A Behind-the-Scenes Look at Practice Facilitation to Improve Delivery of Unhealthy Alcohol Use Screening and Management Services in Primary Care: A Qualitative Study

Background: In 2019, the Agency for Healthcare Research and Quality (AHRQ) funded 6 grantee teams to evaluate the effectiveness of practice facilitation (PF) as an implementation approach for improving the delivery of U.S. Preventive Services Task Force-recommended unhealthy alcohol use (UAU) servic...

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Main Authors: Michelle S. Rockwell, Gabriela Villalobos, Jennifer Bannon, Dawn Bishop, Stephanie Kirchner, Daniel E. Jonas, Alex H. Krist, Melinda Davis, E. Marshall Brooks
Format: Article
Language:English
Published: SAGE Publishing 2025-07-01
Series:Journal of Primary Care & Community Health
Online Access:https://doi.org/10.1177/21501319251351144
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author Michelle S. Rockwell
Gabriela Villalobos
Jennifer Bannon
Dawn Bishop
Stephanie Kirchner
Daniel E. Jonas
Alex H. Krist
Melinda Davis
E. Marshall Brooks
author_facet Michelle S. Rockwell
Gabriela Villalobos
Jennifer Bannon
Dawn Bishop
Stephanie Kirchner
Daniel E. Jonas
Alex H. Krist
Melinda Davis
E. Marshall Brooks
author_sort Michelle S. Rockwell
collection DOAJ
description Background: In 2019, the Agency for Healthcare Research and Quality (AHRQ) funded 6 grantee teams to evaluate the effectiveness of practice facilitation (PF) as an implementation approach for improving the delivery of U.S. Preventive Services Task Force-recommended unhealthy alcohol use (UAU) services in primary care. This report characterizes practice facilitators’ first-hand experiences with implementation. Methods: We invited practice facilitators from each grantee team to participate in group interviews focused on facilitation strategies employed, facilitators and barriers encountered, adaptations made, and practice transformation observed. Interview transcripts were thematically coded using inductive and deductive methods and analyzed using immersion-crystallization. Results: Seventeen practice facilitators who worked with ~300 practices participated. PF was perceived as effective in overcoming barriers to improve screening and counseling for UAU in varied settings and contexts. Practice-centered strategies that personalized practice engagement, met practices “where they are at,” tailored to local context, and fostered deep cultural change were highlighted as instrumental to the multilevel changes needed to transform practice workflow around management of UAU. Facilitator quotes, strategies, and multiple facilitation resources are provided. Conclusions: Practice facilitators’ collective perspectives paint a more complete picture of the processes, adaptations, and outcomes associated with this substantial practice-based research effort. PF is a versatile, flexible, and adaptable implementation approach to improve management of UAU in primary care that provides pragmatic strategies for care teams, practice leaders, researchers, and funders. Practice facilitators’ collective perspectives paint a more complete picture of the processes, adaptations, and outcomes associated with this substantial practice-based research effort.
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spelling doaj-art-e4df6287090d4d9aaad3bfdf8aaa9a162025-08-20T03:28:51ZengSAGE PublishingJournal of Primary Care & Community Health2150-13272025-07-011610.1177/21501319251351144A Behind-the-Scenes Look at Practice Facilitation to Improve Delivery of Unhealthy Alcohol Use Screening and Management Services in Primary Care: A Qualitative StudyMichelle S. Rockwell0Gabriela Villalobos1Jennifer Bannon2Dawn Bishop3Stephanie Kirchner4Daniel E. Jonas5Alex H. Krist6Melinda Davis7E. Marshall Brooks8Virginia Tech Carilion School of Medicine, Roanoke, USAVirginia Commonwealth University, Richmond, USANorthwestern University, Chicago, IL, USAAltarum Institute, Ann Arbor, MI, USAUniversity of Colorado, Aurora, USAThe Ohio State University, Columbus, USAVirginia Commonwealth University, Richmond, USAOregon Health & Science University, Portland, USAVirginia Commonwealth University, Richmond, USABackground: In 2019, the Agency for Healthcare Research and Quality (AHRQ) funded 6 grantee teams to evaluate the effectiveness of practice facilitation (PF) as an implementation approach for improving the delivery of U.S. Preventive Services Task Force-recommended unhealthy alcohol use (UAU) services in primary care. This report characterizes practice facilitators’ first-hand experiences with implementation. Methods: We invited practice facilitators from each grantee team to participate in group interviews focused on facilitation strategies employed, facilitators and barriers encountered, adaptations made, and practice transformation observed. Interview transcripts were thematically coded using inductive and deductive methods and analyzed using immersion-crystallization. Results: Seventeen practice facilitators who worked with ~300 practices participated. PF was perceived as effective in overcoming barriers to improve screening and counseling for UAU in varied settings and contexts. Practice-centered strategies that personalized practice engagement, met practices “where they are at,” tailored to local context, and fostered deep cultural change were highlighted as instrumental to the multilevel changes needed to transform practice workflow around management of UAU. Facilitator quotes, strategies, and multiple facilitation resources are provided. Conclusions: Practice facilitators’ collective perspectives paint a more complete picture of the processes, adaptations, and outcomes associated with this substantial practice-based research effort. PF is a versatile, flexible, and adaptable implementation approach to improve management of UAU in primary care that provides pragmatic strategies for care teams, practice leaders, researchers, and funders. Practice facilitators’ collective perspectives paint a more complete picture of the processes, adaptations, and outcomes associated with this substantial practice-based research effort.https://doi.org/10.1177/21501319251351144
spellingShingle Michelle S. Rockwell
Gabriela Villalobos
Jennifer Bannon
Dawn Bishop
Stephanie Kirchner
Daniel E. Jonas
Alex H. Krist
Melinda Davis
E. Marshall Brooks
A Behind-the-Scenes Look at Practice Facilitation to Improve Delivery of Unhealthy Alcohol Use Screening and Management Services in Primary Care: A Qualitative Study
Journal of Primary Care & Community Health
title A Behind-the-Scenes Look at Practice Facilitation to Improve Delivery of Unhealthy Alcohol Use Screening and Management Services in Primary Care: A Qualitative Study
title_full A Behind-the-Scenes Look at Practice Facilitation to Improve Delivery of Unhealthy Alcohol Use Screening and Management Services in Primary Care: A Qualitative Study
title_fullStr A Behind-the-Scenes Look at Practice Facilitation to Improve Delivery of Unhealthy Alcohol Use Screening and Management Services in Primary Care: A Qualitative Study
title_full_unstemmed A Behind-the-Scenes Look at Practice Facilitation to Improve Delivery of Unhealthy Alcohol Use Screening and Management Services in Primary Care: A Qualitative Study
title_short A Behind-the-Scenes Look at Practice Facilitation to Improve Delivery of Unhealthy Alcohol Use Screening and Management Services in Primary Care: A Qualitative Study
title_sort behind the scenes look at practice facilitation to improve delivery of unhealthy alcohol use screening and management services in primary care a qualitative study
url https://doi.org/10.1177/21501319251351144
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