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

Abstract

This paper reviews the literature on evaluations of brief intervention training programs for health professionals which address one or more lifestyle factors of chronic disease to identify factors impacting on development and implementation of programs. A search was conducted of the literature evaluating brief intervention training programs from 2000–2019 in the databases: Medline, CINAHL, Psychinfo, Academic Premier, Science Direct, Ovid (Including EMBASE and Healthstar), Web of Science and Informit. The content analysis and data extraction were aligned to the domains in the Consolidated Framework for Implementation Research (CFIR) to assist in the narrative synthesis. The search identified eight evaluations of programs targeting multiple risk factors, and 17 targeting single risk factors. The behavioural risk factor most commonly addressed was smoking, followed by alcohol and drug use. Programs consisted of face-to-face workshops and/or online or distance learning methods. Facilitators included availability of sustainable funding, adapting the program to suit the organisation’s structural characteristics and adoption of the intervention into routine client care. For Indigenous programs, the use of culturally appropriate images and language, consultation with Indigenous communities, and development of resources specific to the communities targeted were important considerations.

Notes From the Field: Applying the Consolidated Framework for Implementation Research in a Qualitative Evaluation of Implementation of the Queensland Aboriginal and Torres Strait Islander Brief Intervention Training Program

“…For each of the constructs in the five domains of the CFIR, a valence rating of the strength of the reference (0, 1 or 2), and the relative influence (positive or negative) was created. The valence rating criteria, as used in previous CFIR studies (Damschroder & Lowery, 2013;Soi et al, 2018), considered the nature, numbers and strength of the comments.…”

“…Australia has implemented several BI training programs specifically designed for Aboriginal and Torres Strait Islander (referred to as Indigenous in this paper) health professionals and other health professionals to deliver BIs to Indigenous clients in the primary health care (PHC) sector (Martin et al, 2019;NSW Department of Health, 2010;Queensland Health, 2007). Whilst complex inter-dependent factors are known to impact program implementation in health care (Coles et al, 2017), little knowledge exists about what factors impact on the uptake and adoption by health professionals and health services of programs that train health workers in BI delivery (Sebastian et al, 2020). This study assessed the applicability of the CFIR framework to the qualitative evaluation of the implementation of the B.strong Program and the usefulness of the framework in identifying the facilitators or barriers to program implementation.…”

Role of organisational factors on uptake and implementation of the B.strong brief intervention training program in Queensland Indigenous primary health care services

“…The aim of this study was to explore the organisational factors of trainees’ Indigenous PHC services (organisations), associated with i) their service's training program uptake, and ii) with the subsequent delivery of BIs to Indigenous clients by health professionals who attended the training, from the perspective of B.strong participants. This paper primarily identifies factors associated with the participants’ employer PHC service, rather than those associated with the program itself, which have been explored separately 12 …”

“…Description of intervention and settingThe B.strong Program was a BI training program developed by Menzies School of Health Research, funded by Queensland Health, and implemented in Queensland, Australia 10,12. Training was provided to Indigenous and non-Indigenous health and community staff in all Queensland health service administrative regions and included staff from community-controlled health services and governmentand non-government-operated health and community services.…”

“…Data collectionSeparate interview guides12 were developed for the three groups of participants: health professional trainees, managers or supervisors of the trainees and Queensland Department of Health program managers. Interview guides were informed by the CFIR and developed by the first author, a male, non-Indigenous PhD student, in consultation with other authors.…”