You have an effective brief intervention (BI) for young adults, now what? Concrete strategies to advance BI implementation in usual care settings.

Abstract

Objective: Risky drinking remains high among young adults and is associated with negative health-related consequences. Brief interventions (BIs) are an evidence-based practice for risky drinking that are particularly well suited for young adults. However, the widespread implementation of BIs remains challenging. This article highlights guiding principles for researchers and clinicians seeking to implement BI for young adults. Method: Five guiding principles for the implementation of BIs for young adults with risky drinking are introduced as follows: (a) selecting an implementation model; (b) considering contextual factors; (c) specifying an implementation strategy; (d) assessing implementation outcomes; and (e) embracing hybrid effectiveness-implementation designs. Advancing health equity is considered a key crosscutting theme. Results: Multiple implementation models are discussed including process models, determinant frameworks, classic theories, implementation theories, and evaluation frameworks. Contextual factors impacting BI implementation are then considered across multiple levels within an organization. Next, we present methods for selecting implementation strategies and discuss implementation outcomes that can be measured during preimplementation, implementation, and sustainability phases. Finally, we encourage employing hybrid effectiveness-implementation designs to reduce the BI science-practice gap. Guiding principles are illustrated with examples from two National Institute on Alcohol Abuse and Alcoholism-funded studies exploring BI implementation domestically and internationally. Conclusions: This article introduces foundational principles and emerging strategies to nonspecialist researchers, clinicians, and policymakers seeking to enhance the dissemination and implementation of BIs. Advancing the dissemination and implementation of BIs is essential to ensure that investments in BI research are fully realized to equitably improve public health. Public Health Significance StatementBrief interventions are effective for risky drinking in young adults, but rarely available in the community. This article presents guiding principles for nonspecialists seeking to implement brief interventions in community settings.

Brief alcohol interventions for young adults: Strengthening effects, disentangling mechanisms, and scaling up for impact.

“…Finally, Becker et al (2021) provide a blueprint for implementing effective, evidence-based interventions in community and health care settings (including telehealth/virtual platforms), and identify promising new areas for implementation science (e.g., novel delivery methods or deimplementation approaches that remove/reduce practices that are not evidence-based; Prasad & Ioannidis, 2014). They offer five guiding principles to guide implementation studies: selection of a conceptual schema; consideration of contextual aspects at the individual, provider, and contextual levels; fostering transparency by detailing the implementation strategy; evaluating implementation outcomes (e.g., cost, sustainability, penetration); and incorporating hybrid effectiveness-implementation trials (e.g., Curran et al, 2012).…”

“…Many brief alcohol intervention studies are focused on efficacy or effectiveness evaluations and are largely silent on how to advance and adapt this work beyond highly controlled research settings. Becker et al (2021) suggest that when adaptations of the intervention are attempted in a new setting and are not successful, it is unclear if the failure lies in the intervention or in its deployment. NIAAA’s (2019) CollegeAIM was developed as a tool to offer information about available evidence-based individual- and environmental-level strategies to curb and reduce the harms of college student drinking.…”

Back to the basics and fast forward to multiculturalism.

“…Several studies presented in this special issue used innovative Western mainstream scientific models in fascinating ways to guide their research, such as Bronfenbrenner's model (Becker et al, 2021), genetics theory (Dick et al, 2021), and deviation regulation theory (Leary et al, 2021), with interesting applications and results. However, models with universal assumptions concerning behavior often do not operate as well when applied outside the mainstream from which those assumptions were derived.…”

“…Enlisting the assistance of various early adult communities in the process will be essential to diversifying the science. Becker et al (2021) in this issue advocate for the novel use of implementation and organizational science as a blueprint for making well-reasoned choices for equitable brief interventions to match the cultural perspectives of constituents. The article presents an excellent example of how cross-disciplinary collaboration can be matched to the specific needs of organizations and their constituents as envisioned by leadership.…”

“…They also suggest the desirability of universal screening in universities, a position that aligns with an increasing emphasis on population health in psychology. Becker et al (2021) in this issue introduce principles of organizational science for working with stakeholder policymakers, methods that may be helpful to utilize when advocating for the use of science to university administrators, and encouraging administrative approval of universal campus screenings. Consistency was another concern expressed by Larimer et al (2021).…”