Substance Use Screening, Brief Intervention, and Referral to Treatment in Urban Settings: Barriers and Facilitators to Implementation With Minoritized Youth

Background: Substance use in minoritized youth is associated with negative long-term health and life outcomes. The present study explores perspectives of school stakeholders at urban minority-serving schools regarding integration of an evidence-based intervention, screening, brief intervention, and referral to treatment (SBIRT) into existing school prevention models. Methods: Twenty-two participants were interviewed using the Consolidated Framework for Implementation Research to identify barriers and facilitators to SBIRT implementation. Qualitative data were transcribed, coded, and analyzed. Results: Four major themes related to barriers to SBIRT implementation included: lack of training, unclear role expectations, student confidentiality, and punitive school climates. The 3 major facilitators included: the feasibility of the intervention, its fit within multi-tiered systems of support, and the districts increasing collaboration with community mental health providers. These major themes along with other minor themes are discussed. Implications for School Health Policy, Practice, and Equity: SBIRT implementation within low-income, minority-serving schools may reduce substance use disparities among minoritized youth, improving health and life outcomes. Recommendations addressed training, school climate, and student engagement, highlighting a collaborative and supportive approach involving all stakeholders. Conclusions: While SBIRT implementation has barriers and facilitators, overall, school staff were optimistic about implementation. In light of these findings, additional research should embed SBIRT in these settings.