The COVID-19 pandemic has reshaped the landscape of healthcare and research, presenting unique challenges for primary care practices. The study "Barriers to recruiting primary care practices for implementation research during COVID-19: A qualitative study of practice coaches from the Stop Unhealthy (STUN) Alcohol Use Now trial" sheds light on these challenges and provides insights into overcoming them. This blog post explores how practitioners can enhance their skills by implementing the research outcomes or delving deeper into this vital area.
Understanding the Barriers
The STUN trial aimed to implement screening and interventions for unhealthy alcohol use in primary care practices across North Carolina. However, several barriers emerged during the recruitment phase:
- Pandemic-Related Challenges: The shift in focus to COVID-19 efforts, staffing issues due to illness and quarantine, financial concerns, and remote interactions with coaches were significant hurdles.
- Practice-Specific Barriers: Competing demands, inadequate infrastructure, and organizational structures within health systems posed additional challenges.
- Project-Specific Barriers: Slow project rollout, the sensitive nature of discussing alcohol use, and insufficient incentives further complicated recruitment efforts.
Facilitators and Successes
Despite these barriers, several facilitators were identified that can guide future efforts:
- Coach-Specific Experiences: Coaches expressed optimism about recruitment once pandemic pressures ease and highlighted their enthusiasm for helping practices with behavioral health interventions.
- Incentives for Participation: Financial incentives and access to coaching support were effective motivators for practices to participate in the STUN project.
- Established Relationships: Practices with existing relationships with coaches were more likely to engage in the project.
- COVID-19 as an Opportunity: The pandemic increased awareness of behavioral health issues, providing a window of opportunity to address unhealthy alcohol use.
Strategies for Practitioners
The findings from the STUN trial offer valuable strategies for practitioners looking to improve their skills in implementing evidence-based practices:
- Build Strong Relationships: Establishing trust with practice managers and providers is crucial. Tailor your approach based on the audience—focus on workflows and reimbursement with managers and patient health with providers.
- Leverage Incentives: Highlight both financial and non-monetary benefits of participation. Ensure that practices understand how participating can improve quality metrics and reimbursement opportunities.
- Nurture Infrastructure Development: Support practices in developing strong infrastructure, including EHR capabilities and staffing. Provide training on billing and documentation to increase confidence in addressing sensitive topics like alcohol use.
- Utilize Opportunities Presented by COVID-19: Recognize the increased importance of behavioral health during the pandemic and use it as a catalyst for change within practices.
The Path Forward
The STUN trial's experiences underscore the importance of understanding barriers to implementing evidence-based practices in primary care. Practitioners can enhance their skills by learning from these experiences and applying them to their contexts. By building relationships, leveraging incentives, nurturing infrastructure development, and utilizing opportunities presented by current challenges like COVID-19, practitioners can successfully implement evidence-based interventions that improve patient outcomes.
If you're interested in exploring this topic further or considering conducting similar research, I encourage you to read the original research paper: Barriers to recruiting primary care practices for implementation research during COVID-19: A qualitative study of practice coaches from the Stop Unhealthy (STUN) Alcohol Use Now trial.
