Factors associated with intention to implement SBI and SUD treatment: a survey of primary care clinicians in Texas enrolled in an online course

TL;DR

This study explores what influences primary care clinicians in Texas to implement SBI and SUD treatment, finding that knowledge, colleague support, and workflow integration matter.

Contribution

The study identifies specific factors linked to clinicians' intention to implement SBI and SUD treatment in primary care.

Findings

Most clinicians had low knowledge about standard drink definitions and risky drinking thresholds.

Support from colleagues and routine screening in workflows were positively linked to implementation intentions.

A multi-faceted approach is needed to improve knowledge and support for SBI and SUD treatment.

Abstract

Substance use disorder (SUD) presents a range of public health challenges and consequences. Despite the prevention potential of screening and brief intervention (SBI) in the primary care setting, implementation is low. The purpose of this study was to assess associations of primary care clinicians’ knowledge of SBI and SUD treatment, subjective norms, and perceived behavioral control with intention to incorporate SBI and SUD treatment into regular clinical practice.

This online survey was administered to primary care clinicians who practice in Texas between March 1, 2021, and February 5, 2023. Survey questions were mapped to factors in the Theory of Planned Behavior and included measures of knowledge, subjective norms, and perceived behavioral controls related to SBI and SUD treatment. Intention to engage in SBI and SUD treatment was assessed as the outcome.

Of 645 participants included in this study, 59.5% were physicians. Knowledge was low, with less than half correctly reporting what was considered a standard drink (39.6%) and only 20% knew the correct number of alcoholic beverages considered risky drinking in 21-year-old non-pregnant women. Subjective norms, such as having colleagues within their practice support addressing SUDs, and perceived behavioral control such as having SUD screening routinized within clinic workflows, were positively associated with intention to implement SBI and SUD treatment in primary care settings.

Modifying knowledge gaps, subjective norms, and perceived behavioral control requires a multipronged interventional approach that blends accessible clinician training with systemic workplace enhancements and a collective shift in professional norms.

The online version contains supplementary material available at 10.1186/s12875-024-02427-z.

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