Perceived appropriateness of alcohol screening and brief advice programmes in Colombia, Mexico and Peru and barriers to their implementation in primary health care - a cross-sectional survey
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Perceived appropriateness of alcohol screening and brief advice programmes in Colombia, Mexico and Peru and barriers to their implementation in primary health care - a cross-sectional survey. / Kokole, Daša; Mercken, Liesbeth; Jané-Llopis, Eva; Natera Rey, Guillermina; Arroyo, Miriam; Medina, Perla; Pérez-Gómez, Augusto; Mejía-Trujillo, Juliana; Piazza, Marina; Bustamante, Ines V; O'Donnell, Amy; Kaner, Eileen; Gual, Antoni; Lopez-Pelayo, Hugo; Schulte, Bernd; Manthey, Jakob; Rehm, Jürgen; Anderson, Peter; de Vries, Hein.
In: PRIM HEALTH CARE RES, Vol. 22, e4; PII S1463423620000675, 28.01.2021.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Perceived appropriateness of alcohol screening and brief advice programmes in Colombia, Mexico and Peru and barriers to their implementation in primary health care - a cross-sectional survey
AU - Kokole, Daša
AU - Mercken, Liesbeth
AU - Jané-Llopis, Eva
AU - Natera Rey, Guillermina
AU - Arroyo, Miriam
AU - Medina, Perla
AU - Pérez-Gómez, Augusto
AU - Mejía-Trujillo, Juliana
AU - Piazza, Marina
AU - Bustamante, Ines V
AU - O'Donnell, Amy
AU - Kaner, Eileen
AU - Gual, Antoni
AU - Lopez-Pelayo, Hugo
AU - Schulte, Bernd
AU - Manthey, Jakob
AU - Rehm, Jürgen
AU - Anderson, Peter
AU - de Vries, Hein
PY - 2021/1/28
Y1 - 2021/1/28
N2 - BACKGROUND: Providing alcohol screening and brief advice (SBA) in primary health care (PHC) can be an effective measure to reduce alcohol consumption. To aid successful implementation in an upper middle-income country context, this study investigates the perceived appropriateness of the programme and the perceived barriers to its implementation in PHC settings in three Latin American countries: Colombia, Mexico and Peru, as part of larger implementation study (SCALA).METHODS: An online survey based on the Tailored Implementation for Chronic Diseases (TICD) implementation framework was disseminated in the three countries to key stakeholders with experience in the topic and/or setting (both health professionals and other roles, for example regional health administrators and national experts). In total, 55 respondents participated (66% response rate). For responses to both appropriateness and barriers questions, frequencies were computed, and country comparisons were made using Chi square and Kruskal-Wallis non-parametric tests.RESULTS: Alcohol SBA was seen as an appropriate programme to reduce heavy alcohol use in PHC and a range of providers were considered suitable for its delivery, such as general practitioners, nurses, psychologists and social workers. Contextual factors such as patients' normalised perception of their heavy drinking, lack of on-going support for providers, difficulty of accessing referral services and lenient alcohol control laws were the highest rated barriers. Country differences were found for two barriers: Peruvian respondents rated SBA guidelines as less clear than Mexican (Mann-Whitney U = -18.10, P = 0.001), and more strongly indicated lack of available screening instruments than Colombian (Mann-Whitney U = -12.82, P = 0.035) and Mexican respondents (Mann-Whitney U = -13.56, P = 0.018).CONCLUSIONS: The study shows the need to address contextual factors for successful implementation of SBA in practice. General congruence between the countries suggests that similar approaches can be used to encourage widespread implementation of SBA in all three studied countries, with minor tailoring based on the few country-specific barriers.
AB - BACKGROUND: Providing alcohol screening and brief advice (SBA) in primary health care (PHC) can be an effective measure to reduce alcohol consumption. To aid successful implementation in an upper middle-income country context, this study investigates the perceived appropriateness of the programme and the perceived barriers to its implementation in PHC settings in three Latin American countries: Colombia, Mexico and Peru, as part of larger implementation study (SCALA).METHODS: An online survey based on the Tailored Implementation for Chronic Diseases (TICD) implementation framework was disseminated in the three countries to key stakeholders with experience in the topic and/or setting (both health professionals and other roles, for example regional health administrators and national experts). In total, 55 respondents participated (66% response rate). For responses to both appropriateness and barriers questions, frequencies were computed, and country comparisons were made using Chi square and Kruskal-Wallis non-parametric tests.RESULTS: Alcohol SBA was seen as an appropriate programme to reduce heavy alcohol use in PHC and a range of providers were considered suitable for its delivery, such as general practitioners, nurses, psychologists and social workers. Contextual factors such as patients' normalised perception of their heavy drinking, lack of on-going support for providers, difficulty of accessing referral services and lenient alcohol control laws were the highest rated barriers. Country differences were found for two barriers: Peruvian respondents rated SBA guidelines as less clear than Mexican (Mann-Whitney U = -18.10, P = 0.001), and more strongly indicated lack of available screening instruments than Colombian (Mann-Whitney U = -12.82, P = 0.035) and Mexican respondents (Mann-Whitney U = -13.56, P = 0.018).CONCLUSIONS: The study shows the need to address contextual factors for successful implementation of SBA in practice. General congruence between the countries suggests that similar approaches can be used to encourage widespread implementation of SBA in all three studied countries, with minor tailoring based on the few country-specific barriers.
KW - Adolescent
KW - Adult
KW - Aged
KW - Colombia
KW - Crisis Intervention
KW - Cross-Sectional Studies
KW - Female
KW - Humans
KW - Male
KW - Mexico
KW - Middle Aged
KW - Peru
KW - Primary Health Care
KW - Young Adult
U2 - 10.1017/S1463423620000675
DO - 10.1017/S1463423620000675
M3 - SCORING: Journal article
C2 - 33504413
VL - 22
JO - PRIM HEALTH CARE RES
JF - PRIM HEALTH CARE RES
SN - 1463-4236
M1 - e4; PII S1463423620000675
ER -