.initials: E
authors.lastname: Campbell
authors.affiliation: Research Assistant, Addictions Unit, McGill University Health Centre, Montréal, QC.
authors.forename: Katie
authors.initials: K
authors.lastname: Boodhoo
authors.affiliation: Psychologist, Queen Elizabeth Health Complex, Montréal, QC.
authors.forename: Gail
authors.initials: G
authors.lastname: Gauthier
authors.affiliation: Director, SHERPA, CSSS de la Montagne, Montréal, QC.
authors.forename: Spyridoula
authors.initials: S
authors.lastname: Xenocostas
authors.affiliation: Associate Chair (Education) & Associate Professor, Psychiatry Department, McGill University, Montréal, QC.
authors.forename: Dara A
authors.initials: DA
authors.lastname: Charney
authors.affiliation: Associate Professor, Psychiatry Department, McGill University, Montréal, Québec.
authors.forename: Kathryn
authors.initials: K
authors.lastname: Gill
mesh_terms: D006284:Health Plan Implementation / Q000458:organization & administration*; D006291:Health Policy; D006801:Humans; D009936:Organizational Innovation; D011320:Primary Health Care / Q000458:organization & administration*; D011792:Quebec; D012947:Social Work / Q000458:organization & administration*; D016320:Substance Abuse Treatment Centers / Q000458:organization & administration*; D011795:Surveys and Questionnaires