Abstract
BackgroundSystematic reviews of alcohol screening and brief interventions (ASBI) highlight the challenges of implementation in healthcare and community-based settings. Fewer reviews have explored this through examination of qualitative literature and fewer still focus on interventions with younger people.MethodsThis review aims to examine qualitative literature on the facilitators and barriers to implementation of ASBI both for adults and young people in healthcare and community-based settings. Searches using electronic data bases (Medline on Ovid SP, PsychInfo, CINAHL, Web of Science, and EMBASE), Google Scholar and citation searching were conducted, before analysis.ResultsFrom a total of 239 papers searched and screened, 15 were included in the final review; these were selected based on richness of content and relevance to the review question. Implementation of ASBI is facilitated by increasing knowledge and skills with ongoing follow-up support, and clarity of the intervention. Barriers to implementation include attitudes towards alcohol use, lack of structural and organisational support, unclear role definition as to responsibility in addressing alcohol use, fears of damaging professional/ patient relationships, and competition with other pressing healthcare needs.ConclusionsThere remain significant barriers to implementation of ASBI among health and community-based professionals. Improving the way health service institutions respond to and co-ordinate alcohol services, including who is most appropriate to address alcohol use, would assist in better implementation of ASBI. Finally, a dearth of qualitative studies looking at alcohol intervention and implementation among young people was noted and suggests a need for further qualitative research.
Highlights
Systematic reviews of alcohol screening and brief interventions (ASBI) highlight the challenges of implementation in healthcare and community-based settings
Training and organizational support are interdependent in the successful implementation of Alcohol Screening and Brief Intervention (ASBI) in healthcare and community-based settings
Implementation of ASBI in the studies reviewed was limited by attitudes; some nurses did not see it as their responsibility to address alcohol issues and ‘lifestyle workers’ were mentioned as being more appropriate
Summary
Systematic reviews of alcohol screening and brief interventions (ASBI) highlight the challenges of implementation in healthcare and community-based settings. Efforts to mitigate alcohol use, especially amongst young people is of particular concern for Public Health world-wide and has led to the development of a plethora of alcohol screening and brief interventions (ASBI) aimed at addressing the rise in alcohol-related ill health [3, 4]. These have been designed both for ease of application across varied health and social care settings, and to be cost-effective [5,6,7]. Our intention here, is to focus exclusively on the qualitative literature to generate an understanding of the contemporary facilitators and barriers influencing the implementation of ASBI in both healthcare and community-based settings, and to attempt to capture qualitative literature on youth service settings which quantitative evidence indicates are the places that young people are more likely to access [33]
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