Rosário Frederico, Vasiljevic Milica, Pas Leo, Fitzgerald Niamh, Ribeiro Cristina
Tomaz Ribeiro Primary Health Care Center, Dão Lafões Primary Health Care Centers Grouping, Viseu, Portugal.
Instituto de Medicina Preventiva e Saúde Pública, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal.
Fam Pract. 2019 Mar 20;36(2):199-205. doi: 10.1093/fampra/cmy062.
Alcohol is one of the most important risk factors contributing to the global burden of disease. Screening and brief interventions in primary care settings are effective in reducing alcohol consumption. However, implementation of such interventions in routine practice has been proven difficult. Most programmes in practice and research have lacked a theoretical rationale for how they would change practitioner behaviour.
To determine whether a theory-based behaviour change intervention delivered to primary care practices significantly increases delivery of alcohol screening.
We will conduct a two-arm, cluster-randomized controlled, parallel, open trial. Twelve primary care practices will be randomized to one of two groups: training and support; and waiting-list control. Family physicians, nurses and receptionists will be eligible to participate. The intervention will be a training and support programme. The intervention will be tailored to the barriers and facilitators for implementing alcohol screening and brief interventions following the principles of the Behaviour Change Wheel approach. The primary outcome will be the proportion of patients screened with the Alcohol Use Disorders Identification Test.
This study will test whether a theory-driven implementation programme increases alcohol screening rates in primary care. Results from this trial will provide a useful addition to existing evidence by informing implementation researchers what areas of behaviour change are critical to increasing alcohol screening rates.
clinicaltrials.gov NCT02968186.
酒精是导致全球疾病负担的最重要风险因素之一。在初级保健机构进行筛查和简短干预对于减少酒精消费是有效的。然而，在常规实践中实施此类干预已被证明是困难的。实践和研究中的大多数项目都缺乏关于如何改变从业者行为的理论依据。
确定向初级保健机构提供的基于理论的行为改变干预措施是否能显著提高酒精筛查的实施率。
我们将进行一项双臂、整群随机对照、平行、开放试验。12个初级保健机构将被随机分为两组之一：培训与支持组；以及等待名单对照组。家庭医生、护士和接待员将有资格参与。干预措施将是一个培训与支持项目。该干预措施将根据行为改变轮方法的原则，针对实施酒精筛查和简短干预的障碍与促进因素进行调整。主要结局将是使用酒精使用障碍识别测试进行筛查的患者比例。
本研究将测试一个理论驱动的实施项目是否能提高初级保健中的酒精筛查率。该试验的结果将通过告知实施研究人员行为改变的哪些领域对于提高酒精筛查率至关重要，为现有证据提供有益补充。
clinicaltrials.gov NCT02968186。
