Centering Patient Voices: Implementing Screening, Brief Intervention, and Referral to Treatment to Address Risky Substance Use in Family Planning Clinics.

BACKGROUND

To describe the contextual factors that affect patients' acceptability and feasibility of alcohol and substance use-related service implementation in family planning (FP) clinics in Massachusetts.

MATERIALS AND

METHODS

We conducted a qualitative study of patients at an FP clinic in Massachusetts. Through semistructured interviews (N = 11), we asked participants about their perspectives regarding receiving substance use screening, patient preferences for care and referral, barriers and facilitators to receiving care, and their acceptability of receiving screening, brief intervention, and referral to treatment (SBIRT) implementation within the FP clinic context. Interview data was analyzed through content thematic analysis utilizing Dedoose software.

RESULTS

Patients shared insightful knowledge about the barriers and facilitators to their acceptance of SBIRT implementation within FP clinics in Massachusetts. Patients emphasized the need for SBIRT implementation efforts to be contextually rooted within FP care while also considering how best to alleviate barriers to accessing care. Facilitators to SBIRT implementation included provider trust, psychological safety, provider congruence, varied care modalities, and selectivity by appointment type. Barriers to SBIRT implementation included stigma, transportation, funding, scheduling, and staffing scarcity.

CONCLUSIONS

Despite persistent structural and systemic barriers, participants expressed broad support for integrating SBIRT into FP settings when delivered in ways that felt affirming, trauma-informed, and individualized to patient needs. Findings revealed critical opportunities for integrating alcohol and/or substance use-related care into FP settings.