SBIR Intervention Protocol for Modifiable Risk Factors

The inclusion criteria for patients to be enrolled in the SBIR intervention were: a) patients aged 18 or older; b) resident of Alberta; c) cognitively and emotionally able to participate as assessed by the healthcare provider; and d) patients’ willingness to participate. Clinical providers were asked to routinely screen eligible patients for these four modifiable risk factors using standardized screening questions (Screening) [24 (link), 26 (link)–31 (link)] and discuss the screening results with the patients. Patients who screened low risk on these factors were provided positive reinforcement. Patients who screened medium or high risk on these factors were offered brief, tailored advice and resources to encourage health behavior modification (Brief Intervention). Lastly, providers were required to offer referral(s) to health promotion programs (e.g., the AlbertaQuits smoking cessation program) in the community or within the hospital for high-risk patients (or upon patient request) who could benefit from more intensive behavior change support outside the scope of brief intervention (Referral). Paper-based SBIR pathways and form were designed to guide providers in the implementation process and the documentation of screening, brief intervention, referral aspects of the intervention received by each patient (Figure 1; Supplementary Material). Not all eligible patients cared for in the participating units were invited by healthcare providers to participate in the intervention. The providers were given latitude to suspend implementation periodically based on their judgement of feasibility within their clinical workflow.