The response rates among nurses varied between 66 and 99% and among physicians between 76 and 95% depending on the issue. Factors related to knowledge seem to be a barrier to the adoption of brief intervention: only 18% of respondents reported having enough knowledge to provide competent brief intervention and half of the respondents reported wanting more training. Contrary to expectations, physicians consider themselves to be better equipped to do brief intervention than nurses. Practical training in using alcohol questionnaires and on the content of brief intervention would help promote it. Such training was seen as important by 90% of the respondents. Giving more information on the evidence in favour of brief intervention would also be useful.

The objective of this study was to identify possible obstacles to carrying out competent early identification and brief intervention (EIBI) of heavy drinkers in primary health care. Qualitative focus group discussion method study applying the deductive framework approach. Six focus groups involving 18 general practitioners and 19 nurses were recruited from primary health care of the City of Tampere, Finland. Possible obstacles are: (1) confusion regarding the content of early-phase heavy drinking, (2) lack of self-efficacy among primary health care professionals, (3) sense of lacking time needed for carrying out brief intervention, (4) not having simple guidelines for brief intervention, (5) sense of difficulty in identifying of early-phase heavy drinkers, and (6) uncertainty about the justification for initiating discussion on alcohol issues with patients. The main actions to be taken to promote brief intervention are to educate professionals about the content of early-phase heavy drinking and to produce directing, but not excessively demanding guidelines for carrying out EIBI. Probably successful personal experiences carrying out EIBI can improve professionals' self-efficacy and give to them final justification for discussion alcohol issues with their patients.

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Brief alcohol intervention reduces heavy drinking, but its implementation has been challenging. The purpose was to evaluate self-reported changes in attitudes, skills and knowledge regarding brief intervention among nurses and general practitioners (GPs) during an implementation project. A questionnaire survey was used before and after the implementation to all nurses and GPs working at the time in the seven primary health-care centres of the city of Tampere, Finland. Several positive changes indicate an increased amount of knowledge regarding brief intervention among the professionals during the implementation. This was found especially among the nurses. The success in increasing the knowledge can also be seen in a decrease of training needs. Instead, attitudes and skills among the professionals did not seem to develop positively. Increasing motivational skills especially seems to be the future challenge.

Of the respondents (response rate 85%) 45% (29/64) reported carrying out brief alcohol interventions. Male GPs provided brief interventions more often than female GPs (71% versus 36%, P = 0.017). The respondents had mainly positive attitudes to brief interventions for excessive drinkers. The working style typology did not show any relationship with brief intervention activity.