The role of training in IBA implementation beyond primary health care settings in the UK

Abstract

There has been a considerable drive to encourage a wide range of professional groups to incorporate alcohol screening (or identification) and brief advice (IBA) into their everyday practice. This article aims to examine the role of training in promoting IBA delivery in contexts outside primary care and other health settings. The data are drawn mainly from a structured online survey supplemented by illustrative material from nine qualitative interviews and insights from an expert workshop. Findings support the results from other research that issues relating to role relevance and role security continue to act as barriers to professional change. Furthermore, issues of organisational commitment and organisational barriers are insufficiently addressed in strategy to promote wider use of IBA. The article concludes that development of appropriate training for alcohol IBA needs to take account of the role of IBA within a complex interactive system of related services and help seeking pathways and consider how training can contribute to changing both professional attitudes and behaviours and organisational approaches to implementing and sustaining IBA in everyday professional practice.

Extending alcohol brief advice into non-clinical community settings: a qualitative study of experiences and perceptions of delivery staff

“…This study helps to illustrate how these concerns can vary across and within settings and relate to beliefs about existing role boundaries and public expectations. Implementation issues relating to role legitimacy, role relevance and role support have been reported by others [32] and IBA is more likely to be accepted when perceived as compatible with existing goals and ways of working [20]. These findings provide support to existing arguments and illustrate their relevance in alternative settings.…”

“…Health and wellbeing advisors from community health settings also benefited from their existing skills and expertise in behaviour change, the provision of health advice, and knowledge of local resources and support. Other non-clinical settings in which IBA have been more recently encouraged, such as social services or probation, face challenges associated with alcohol issues being mainly seen and experienced in terms of dependency and problematic drinking [32]. This was not an issue in the settings included in this study, however, some staff felt that the success of the intervention was limited by the lack of engagement by those in higher risk categories.…”

“…Evidence to support the efficacy and effectiveness of IBA within community pharmacy and other community settings however is limited [29–31]. There is also little understanding of the mechanisms of impact and contextual factors that might support the widening of IBA delivery to non-clinical settings in line with a health in all policy approach [32] and, in the UK setting, the Making Every Contact Count agenda [33].…”

Delivering information and brief advice on alcohol (IBA) in social work and social care settings: an exploratory study

“…We recognise that the term IBA is largely used in England and Wales and that, even within England and Wales there is considerable variety not only in the terminology used to describe the intervention but also in its application. However, as this case study was derived from a larger study which examined the potential for the wider delivery of IBA by housing, probation and social work professionals (Thom, Herring, & Bayley, 2016a;Thom, Herring, Bayley, & Hafford-Letchfield, 2016b), we continue to use the term IBA in this paper.…”

Spreading alcohol brief interventions from health care to non-health care settings: Is it justified?

“…& Newbury-Birch, 2016; Thom, Herring, & Bayley, 2016). The classic triad of role legitimacy, role adequacy and role support, originally described by Shaw, Sprately, Cartwright, and Harwin (1978) nearly 40 years ago, together with the related concept of therapeutic commitment, seems as important in NHC as in HC settings for analysing difficulties in persuading practitioners to undertake alcohol work.…”