263238 Importance of proximal factors in the early adoption stage for adoption of brief screening and interventions for alcohol in dental practice settings

Monday, October 29, 2012

James Alan Neff, PhD, MPH , College of Health Sciences, Old Dominion University, Norfolk, VA
Abby L. Braitman, PhD , Department of Psychology, Old Dominion University, Norfolk, VA
Michelle L. Kelley, PhD , Department of Psychology, Old Dominion University, Norfolk, VA
James F. Paulson, PhD , Department of Psychology, Old Dominion University, Norfolk, VA
Scott T. Walters, PhD , School of Public Health, University of North Texas Health Science Center, Fort Worth, TX
Michele Darby, MS, RDH , School of Dental Hygiene, Old Dominion University, Norfolk, VA
Tegwyn H. Brickhouse, DDS, PhD , School of Dentistry, VIrginia Commonwealth University, Richmond, VA
John C. Gunsolley, DDS, MS , School of Dentistry, VIrginia Commonwealth University, Richmond, VA
Margaret Lemaster, MS , Gene W. Hirschfeld School of Dental Hygiene, Old Dominion University-College of Health Sciences, Norfolk, VA
Margaret M. Walsh, MS, EdD , Department of Preventive and Restorative Dental Sciences; Center to Address Disparities in Chidren's Oral Health (CAN DO), University of California, San Francisco, San Francisco, CA
Purpose: Previous analyses predicting dental practice adoption of Screening, Brief Intervention, Referral, and Treatment (SBIRT) protocols for heavy drinking did not support the role of hypothesized distal practitioner-level or practice-level predictors. The present paper explores proximal factors in the early adoption stage which may influence adoption. Methods: Approximately 387 dentists were approached regarding participation in a study of SBIRT adoption and effectiveness. Analyses are presented on data from the 91 dentists who responded to recruitment efforts, examining factors associated with level of participation (Refused: 72; Agreed but did not participate: 3; Participated but dropped out:2; Continuously participated: 14). Research staff rated practices on factors they felt may have facilitated or impeded adoption. Results: As analyses did not identify predictors of participation vs. refusal, the 19 practices initially agreeing to participate were compared to identify factors associated with continued participation vs. drop-out. Analyses indicated that:1) 57% of consistently participating practices had a designated staff point of contact vs. 0% of other groups (2 = 4.94, p= .09) and 2) 100% of practices agreeing but never participating experienced events impeding adoption (e.g., practice moved; frequent international travel) vs. 0% of others: (2= 19.00, p<.001). Project staff indicated that two of these initially agreeing practices lacked staff buy-in. Conclusions: Analyses suggest that distal Practitioner or Practice characteristics like available resources may be less predictive of SBIRT adoption than more proximal factors in the early adoption stage such as the presence of reliable internal contacts, staff buy-in, or the occurrence of complicating circumstances.

Learning Areas:
Conduct evaluation related to programs, research, and other areas of practice
Implementation of health education strategies, interventions and programs

Learning Objectives:
List proximal factors associated with adoption of brief screening and intervention approaches for alcohol in dental practice.

Keywords: Alcohol Use, Substance Abuse Prevention

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am Principal Investigator on the NIDCR funded grant as part of which the intervention program described was developed. My scientific interests include alcohol, substance abuse, and brief interventions for these conditions
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.