| BMC Public Health | |
| Large-scale implementation of alcohol brief interventions in new settings in Scotland: a qualitative interview study of a national programme | |
| Jim McCambridge1  Susie Heywood3  Lucy Platt1  Niamh Fitzgerald2  | |
| [1] Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SH, UK;Institute for Health and Wellbeing Research, Robert Gordon University, Riverside Campus, Aberdeen AB10 7GJ, UK;Glasgow City Community Health Partnership, North-East Sector, Eastbank Health Promotion & Training Centre, Academy Street, Glasgow G32 9AA, UK | |
| 关键词: Target; Brief advice; Implementation; Brief intervention; Alcohol; | |
| Others : 1170967 DOI : 10.1186/s12889-015-1527-6 |
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| received in 2014-10-01, accepted in 2015-02-12, 发布年份 2015 | |
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【 摘 要 】
Background
This study aimed to explore experiences of implementation of alcohol brief interventions (ABIs) in settings outside of primary healthcare in the Scottish national programme. The focus of the study was on strategies and learning to support ABI implementation in settings outside of primary healthcare in general, rather on issues specific to any single setting.
Methods
14 semi-structured telephone interviews were conducted with senior implementation leaders in antenatal, accident and emergency and wider settings and audio-recorded. Interviews were analysed inductively.
Results
The process of achieving large-scale, routine implementation of ABI proved challenging for all involved across the settings. Interviewees reported their experiences and identified five main strategies as helpful for strategic implementation efforts in any setting: (1) Having a high-profile target for the number of ABIs delivered in a specific time period with clarity about whose responsibility it was to implement the target; (2) Gaining support from senior staff from the start; (3) Adapting the intervention, using a pragmatic, collaborative approach, to fit with current practice; (4) Establishing practical and robust recording, monitoring and reporting systems for intervention delivery, prior to widespread implementation; and (5) Establishing close working relationships with frontline staff including flexible approaches to training and readily available support.
Conclusions
This qualitative study suggests that even with significant national support, funding and a specific delivery target, ABI implementation in new settings is not straightforward. Those responsible for planning similar initiatives should critically consider the relevance and value of the five implementation strategies identified.
【 授权许可】
2015 Fitzgerald et al.; licensee BioMed Central.
【 预 览 】
| Files | Size | Format | View |
|---|---|---|---|
| 20150418020709518.pdf | 411KB |
【 参考文献 】
- [1]Heather N: Interpreting the evidence on brief interventions for excessive drinkers: the need for caution. Alcohol Alcohol 1995, 30:287-96.
- [2]McCambridge J, Cunningham J a: The early history of ideas on brief interventions for alcohol. Addiction 2014, 109:538-46.
- [3]McCambridge J: Brief intervention content matters. Drug Alcohol Rev 2013, 32:339-41.
- [4]Michie S, Whittington C, Hamoudi Z, Zarnani F, Tober G, West R: Identification of behaviour change techniques to reduce excessive alcohol consumption. Addiction 2012, 107:1431-40.
- [5]Scottish Government Health Department. HEAT (H4) Alcohol Brief Interventions - National Guidance on Data Reporting 2008–9. 2008
- [6]Babor TF, Higgins-Biddle JC: Brief Intervention for Hazardous and Harmful Drinking. A Manual for Use in Primary Care. World Health Organisation, Geneva; 2001.
- [7]Kaner E, Dickinson H, Beyer F, Campbell F, Schlesinger F, Heather N, Saunders J, Burnand B, Pienaar E. Effectiveness of brief alcohol interventions in primary care (review). Cochrane Database Syst Rev 2007: Art. No.: CD004148. DOI: 10.1002/14651858.CD004148.
- [8]Bertholet N, Daeppen J-B, Wietlisbach V, Fleming M, Burnand B: Reduction of alcohol consumption by brief alcohol intervention in primary care: systematic review and meta-analysis. Arch Intern Med 2005, 165:986-95.
- [9]Havard A, Shakeshaft A, Sanson-Fisher R: Systematic review and meta-analyses of strategies targeting alcohol problems in emergency departments: interventions reduce alcohol-related injuries. Addiction 2008, 103:368-76. discussion 377–8
- [10]Nilsen P, Baird J, Mello MJ, Nirenberg T, Woolard R, Bendtsen P, et al.: A systematic review of emergency care brief alcohol interventions for injury patients. J Subst Abuse Treat 2008, 35:184-201.
- [11]McQueen J, Howe TE, Allan L, Mains D, Hardy V: Brief interventions for heavy alcohol users admitted to general hospital wards. Cochrane database Syst Rev 2011, 8:CD005191.
- [12]Stade B, Bailey C, Dzendoletas D, Sgro M, Dowswell T, Bennett D. Psychological and/or Educational Interventions for Reducing Alcohol Consumption in Pregnant Women and Women Planning Pregnancy (Review). 2009:CD004228. doi:10.1002/14651858.CD004228.pub2.
- [13]Gilinsky A, Swanson V, Power K: Interventions delivered during antenatal care to reduce alcohol consumption during pregnancy: A systematic review. Addict Res Theory 2011, 19:235-50.
- [14]Dhital R, Norman I, Whittlesea C, McCambridge J: Effectiveness of alcohol brief intervention delivered by community pharmacists: study protocol of a two-arm randomised controlled trial. BMC Public Health 2013, 13:152. BioMed Central Full Text
- [15]Patton R, Deluca P, Kaner E, Newbury-Birch D, Phillips T, Drummond C: Alcohol Screening and Brief Intervention for Adolescents: The How, What and Where of Reducing Alcohol Consumption and Related Harm Among Young People. Alcohol Alcohol 2013, 0:1-6.
- [16]Coulton S, Newbury-Birch D, Cassidy P, Dale V, Deluca P, Gilvarry E, et al.: Screening for alcohol use in criminal justice settings: an exploratory study. Alcohol Alcohol 2012, 47:423-7.
- [17]Pilowsky DJ, Wu L-T: Screening instruments for substance use and brief interventions targeting adolescents in primary care: a literature review. Addict Behav 2013, 38:2146-53.
- [18]Beich A, Thorsen T, Rollnick S: Screening in brief intervention trials targeting excessive drinkers in general practice: systematic review and meta-analysis. BMJ 2003, 327:536-42.
- [19]Göransson M, Magnusson A, Heilig M: Identifying hazardous alcohol consumption during pregnancy: implementing a research-based model in real life. Acta Obstet Gynecol Scand 2006, 85:657-62.
- [20]Sise MJ, Sise CB, Kelley DM, Simmons CW, Kelso DJ: Implementing screening, brief intervention, and referral for alcohol and drug use: the trauma service perspective. J Trauma 2005, 59(3 Suppl):S112-8. discussion S124–33
- [21]Heather N, Dallolio E, Hutchings D, Kaner E, White M: Implementing routine screening and brief alcohol intervention in primary health care: A Delphi survey of expert opinion. J Subst Use 2004, 9:68-85.
- [22]National Institute for Health and Care Excellence. Alcohol-Use Disorders: Preventing Harmful Drinking, NICE Public Health Guidance 24. 2010 (June).
- [23]Scottish Government. HEAT Standard. Alcohol Brief Interventions National Guidance : 2013–14. 2013(January):1–14.
- [24]Government S: Changing Scotland’s Relationship with Alcohol: A Framework for Action.. Scottish Government, Edinburgh; 2010.
- [25]Damschroder L, Aron D, Keith R: Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science. Implement Sci 2009, 15:1-15.
- [26]Feldstein AC, Glasgow RE: A Practical, Robust Implementation and Sustainability Model (PRISM) for Integrating Research Findings into Practice. Jt Comm J Qual Patient Saf 2008, 34:228-43.
- [27]Nilsen P, Aalto M, Bendtsen P, Seppä K: Effectiveness of strategies to implement brief alcohol intervention in primary healthcare. A systematic review. Scand J Prim Health Care 2006, 24:5-15.
- [28]Johnson M, Jackson R, Guillaume L, Meier P, Goyder E: Barriers and facilitators to implementing screening and brief intervention for alcohol misuse: a systematic review of qualitative evidence. J Public Health (Bangkok) 2010, 33:412-21.
- [29]Scottish Government. Chief Executive’s Letter, December 2007. Guidance on HEAT Targets for NHS Boards. 2007.
- [30]Parkes T, Atherton I, Evans J, Gloyn S, Mcghee S, Stoddart B, et al. An evaluation to assess the implementation of NHS delivered Alcohol Brief Interventions. 2011.
- [31]Fitzgerald N, Winterbottom J: Alcohol Brief Interventions Training Manual. NHS Health Scotland, Edinburgh; 2009.
- [32]Scottish Government: Changing Scotland’s Relationship with Alcohol: A Discussion Paper on Our Strategic Approach. Scottish Government, Edinburgh; 2008.
- [33]Nilsen P, Wåhlin S, Heather N: Implementing brief interventions in health care: lessons learned from the Swedish Risk Drinking Project. Int J Environ Res Public Health 2011, 8:3609-27.
- [34]Mäkelä P, Havio M, Seppä K: Alcohol-related discussions in health care–a population view. Addiction 2011, 106:1239-48.
- [35]Nilsen P, McCambridge J, Karlsson N, Bendtsen P: Brief interventions in routine health care: a population-based study of conversations about alcohol in Sweden. Addiction 2011, 106:1748-56.
- [36]ISD Scotland. Publication Report Alcohol Brief Interventions 2013/14. 2014. (June).
- [37]ISD Scotland. Alcohol Brief Interventions 2012/13. 2013(June).
- [38]Gale NK, Heath G, Cameron E, Rashid S, Redwood S: Using the framework method for the analysis of qualitative data in multi-disciplinary health research. BMC Med Res Methodol 2013, 13:117. BioMed Central Full Text
- [39]Huis A, van Achterberg T, de Bruin M, Grol R, Schoonhoven L, Hulscher M: A systematic review of hand hygiene improvement strategies: a behavioural approach. Implement Sci 2012, 7:92. BioMed Central Full Text
- [40]Goetz MB, Bowman C, Hoang T, Anaya H, Osborn T, Gifford AL, et al.: Implementing and evaluating a regional strategy to improve testing rates in VA patients at risk for HIV, utilizing the QUERI process as a guiding framework: QUERI Series. Implement Sci 2008, 3:16. BioMed Central Full Text
- [41]Désy PM, Perhats C: Alcohol Screening, Brief Intervention, and Referral in the Emergency Department: An Implementation Study. 2008.
- [42]Mcmanus S, Hipkins J, Haddad P, Guthrie E, Creed F: Implementing an effective intervention for problem drinkers on medical wards. Gen Hosp Psychiatry 2003, 25:332-7.
- [43]Johnson JA, Woychek A, Vaughan D, Seale JP: Screening for at-risk alcohol use and drug use in an emergency department: integration of screening questions into electronic triage forms achieves high screening rates. Ann Emerg Med 2013, 62:262-6.
- [44]Weiland TJ, Dent AW, Phillips GA, Lee NK: Emergency clinician-delivered screening and intervention for high-risk alcohol use: a qualitative analysis. Emerg Med Australas 2008, 20:129-35.
- [45]Kennedy C, Finkelstein N, Hutchins E, Mahoney J: Improving Screening for Alcohol Use During Pregnancy: The Massachusetts ASAP Program. Matern Child Health J 2004, 8:137-47.
- [46]Fitzgerald N, Molloy H, MacDonald F, McCambridge J. Alcohol brief interventions practice following training for multidisciplinary health and social care teams: a qualitative interview study. Drug Alcohol Rev. 2015;34(2):185-93.
- [47]Brooker C, Peters J, McCabe C, Short N: The views of nurses to the conduct of a randomised controlled trial of problem drinkers in an accident and emergency department. Int J Nurs Stud 1999, 36:33-9.
- [48]Li C, Olsen Y, Kvigne V, Welty T: Implementation of substance use screening in prenatal clinics. S D J Med 1999, 52:59-64.
- [49]Anderson S, Eadie DR, MacKintosh AM, Haw S: Management of alcohol misuse in Scotland: the role of A&E nurses. Accid Emerg Nurs 2001, 9:92-100.
- [50]Graham DM, Maio RF, Blow FC, Hill EM: Emergency physician attitudes concerning intervention for alcohol abuse/dependence delivered in the emergency department: a brief report. J Addict Dis 2000, 19:45-53.
- [51]Doi LK. Screening and alcohol brief interventions in antenatal care: a realistic evaluation. University of Stirling; 2012. http://dspace.stir.ac.uk/handle/1893/9513.
- [52]Duncan EM. Alcohol and nicotine use during pregnancy: it’s nature, occurrence and consequences. Robert Gordon University; 2010. https://openair.rgu.ac.uk/bitstream/10059/661/1/Eilidh%20Duncan%20PhD.pdf.
- [53]McCambridge J, Platts S, Whooley D, Strang J: Encouraging Gp Alcohol Intervention: Pilot Study of Change-Orientated Reflective Listening (Corl). Alcohol Alcohol 2004, 39:146-9.
- [54]Williams EC, Johnson ML, Lapham GT, Caldeiro RM, Chew L, Fletcher GS, et al.: Strategies to implement alcohol screening and brief intervention in primary care settings: a structured literature review. Psychol Addict Behav 2011, 25:206-14.
- [55]Bevan G: Setting Targets for Health Care Performance: Lessons from a Case Study of the English NHS. Natl Inst Econ Rev 2006, 197:67-79.
- [56]Gubb J: Have targets done more harm than good in the English NHS? Yes. BMJ 2009, 338:a3130.
- [57]Bevan G: Have targets done more harm than good in the English NHS? No. BMJ 2009, 338:a3129.
- [58]Damschroder L, Hagedorn H: A guiding framework and approach for implementation research in substance use disorders treatment. Psychol Addict Behav 2011, 25:194-205.
- [59]Gaume J, McCambridge J, Bertholet N, Daeppen J-B: Mechanisms of action of brief alcohol interventions remain largely unknown - a narrative review. Front Psychiatry 2014, 5:108.
- [60]Heather N: The efficacy-effectiveness distinction in trials of alcohol brief intervention. Addict Sci Clin Pract 2014, 9:13. BioMed Central Full Text
- [61]McCambridge J: Fifty years of brief intervention effectiveness trials for heavy drinkers. Drug Alcohol Rev 2011, 30:567-8.
- [62]Tong A, Sainsbury P, Craig J: Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Health Care 2007, 19:349-57.
- [63]Clark J: How to peer review a qualitative manuscript. In Peer Rev Heal Sci. Second. Edited by Godlee F, Jefferson T. BMJ Books, London; 2003:219-35.
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