Alcoholism
Conditions
Keywords
Primary health care, Identification and Brief Intervention Programmes, Hazardous and harmful alcohol consumption
Brief summary
The overall objective is to study if training and support, financial reimbursement and referral to an internet based brief intervention programme, singly or in combination, may increase implementation of evidence based methods of identification and brief intervention for excessive alcohol consumption in routine primary health care.
Detailed description
The study will be a stepped cluster RCT in 5 countries and the endpoint of the study is the number of interventions delivered during a certain time period. More specifically, the RCT will examine: * The effect of Continuous Medical Education (CME) to PHC providers * The effect of financial reimbursement to PHC providers as a pay-for-performance of brief alcohol interventions * Whether an alternative internet based method of delivering brief intervention can increase the proportion of patients reached * If one implementation strategy will give an added value to one already enforced.
Interventions
OTHERTraining and support (T&S)
Two face-to-face educational meetings of at least one hour and a maximum of 2 hours, and one telephone support call of at least ten minutes and a maximum of 30 minutes. The telephone call will be offered to one of the GPs ('leader'). Depending on the needs of the PHCU, one additional face to face training (1 to 2 hours) may be offered. The time interval between meetings will be on average 2 weeks. The training sessions will address improving knowledge, skills, attitudes, and perceived barriers and facilitators by combining theory and practice-based training.
OTHERFinancial incentive
Groups will receive a financial incentive depending on their screening and brief intervention activities. They will be paid for the performance, with the country dependent system of pay (fee for item or fee for achieving set rates) and based on normal practices and financial rates for financial incentives for clinical preventive activities.
OTHERE-SBI (online screening and brief intervention)
Referring identified at-risk patients to an approved e-SBI programme, which will be either country specific (where these exist) or based on the WHO e-SBI programme (Poland).
Sponsors
European Commission
Stichting Katholieke Universiteit
University of Newcastle Upon-Tyne
King's College London
Göteborg University
Linkoeping University
Department of Health, Generalitat de Catalunya
State Agency for Solving Alcohol Problems
University College, London
Maastricht University
Pomeranian Medical University Szczecin
Fundacion Clinic per a la Recerca Biomédica
Study design
Allocation
RANDOMIZED
Intervention model
FACTORIAL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Eligibility
Sex/Gender
ALL
Healthy volunteers
No
Inclusion criteria
* Primary Health Care Units (PHCU) of approximate size of 5.000-20.000 registered patients * Primary Health Care Units (PHCU) located in Spain, Poland, Sweden, England or The Netherlands * Providers must be physicians or nurses
Exclusion criteria
* Primary Health Care Units with less than 5.000 registered patients or over 20.000 registered patients
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Number of screening tests carried out in primary health care settings to detect excessive alcohol consumption care | 5 months | Screening rates will be calculated at five time points: during a four week period during the third month before the start of the study (baseline measurement), in three consecutive four week blocks during the twelve week intervention period (intervention measurement) and during a four week block during the sixth month after the end of the intervention period (follow-up measurement). |
| Number of brief interventions for excessive alcohol consumption delivered in primary health care settings | 5 months | Brief intervention rates will be calculated at five time points: during a four week period during the third month before the start of the study (baseline measurement), in three consecutive four week blocks during the twelve week intervention period (intervention measurement) and during a four week block during the sixth month after the end of the intervention period (follow-up measurement). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Level of role security of primary health care providers measured by their answers to the SAAPPQ instrument | 3 months | Role security of the primary health care providers will be measured through their responses to the SAAPPQ (a validated instrument based on factor analysis (Anderson & Clement 1987) of the original alcohol and alcohol problems perception questionnaire developed and validated by Cartwright (1980))at three time points: baseline, end of intervention period, and follow-up. |
| Level of therapeutic commitment of primary health care providers measured by their answers to the SAAPPQ instrument | 3 months | Therapeutic commitment of the primary health care providers will be measured through their responses to the SAAPPQ (a validated instrument based on factor analysis (Anderson & Clement 1987) of the original alcohol and alcohol problems perception questionnaire developed and validated by Cartwright (1980))at three time points: baseline, end of intervention period, and follow-up. |
Countries
Netherlands, Poland, Spain, Sweden, United Kingdom
Outcome results
None listed