Costa Pedro Henrique Antunes da, Mota Daniela Cristina Belchior, Cruvinel Erica, Paiva Fernando Santana de, Ronzani Telmo Mota
Intervenção e Avaliação em Álcool e Drogas, Centro de Referência em Pesquisa, Departamento de Psicologia, Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brazil.
Rev Panam Salud Publica. 2013 May;33(5):325-31. doi: 10.1590/s1020-49892013000500003.
To develop a methodology to implement practices of prevention against the use of alcohol and other drugs in the context of primary health care (PHC) that will contribute to the debate about policies and actions in Latin American countries.
This intervention research project was carried out in a small/medium-sized Brazilian city. The development process was assessed through participant observation with the aim of adapting the methodology to local needs and identifying existing weaknesses and strengths with impact on implementation.
A model was developed with six stages: initial contact and planning, diagnosis and mapping, sensitization, training, follow-up, and communication of results to participants. The following weaknesses were identified: limitation of resources (human, financial, infrastructural), limitations in the coverage and comprehensiveness of the assistance network, poor participation from physicians, training based on medicalized care, insufficient participation of health care management, insufficient involvement and participation of civil society, and few opportunities for participation of the population in the planning and execution of public policies. Strengths included the participation of community health agents and nurses in applying, organizing, and planning initiatives, in addition to the organization of educative and preventive actions in schools and communities by health care teams, suggesting that it is possible to implement screening, brief intervention, and referral to treatment (SBIRT) initiatives in the context of PHC in Latin America.
The methodology developed in this study can be useful for Latin American countries if local needs are taken into consideration. It should be noted, however, that results will only be observed in the mid- to long term, rather than strictly in the short term.
制定一种方法，以便在初级卫生保健（PHC）背景下实施预防酒精和其他药物使用的措施，这将有助于拉丁美洲国家有关政策和行动的辩论。
该干预研究项目在巴西一个中小城市开展。通过参与观察对开发过程进行评估，目的是使方法适应当地需求，并确定对实施有影响的现有弱点和优势。
开发了一个包含六个阶段的模型：初步接触与规划、诊断与映射、宣传、培训、随访以及向参与者通报结果。确定了以下弱点：资源（人力、财力、基础设施）有限，援助网络的覆盖范围和全面性存在局限，医生参与度低，基于医疗化护理的培训，卫生保健管理参与不足，民间社会参与和投入不够，以及民众参与公共政策规划和执行的机会很少。优势包括社区卫生工作者和护士参与应用、组织和规划举措，此外还有卫生保健团队在学校和社区组织教育和预防行动，这表明在拉丁美洲初级卫生保健背景下实施筛查、简短干预和转诊治疗（SBIRT）举措是可行的。
如果考虑当地需求，本研究中开发的方法对拉丁美洲国家可能有用。然而，应该指出的是，结果只能在中长期观察到，而不是严格在短期内。
