Translating medical SBIRT for alcohol misuse into behavioral healthcare practice in workplace settings

Alcohol SBI is an evidence-based approach to addressing a major public health concern - impaired driving. Workplace settings including employee assistance, health promotion and wellness, disability and risk management, and occupational health and safety programs are uniquely positioned to use SBI to identify and intervene early with employees who misuse alcohol before their drinking results in adverse consequences or dependence. Substantial empirical support exists for alcohol SBI in medical, but not non-medical settings such as the workplace - an underutilized venue for alcohol interventions. This research aims to translate medical SBI into practice in work-related settings where workers spend much of their time each day and millions of workers can be reached annually. The objectives are: a) assess feasibility of adapting medical SBI practices for workplace settings; b) develop feasible, practical training, implementation, and quality/fidelity monitoring protocols that can be integrated into existing practices; c) conduct proof of concept pilots to assess impact of implementing systematic, routine alcohol SBI on program performance (e.g., rates of screening, alcohol problem identification); and d) assess preliminary employee outcomes (e.g., self-reported alcohol use, productivity). Five employers and their behavioral healthcare providers served as pilot sites. The Brief Intervention Group (BIG) Initiative was convened to inform the adaptation of SBI procedures for workplace based on WHO protocols. It includes systematic screening using the AUDIT, brief motivational intervention, referral to treatment/counseling, and follow-up. Findings suggest integration of routine SBI in workplace settings is not only feasible, but also increases identification and opportunity for brief motivational consultation.