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Attitudes and Learning through Practice Are Key to Delivering Brief Interventions for Heavy Drinking in Primary Health Care: Analyses from the ODHIN Five Country Cluster Randomized Factorial Trial
Newcastle University, England; Maastricht University, Netherlands.
Newcastle University, England.
Radboud University of Nijmegen, Netherlands; Saxion University of Appl Science, Netherlands.
Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in West Östergötland, Department of Medical Specialist in Motala.
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2017 (English)In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 14, no 2, 121Article in journal (Refereed) Published
Abstract [en]

In this paper, we test path models that study the interrelations between primary health care provider attitudes towards working with drinkers, their screening and brief advice activity, and their receipt of training and support and financial reimbursement. Study participants were 756 primary health care providers from 120 primary health care units (PHCUs) in different locations throughout Catalonia, England, The Netherlands, Poland, and Sweden. Our interventions were training and support and financial reimbursement to providers. Our design was a randomized factorial trial with baseline measurement period, 12-week implementation period, and 9-month follow-up measurement period. Our outcome measures were: attitudes of individual providers in working with drinkers as measured by the Short Alcohol and Alcohol Problems Perception Questionnaire; and the proportion of consulting adult patients (age 18+ years) who screened positive and were given advice to reduce their alcohol consumption (intervention activity). We found that more positive attitudes were associated with higher intervention activity, and higher intervention activity was then associated with more positive attitudes. Training and support was associated with both positive changes in attitudes and higher intervention activity. Financial reimbursement was associated with more positive attitudes through its impact on higher intervention activity. We conclude that improving primary health care providers screening and brief advice activity for heavy drinking requires a combination of training and support and on-the-job experience of actually delivering screening and brief advice activity.

Place, publisher, year, edition, pages
MDPI AG , 2017. Vol. 14, no 2, 121
Keyword [en]
primary health care; heavy drinking; screening and brief advice; training and support; financial reimbursement; role security; therapeutic commitment; short alcohol and alcohol problems perception questionnaire
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:liu:diva-136668DOI: 10.3390/ijerph14020121ISI: 000395467900013PubMedID: 28134783OAI: oai:DiVA.org:liu-136668DiVA: diva2:1089748
Note

Funding Agencies|European Union [259268]; NIHR School of Public Health Research; NIHR School of Primary Care Research; Netherlands Organization for Health Research and Development (ZonMW, Prevention Programme) [200310017, Art.II.17]; Polish science; project ODHIN

Available from: 2017-04-20 Created: 2017-04-20 Last updated: 2017-08-08

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Bendtsen, Preben
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