Factors Impacting Implementation of Electronic Screening and Brief Intervention (eSBI) for Alcohol in a Reproductive Healthcare Setting

Excessive alcohol use is increasing among pregnant and non-pregnant women and is associated with multiple negative health outcomes. Even among those meeting criteria for alcohol use disorder, the majority is neither in treatment nor feel it is needed. Health systems play an important role in addressing alcohol use through their ability to proactively identify non-treatment-seeking women and promote change via Screening and Brief Intervention (SBI). However, traditional provider-delivered SBI often faces implementation challenges. We used a mixed methods approach to evaluate a program that implemented technology-based SBI (eSBI) within reproductive health clinics in a large health system to identify implementation barriers and facilitators. Key factors impacting eSBI implementation included the flexibility of the eSBI platform, electronic health record integration, low burden on clinic staff, COVID-19 impacts on clinical care, modest leadership support, and possible “assessment overload” among patients and providers. Implications for improving eSBI implementation are described.