Derges Jane, Kidger Judi, Fox Fiona, Campbell Rona, Kaner Eileen, Hickman Matthew
University of Bristol School of Social and Community Medicine, Avon, Bristol, UK.
Institute of Health and Society, Newcastle University, Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, NE2 4AX, UK.
BMC Public Health. 2017 Jun 9;17(1):562. doi: 10.1186/s12889-017-4476-4.
Systematic 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.
This 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.
From 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.
There 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.
对酒精筛查与简短干预（ASBI）的系统评价凸显了在医疗保健和社区环境中实施该干预的挑战。通过对定性文献的研究来探讨这一问题的综述较少，而关注针对年轻人的干预措施的综述则更少。
本综述旨在研究关于在医疗保健和社区环境中，针对成年人及年轻人实施ASBI的促进因素和障碍的定性文献。在进行分析之前，利用电子数据库（Ovid SP上的Medline、PsychInfo、CINAHL、Web of Science和EMBASE）、谷歌学术以及引文检索进行了搜索。
在总共检索和筛选的239篇论文中，有15篇被纳入最终综述；这些论文是根据内容丰富度和与综述问题的相关性来挑选的。通过持续的后续支持增加知识和技能以及明确干预措施，有助于ASBI的实施。实施障碍包括对饮酒的态度、缺乏结构和组织支持、在解决饮酒问题方面责任的角色定义不明确、担心损害专业人员/患者关系以及与其他紧迫医疗需求的竞争。
在卫生和社区专业人员中，ASBI的实施仍然存在重大障碍。改善卫生服务机构应对和协调酒精服务的方式，包括确定谁最适合解决饮酒问题，将有助于更好地实施ASBI。最后，注意到针对年轻人的酒精干预和实施的定性研究匮乏，这表明需要进一步开展定性研究。
