Process evaluation of the implementation of a screening and brief intervention program for alcohol risk in primary health care: An experience in Brazil

Abstract

The barriers and facilitators were related to two main factors: organisational culture and personal attitudes. The action research provided the opportunity to bridge the gap between research and practice, but it also showed that SBI faces significant challenges before it can be implemented as a routine procedure in PHC settings in Brazil.

Early Risky Drug Use Detection in Primary Healthcare: How Does It Work in the Real World?

“…Other authors from Brazil reported factors other than the ones previously cited, including some discomfort in dealing with the issue, a focus on substance dependence treatment, replacement of managers and professionals during the implementation process, other priorities, and difficulties in patient referrals to other services (Amaral et al, 2010). Some of these barriers were also found in the present study.…”

“…To change the professionals' attitudes about substance use issues and improve the efficacy of the implementation process, some strategies may be proposed: (1) the need for more intensive practical training (Gonçalves, 2005;Holmqvist et al, 2008;Ronzani, et al, 2005;Ronzani et al, 2008b;Souza-Formigoni et al, 2008, Amaral et al, 2010, (2) constant attendance to increase the involvement of healthcare professionals (Anderson et al, 2003, Amaral et al, 2010, (3) introducing methods of detection and intervention into the curricula and continuing education programs in health-related schools (Holmqvist, et al2008), and (4) improving the motivation for preventive strategies (Ronzani et al, 2008a).…”

“…In Brazilian settings, researchers have made some efforts to implement SBI, especially in PHC, but many barriers have been reported by professionals (Gonçalves, 2005;Amaral et al, 2010). The current healthcare systems do not yet focus on preventive care.…”

“…Screening and brief intervention techniques have been used in PHC services in many countries and are considered effective prevention strategies for detecting alcohol use-related problems at early stages and delivering counseling to help reduce excessive alcohol consumption and its adverse consequences, reduce the risk of trauma, and increase the percentage of patients who enter specialized substance user treatment 1 (Amaral, Ronzani, & Souza-Formigoni, 2010). The efficacy and effectiveness in reducing excessive drinking when using instruments that detect hazardous and harmful use earlier followed by BI in PHC have been supported by several studies, systematic reviews, and meta-analyses (Ballesteros, Duffy, Querejeta, Ariño, & González-Pinto, 2004;Kaner et al, 2009).…”

Screening, brief intervention and referral to treatment (SBIRT): implementation barriers, facilitators and model migration

“…Studies have identified impediments to Screening and Brief Intervention (SBI) implementation in health-care settings in a variety of countries, including Finland [8,9], Sweden [10,11], Denmark [12], Norway [13], Australia [14] and Brazil [15]. Challenges to conducting SBI include time constraints, the need to focus upon more medically urgent issues, poor training, negative provider attitudes and perceptions of role incompatibility [8,[16][17][18].…”