What to know
Alcohol screening and brief intervention (SBI) works. It is quick and reimbursable. Many tools and resources are available to help healthcare providers overcome barriers to conducting alcohol SBI.
CDC resources and activities
CDC and partners work together to support alcohol SBI implementation in medical and other settings. They also identify and partner with healthcare providers, health systems, and health plans to develop system-level strategies that foster alcohol SBI implementation.
BRFSS Statistical Brief: Alcohol Screening & Brief Intervention Optional Module: This document provides guidance for Behavioral Risk Factor Surveillance System (BRFSS) data users when conducting analyses on the BRFSS Alcohol Screening & Brief Intervention Optional Module data.
Alcohol SBI implementation guide [52 Pages, Print Only]: This guide provides the process and resources necessary to help staff in any primary healthcare setting plan and implement alcohol SBI. The Guide also provides information on excessive use and how it can be addressed through alcohol SBI.
Guide for tribal communities: This guide was adapted from Planning and Implementing Screening and Brief Intervention for Risky Alcohol Use: A Step-by-Step Guide for Primary Care Practices to improve cultural relevance for American-Indian/Alaska-Native communities.
Medscape CDC Expert Commentary: The commentary, "5 Things to Know About Alcohol Use During and After Pregnancy" highlights data related to alcohol use during and after pregnancy and alcohol SBI. It also includes resources for clinicians to help facilitate discussing alcohol use during pregnancy with patients and implementing and conducting alcohol SBI.
FASD prevention resources: Free, online trainings are available for healthcare providers who care for people at risk for alcohol use during pregnancy, and for those who work with individuals living with fetal alcohol spectrum disorders (FASDs). These online trainings provide strategies to improve the delivery of care related to FASDs and their prevention.
Improving quality of care through alcohol SBI and its reporting in electronic clinical data systems: CDC and the Substance Abuse and Mental Health Services Administration (SAMHSA) worked with the National Committee for Quality Assurance (NCQA) to promote a Healthcare Effectiveness Data and Information Set (HEDIS) performance measure called Unhealthy Alcohol Use Screening and Follow-Up, or ASF, through a quality improvement learning collaborative with participating health plans. This resulted in the Screening and Follow-Up for Unhealthy Alcohol Use: Quality Improvement Change Package for Health Plans toolkit. This toolkit is designed to help health plans address excessive alcohol use among their members. It includes examples of effective quality improvement tools, including strategies and best practices for improving HEDIS measure performance.
Implementing alcohol SBI in systems: To prevent alcohol use during pregnancy, CDC, in 2018, funded organizations providing health services to women. These projects focused on development, implementation, and evaluation of alcohol SBI protocols in primary care clinics, facilitation of system-level approaches, such as integration of electronic health records, and sharing of lessons learned.
Alcohol SBI clinical decision support
CDC funded the MITRE Corporation to develop standards-based clinical decision support (CDS) for alcohol screening and brief intervention. These CDS tools can assist with adoption of this important clinical preventive service in primary care settings. Users can integrate the tools into electronic health record (EHR) systems and other digital formats to inform decisions and improve healthcare delivery.
The resources below are available to the public and posted on CDS Connect, a web-based platform for authoring and sharing CDS products. CDS Connect is maintained by the Agency for Healthcare Research and Quality (AHRQ). Select CDS resources are also available under open source license via GitHub.com, an online platform where software developers and coders can post and share code and software.
CDS resources
Logic expressions and flow diagrams for five CDS tools
- AUDIT: Alcohol Use Disorders Identification Test (developed by the World Health Organization)
- USAUDIT (adapted for the United States)
- National Institute on Drug Abuse (NIDA) Quick Screen (for multiple substances)
- Alcohol Brief Intervention and Referral
- Patient Decision Aid on Alcohol Use
Computer code and test files for each CDS
- Coded logic expressed using clinical quality language and Fast Healthcare Interoperability Resources
- Synthetic testing prior to integration into an EHR system
Implementation guides for each CDS outlining
- Description of selected instrument or evidence-based guidance
- Clinical considerations for implementation
- Key decisions on interpreting evidence-based guidance
- Technical details and product testing processes
Related apps and software for several CDS on GitHub
A pilot project was conducted to test two of the CDS tools in a real-world setting. Access either the WHO Alcohol Use Disorders Identification Test CDS or the Alcohol Brief Intervention and Referral CDS for the Pilot Final Report describing this work.
Visit AHRQ's CDS Connect website and Github.com to learn more.