Abstract
BackgroundThis study aimed to explore experiences of implementation of alcohol brief interventions (ABIs) in settings outside of primary healthcare in the Scottish national programme. The focus of the study was on strategies and learning to support ABI implementation in settings outside of primary healthcare in general, rather on issues specific to any single setting.Methods14 semi-structured telephone interviews were conducted with senior implementation leaders in antenatal, accident and emergency and wider settings and audio-recorded. Interviews were analysed inductively.ResultsThe process of achieving large-scale, routine implementation of ABI proved challenging for all involved across the settings. Interviewees reported their experiences and identified five main strategies as helpful for strategic implementation efforts in any setting: (1) Having a high-profile target for the number of ABIs delivered in a specific time period with clarity about whose responsibility it was to implement the target; (2) Gaining support from senior staff from the start; (3) Adapting the intervention, using a pragmatic, collaborative approach, to fit with current practice; (4) Establishing practical and robust recording, monitoring and reporting systems for intervention delivery, prior to widespread implementation; and (5) Establishing close working relationships with frontline staff including flexible approaches to training and readily available support.ConclusionsThis qualitative study suggests that even with significant national support, funding and a specific delivery target, ABI implementation in new settings is not straightforward. Those responsible for planning similar initiatives should critically consider the relevance and value of the five implementation strategies identified.
Highlights
This study aimed to explore experiences of implementation of alcohol brief interventions (ABIs) in settings outside of primary healthcare in the Scottish national programme
Alcohol brief interventions (ABIs) are heterogeneous interventions [1,2,3,4] that include ‘short conversations aiming in a non-confrontational way to motivate individuals to think about and/or plan a change in their drinking behaviour in order to reduce their consumption and/or their risk of harm’ [5]
The Scottish Government national alcohol strategy states “we know brief interventions are effective in helping people to reduce their drinking, and as such their risk of alcohol related harm” in describing the national ABI programme, which prioritises implementation in A&E, antenatal and primary care settings [24]
Summary
This study aimed to explore experiences of implementation of alcohol brief interventions (ABIs) in settings outside of primary healthcare in the Scottish national programme. ABIs have historically included the use of a screening questionnaire to explore an Systematic reviews have concluded that ABI delivery in primary care has modest efficacy in reducing alcohol consumption in hazardous and harmful drinkers [7,8]. Implementation of ABIs has been recommended in the UK in a wide range of such settings (National Institute for Health and Care Excellence [22]; Scottish Government [23]). The Scottish Government national alcohol strategy states “we know brief interventions are effective in helping people to reduce their drinking, and as such their risk of alcohol related harm” in describing the national ABI programme, which prioritises implementation in A&E, antenatal and primary care settings [24]
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