Abstract
BackgroundIdentifying and addressing heavy drinking represents a major public health priority worldwide. Whilst the majority of alcohol screening and brief intervention (ASBI) research has been conducted in western, high-income countries, evidence is growing that ASBI can also impact positively on heavy drinkers in low- and middle-income country populations. This mixed methods study aims to assess the feasibility of conducting a fully randomised controlled trial of the effectiveness of ASBI in primary care in Kazakhstan and explore the feasibility and acceptability of implementing ASBI in this setting from patients’ and physicians’ perspectives.MethodsSix primary health care units in the region of Pavlodar will be cluster randomised to either an intervention (WHO manualised 5 min alcohol brief intervention plus alcohol leaflet) or control group (simple feedback plus alcohol leaflet). Primary feasibility measures will be rates of participation at baseline and retention of eligible patients at the 3-month follow-up point. Patient/physician questionnaires and physician focus groups will assess additional dimensions of feasibility, as well as acceptability, according to the RE-AIM framework: Reach (rates of eligible patients screened/received advice); Effectiveness (change in AUDIT-C score); Adoption (rate/representativeness of participating physicians); Implementation (quality of ASBI/barriers and facilitators to delivery); and Maintenance (potential sustainability of intervention).DiscussionThis is the first trial of the feasibility and acceptability of ASBI in Kazakhstan. As the planning and assessment of implementation determinants is based on the RE-AIM framework, the project outcomes will be relevant for the future development, tailoring and implementation of ASBI in Kazakhstan.Trial registrationDRKS, DRKS00015882, Registered 17 December 2018.
Highlights
Identifying and addressing heavy drinking represents a major public health priority worldwide
Within Kazakhstan itself, rates of alcohol consumption vary, with the highest levels found in the Northern, Eastern and Central regions
Compared to Kazakhstan as a whole, Pavlodar reports a higher prevalence of hypertensive heart disease, cardiac ischemia (23% higher), and trauma (61% higher)
Summary
Identifying and addressing heavy drinking represents a major public health priority worldwide. Whilst the majority of alcohol screening and brief intervention (ASBI) research has been conducted in western, highincome countries, evidence is growing that ASBI can impact positively on heavy drinkers in low- and middleincome country populations. In the Pavlodar region for example, the official prevalence of alcohol dependence in 2010 was about twice as high as that found nationally (2.3% vs 1.4%) [19]. Whilst this difference has declined in recent years (0.75% vs 0.61% in 2017) [21], Pavlodar continues to experience substantial alcohol-related harms, with higher rates of severe alcohol intoxications and mortality due to alcohol intoxication than the rest of the country. The mortality rate due to trauma, intoxication and accidents was found to be 30% higher in Pavlodar compared to the national average in 2016, with the number of deaths per capita caused by circulatory system diseases, 20% higher [22]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
