Institutionalization of Brief Alcohol Intervention in Primary Health Care—The Finnish Case

Abstract

There have been several research and practical projects to promote alcohol brief interventions (BIs) in healthcare settings, but no reports of nationwide outcome have so far been published. In Finland, these activities started in the early 1990s, and in the past years, the focus has been mainly on primary and occupational health care. The aim of the present study was to ascertain whether the extensive and long-lasting implementation efforts have led to the institutionalization of this activity among primary healthcare physicians and to the identification of factors that may be associated with it. The data were gathered by a questionnaire sent to all Finnish primary healthcare physicians in 2002 and 2007. In both years, the questionnaire contained questions on demographics, professional background and the physicians' own BI activity (regular, occasional, or none). In 2007, a question eliciting information about the change in BI activity during the past 5 years was added. The response rate was 67.1% (95% CI 65.4 to 68.8) (2,001/2,980) in 2002 and 50.9% (95% CI 49.2 to 52.6) (1,610/3,163) in 2007. The number of physicians offering BI had increased during the study years from 59.2 to 78.5%. Regular activity was reported in 2002 by 9.3% of physicians and in 2007 by 17.2% and occasional activity correspondingly by 49.9 and 61.3%. Of the physicians who offered BI in 2007, 52.4% reported increased activity and 42.6% similar activity to that reported 5 years earlier. Having a specialist's license in general practice or occupational health care or long experience as a primary healthcare physician predicted high activity. The BI activity of Finnish primary healthcare physicians is reasonably high and rising. Training and motivating those with low BI activity remains future challenge.