Alcohol screening and brief interventions for adults and young people in health and community-based settings: a qualitative systematic literature review

Abstract

BackgroundSystematic reviews of alcohol screening and brief interventions (ASBI) highlight the challenges of implementation in healthcare and community-based settings. Fewer reviews have explored this through examination of qualitative literature and fewer still focus on interventions with younger people.MethodsThis review aims to examine qualitative literature on the facilitators and barriers to implementation of ASBI both for adults and young people in healthcare and community-based settings. Searches using electronic data bases (Medline on Ovid SP, PsychInfo, CINAHL, Web of Science, and EMBASE), Google Scholar and citation searching were conducted, before analysis.ResultsFrom a total of 239 papers searched and screened, 15 were included in the final review; these were selected based on richness of content and relevance to the review question. Implementation of ASBI is facilitated by increasing knowledge and skills with ongoing follow-up support, and clarity of the intervention. Barriers to implementation include attitudes towards alcohol use, lack of structural and organisational support, unclear role definition as to responsibility in addressing alcohol use, fears of damaging professional/ patient relationships, and competition with other pressing healthcare needs.ConclusionsThere remain significant barriers to implementation of ASBI among health and community-based professionals. Improving the way health service institutions respond to and co-ordinate alcohol services, including who is most appropriate to address alcohol use, would assist in better implementation of ASBI. Finally, a dearth of qualitative studies looking at alcohol intervention and implementation among young people was noted and suggests a need for further qualitative research.

Factors Impacting on Development and Implementation of Training Programs for Health Professionals to Deliver Brief Interventions, with a Focus on Programs Developed for Indigenous Clients: A Literature Review

“…The size and spread of the health service, the structure and duration of the training program, the materials and resources developed, and the program's requirement to cater for a mix of health professionals are important considerations in its implementation [41,42]. We also know that systemic barriers of lack of time of health services and personnel, competition with other pressing healthcare needs, and lack of policies and systems in place within the participating organisations are barriers to implementing BI training programs [10,43]. Attitudes towards the behaviour targeted, lack of structural and organisational support, unclear role definition as to responsibility in addressing the behaviour with clients, and fears of damaging professional/ client relationships are also known to be barriers to intervention implementation [42,43].…”

Missing in action: Insights from an exploratory ethnographic observation study of alcohol in everyday UK community pharmacy practice

“…Primary care practitioners other than pharmacists have been shown to have concerns about damaging relationships with patients in conducting alcohol brief interventions. For pharmacists, the risks were similar and the seeming alternative within a largely binary construction of right or wrong alcohol consumption was to ‘condone’ or legitimise patients’ drinking (OBS‐010). For one pharmacist, the possible threat alcohol discussions posed to maintenance of good relationships with customers meant avoiding raising the topic altogether.…”

Diversity and participation in private apartment buildings: a review of the literature

“…An initial key author and review article search proved extremely useful in what Derges et al . () term a “pearl‐growing” search technique. The initial search informed the selection of search terms (Table ) for a more targeted pearl‐growing exercise.…”

“…Listing key authors and review articles was undertaken in tandem with a brief literature review search using an iterative approach. An initial key author and review article search proved extremely useful in what Derges et al (2017) term a "pearl-growing" search technique. The initial search informed the selection of search terms (Table 1) for a more targeted pearl-growing exercise.…”