Abstract
Alcohol measurement delivered by health care providers in primary health care settings is an efficacious and cost-effective intervention to reduce alcohol consumption among patients. However, this intervention is not yet routinely implemented in practice. Community support has been recommended as a strategy to stimulate the delivery of alcohol measurement by health care providers, yet evidence on the effectiveness of community support in this regard is scarce. The current study used a pre-post quasi-experimental design in order to investigate the effect of community support in three Latin American municipalities in Colombia, Mexico, and Peru on health care providers’ rates of measuring alcohol consumption in their patients. The analysis is based on the first 5 months of implementation. Moreover, the study explored possible mechanisms underlying the effects of community support, through health care providers’ awareness of support, as well as their attitudes, subjective norms, self-efficacy, and subsequent intention toward delivering the intervention. An ANOVA test indicated that community support had a significant effect on health care providers’ rates of measuring alcohol consumption in their patients (F (1, 259) = 4.56, p = 0.034, ηp2 = 0.018). Moreover, a path analysis showed that community support had a significant indirect positive effect on providers’ self-efficacy to deliver the intervention (b = 0.07, p = 0.008), which was mediated through awareness of support. Specifically, provision of community support resulted in a higher awareness of support among health care providers (b = 0.31, p < 0.001), which then led to higher self-efficacy to deliver brief alcohol advice (b = 0.23, p = 0.010). Results indicate that adoption of an alcohol measurement intervention by health care providers may be aided by community support, by directly impacting the rates of alcohol measurement sessions, and by increasing providers’ self-efficacy to deliver this intervention, through increased awareness of support. Trial Registration ID: NCT03524599; Registered 15 May 2018; https://clinicaltrials.gov/ct2/show/NCT03524599
Highlights
Worldwide about three million deaths are caused by alcohol every year, making alcohol consumption one of the leading preventable risk factors for physical, mental, and social harms
For H1, i.e. testing whether the provision of community support leads to increased rates of alcohol measurement sessions delivered by primary health care (PHC) providers, of the 291 providers included in the analysis, 53 were from Colombia, 100 from Mexico, and 138 from Peru
This study aimed to assess the effectiveness of community support for bolstering the delivery of an alcohol measurement intervention in a PHC setting
Summary
Worldwide about three million deaths are caused by alcohol every year, making alcohol consumption one of the leading preventable risk factors for physical, mental, and social harms. In 2018, the World Health Organization (WHO) launched the SAFER alcohol control initiative, which entails five cost-effective strategies to combat harmful alcohol use (WHO, 2018). One of these strategies is the facilitation of patients’ access to alcohol measurement, meaning that health professionals should be actively involved in detecting and managing patterns of alcohol use in their patients. Kaner and colleagues (1999) found in their UK-based study that supportive actions (operationalized as fortnightly telephone calls to providers) had a positive impact on the delivery of alcohol measurement in a PHC setting, over and above training. In their study, the effect of the supportive actions could not be disentangled from that of the training
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