Implementation of a screening, brief intervention and referral to treatment programme for risky substance use in South African emergency centres: A mixed methods evaluation study
Background: Screening, brief intervention, and referral to treatment (SBIRT) for risky substance use is infrequently included in routine healthcare in low-resourced settings. A SBIRT programme, adopted by the Western Cape provincial government within an alcohol harm reduction strategy, employed vari...
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| Format: | Journal Article |
| Language: | English |
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PUBLIC LIBRARY SCIENCE
2019
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| Online Access: | http://hdl.handle.net/20.500.11937/85662 |
| _version_ | 1848764760407932928 |
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| author | Van Der Westhuizen, C. Myers-Franchi, Bronwyn Malan, M. Naledi, T. Roelofse, M. Stein, D.J. Lahri, S. Sorsdahl, K. |
| author_facet | Van Der Westhuizen, C. Myers-Franchi, Bronwyn Malan, M. Naledi, T. Roelofse, M. Stein, D.J. Lahri, S. Sorsdahl, K. |
| author_sort | Van Der Westhuizen, C. |
| building | Curtin Institutional Repository |
| collection | Online Access |
| description | Background: Screening, brief intervention, and referral to treatment (SBIRT) for risky substance use is infrequently included in routine healthcare in low-resourced settings. A SBIRT programme, adopted by the Western Cape provincial government within an alcohol harm reduction strategy, employed various implementation strategies executed by a diverse team to translate an evidence-based intervention into services at three demonstration sites before broader programme scale-up. This paper evaluates the implementation of this programme delivered by facility-based counsellors in South African emergency centres.
Method: Guided by the Consolidated Framework for Implementation Research, this mixed methods study evaluated the feasibility, acceptability, appropriateness and adoption of this task-shared SBIRT programme. Quantitative data were extracted from routinely collected health information. Qualitative interviews were conducted with 40 stakeholders in the programme’s second year. Results In the first year, 13 136 patients were screened and 4 847 (37%) patients met criteria for risky substance use. Of these patients, 83% received the intervention, indicating programme feasibility. The programme was adopted into routine services and found to be acceptable and appropriate, particularly by stakeholders familiar with the emergency environment. These stakeholders highlighted the burden of substance-related harm in emergency centres and favourable patient responses to SBIRT. However, some stakeholders expressed scepticism of the behaviour change approach and programme compatibility with emergency centre operations. Furthermore, adoption was both facilitated and hampered by a top-down directive from provincial leadership to implement SBIRT, while rapid implementation limited effective engagement with a diverse stakeholder group.
Conclusion: This is one of the first studies to address SBIRT implementation in low-resourced settings. The results show that SBIRT implementation and adoption was largely successful, and provide valuable insights that should be considered prior to implementation scale-up. Recommendations include ensuring ongoing monitoring and evaluation, and early stakeholder engagement to improve implementation readiness and programme compatibility in the emergency setting. |
| first_indexed | 2025-11-14T11:24:29Z |
| format | Journal Article |
| id | curtin-20.500.11937-85662 |
| institution | Curtin University Malaysia |
| institution_category | Local University |
| language | English |
| last_indexed | 2025-11-14T11:24:29Z |
| publishDate | 2019 |
| publisher | PUBLIC LIBRARY SCIENCE |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | curtin-20.500.11937-856622021-10-21T03:29:25Z Implementation of a screening, brief intervention and referral to treatment programme for risky substance use in South African emergency centres: A mixed methods evaluation study Van Der Westhuizen, C. Myers-Franchi, Bronwyn Malan, M. Naledi, T. Roelofse, M. Stein, D.J. Lahri, S. Sorsdahl, K. Science & Technology Multidisciplinary Sciences Science & Technology - Other Topics HEALTH-SERVICES SBIRT IMPLEMENTATION CARE MISUSE FACILITATORS METAANALYSIS DISORDERS FRAMEWORK BARRIERS CONTEXT Background: Screening, brief intervention, and referral to treatment (SBIRT) for risky substance use is infrequently included in routine healthcare in low-resourced settings. A SBIRT programme, adopted by the Western Cape provincial government within an alcohol harm reduction strategy, employed various implementation strategies executed by a diverse team to translate an evidence-based intervention into services at three demonstration sites before broader programme scale-up. This paper evaluates the implementation of this programme delivered by facility-based counsellors in South African emergency centres. Method: Guided by the Consolidated Framework for Implementation Research, this mixed methods study evaluated the feasibility, acceptability, appropriateness and adoption of this task-shared SBIRT programme. Quantitative data were extracted from routinely collected health information. Qualitative interviews were conducted with 40 stakeholders in the programme’s second year. Results In the first year, 13 136 patients were screened and 4 847 (37%) patients met criteria for risky substance use. Of these patients, 83% received the intervention, indicating programme feasibility. The programme was adopted into routine services and found to be acceptable and appropriate, particularly by stakeholders familiar with the emergency environment. These stakeholders highlighted the burden of substance-related harm in emergency centres and favourable patient responses to SBIRT. However, some stakeholders expressed scepticism of the behaviour change approach and programme compatibility with emergency centre operations. Furthermore, adoption was both facilitated and hampered by a top-down directive from provincial leadership to implement SBIRT, while rapid implementation limited effective engagement with a diverse stakeholder group. Conclusion: This is one of the first studies to address SBIRT implementation in low-resourced settings. The results show that SBIRT implementation and adoption was largely successful, and provide valuable insights that should be considered prior to implementation scale-up. Recommendations include ensuring ongoing monitoring and evaluation, and early stakeholder engagement to improve implementation readiness and programme compatibility in the emergency setting. 2019 Journal Article http://hdl.handle.net/20.500.11937/85662 10.1371/journal.pone.0224951 English http://creativecommons.org/licenses/by/4.0/ PUBLIC LIBRARY SCIENCE fulltext |
| spellingShingle | Science & Technology Multidisciplinary Sciences Science & Technology - Other Topics HEALTH-SERVICES SBIRT IMPLEMENTATION CARE MISUSE FACILITATORS METAANALYSIS DISORDERS FRAMEWORK BARRIERS CONTEXT Van Der Westhuizen, C. Myers-Franchi, Bronwyn Malan, M. Naledi, T. Roelofse, M. Stein, D.J. Lahri, S. Sorsdahl, K. Implementation of a screening, brief intervention and referral to treatment programme for risky substance use in South African emergency centres: A mixed methods evaluation study |
| title | Implementation of a screening, brief intervention and referral to treatment programme for risky substance use in South African emergency centres: A mixed methods evaluation study |
| title_full | Implementation of a screening, brief intervention and referral to treatment programme for risky substance use in South African emergency centres: A mixed methods evaluation study |
| title_fullStr | Implementation of a screening, brief intervention and referral to treatment programme for risky substance use in South African emergency centres: A mixed methods evaluation study |
| title_full_unstemmed | Implementation of a screening, brief intervention and referral to treatment programme for risky substance use in South African emergency centres: A mixed methods evaluation study |
| title_short | Implementation of a screening, brief intervention and referral to treatment programme for risky substance use in South African emergency centres: A mixed methods evaluation study |
| title_sort | implementation of a screening, brief intervention and referral to treatment programme for risky substance use in south african emergency centres: a mixed methods evaluation study |
| topic | Science & Technology Multidisciplinary Sciences Science & Technology - Other Topics HEALTH-SERVICES SBIRT IMPLEMENTATION CARE MISUSE FACILITATORS METAANALYSIS DISORDERS FRAMEWORK BARRIERS CONTEXT |
| url | http://hdl.handle.net/20.500.11937/85662 |