Implementing training and support, financial reimbursement, and referral to an internet-based brief advice program to improve the early identification of hazardous and harmful alcohol consumption in primary care (ODHIN): study protocol for a cluster randomized factorial trial

Implementation Science

Miranda GH Laurant³  Toni Gual⁹  Eileen Kaner⁷  Dorothy Newbury-Birch⁷  Paul Wallace⁶  Karolina Kłoda⁸  Artur Mierzecki⁸  Ben van Steenkiste⁴  Paolo Deluca¹  Colin Drummond¹  Jillian Reynolds⁹  Joan Colom⁵  Lidia Segura⁵  Preben Bendtsen²  Fredrik Spak^1,10  Peter Anderson⁷  Myrna N Keurhorst³ 

[1]Addictions Department, National Addiction Centre, Institute of Psychiatry, King’s College London, 4 Windsor Walk, London, SE5 8BB, UK

[2]Department of Medicine and Health, Linköping University, 581 83, Linköping, Sweden

[3]Radboud University Nijmegen Medical Centre, Scientific Institute for Quality of Healthcare (IQ healthcare), P.O. Box 9101, 114 IQ healthcare, 6500 HB Nijmegen, The Netherlands

[4]Department of General Practice, Maastricht University, School CAPHRI, P.O Box 616, 6200 MD, Maastricht, The Netherlands

[5]Program on Substance Abuse, Public Health Agency, Government of Catalonia, Barcelona, Spain

[6]Department of Primary Care and Population Health, University College London, London, UK

[7]Institute of Health and Society, Medical Faculty, Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, NE2 4AX, United Kingdom

[8]Independent Laboratory of Family Physician Education, Pomeranian Medical University in Szczecin, ul. Rybacka 1, 70-204, Szczecin, Poland

[9]Hospital Clínic de Barcelona, Addictions Unit, Institut Clínic de Neurosciències, C/Villarroel 170, CP 08036, Barcelona, Spain

[10]Department of Social medicine, University of Gothenburg, P.O. Box 453, 405 30, Gothenburg, Sweden

关键词: Implementation;    Internet;    Financial reimbursement;    Training and support;    Primary healthcare;    Brief interventions;    Screening;    Alcohol;   

Others  :  813818
DOI  :  10.1186/1748-5908-8-11

 received in 2012-11-18, accepted in 2013-01-22,  发布年份 2013

【 摘 要 】

Background

The European level of alcohol consumption, and the subsequent burden of disease, is high compared to the rest of the world. While screening and brief interventions in primary healthcare are cost-effective, in most countries they have hardly been implemented in routine primary healthcare. In this study, we aim to examine the effectiveness and efficiency of three implementation interventions that have been chosen to address key barriers for improvement: training and support to address lack of knowledge and motivation in healthcare providers; financial reimbursement to compensate the time investment; and internet-based counselling to reduce workload for primary care providers.

Methods/design

In a cluster randomized factorial trial, data from Catalan, English, Netherlands, Polish, and Swedish primary healthcare units will be collected on screening and brief advice rates for hazardous and harmful alcohol consumption. The three implementation strategies will be provided separately and in combination in a total of seven intervention groups and compared with a treatment as usual control group. Screening and brief intervention activities will be measured at baseline, during 12 weeks and after six months. Process measures include health professionals’ role security and therapeutic commitment of the participating providers (SAAPPQ questionnaire). A total of 120 primary healthcare units will be included, equally distributed over the five countries. Both intention to treat and per protocol analyses are planned to determine intervention effectiveness, using random coefficient regression modelling.

Discussion

Effective interventions to implement screening and brief interventions for hazardous alcohol use are urgently required. This international multi-centre trial will provide evidence to guide decision makers.

Trial registration

ClinicalTrials.gov. Trial identifier: NCT01501552

【 授权许可】

   
2013 Keurhorst et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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