Addiction Medicine, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
Subst Abus. 2020;41(3):347-355. doi: 10.1080/08897077.2019.1635963. Epub 2019 Jul 31.
In primary care, electronic self-administered screening and brief interventions for unhealthy alcohol may overcome some of the implementation barriers of face-to-face intervention. We developed an anonymous electronic self-administered screening brief intervention device for unhealthy alcohol use and assessed its feasibility and acceptability in primary care practice waiting rooms. Two modes of delivery were compared: with or without the presence of a research assistant (RA) to make patients aware of the device's presence and help users. Using the device was optional. The devices were placed in 10 participating primary care practices waiting rooms for 6 weeks, and were accessible on a voluntary basis. Number of appointments by each practice during the course of the study was recorded. Access to the electronic brief intervention was voluntary among those who screened positive. Screening and brief intervention rates and characteristics of users were compared across the modes of delivery. During the study, there were 7270 appointments and 1511 individuals used the device (20.8%). Mean age of users was 45.3 (19.5), and 57.9% screened positive for unhealthy alcohol use. Of them, 53.8% accessed the brief intervention content. The presence of the RA had a major impact on the device's usage (59.6% vs 17.4% when absent). When the RA was present, participants were less likely to screen positive (49.4% vs 60.7%, = 0.0003) but more likely to access the intervention (62.7% vs 51.4%, = 0.009). Results from the satisfaction survey indicated that users found the device easy to use (93.5%), questions useful (89-95%) and 77.2% reported that their friends would be willing to use it. This pilot project indicates that the implementation of an electronic screening and brief intervention device for unhealthy alcohol is feasible and acceptable in primary care practices but that, without human support, its use is rather limited.
在初级保健中，电子自我管理的筛查和简短干预可能会克服一些面对面干预的实施障碍。我们开发了一种匿名的电子自我管理的筛查和简短干预设备，用于评估其在初级保健实践候诊室的可行性和可接受性。比较了两种交付模式：有或没有研究助理（RA）在场，以提醒患者注意设备的存在并帮助用户。使用该设备是可选的。在 10 个参与的初级保健实践候诊室中放置了该设备 6 周，供自愿使用。在研究过程中，记录了每个实践的预约次数。在筛查阳性的人群中，对电子简短干预的访问是自愿的。比较了两种交付模式下的筛查和简短干预率以及用户特征。在研究期间，共有 7270 次预约，有 1511 人使用了该设备（20.8%）。用户的平均年龄为 45.3（19.5），57.9%的人筛查出不健康的饮酒行为。其中，53.8%的人访问了简短干预内容。RA 的存在对设备的使用有重大影响（有 RA 时为 59.6%，无 RA 时为 17.4%）。当 RA 在场时，参与者筛查阳性的可能性较低（49.4%对 60.7%， = 0.0003），但更有可能访问干预措施（62.7%对 51.4%， = 0.009）。满意度调查结果表明，用户认为该设备易于使用（93.5%），问题有用（89-95%），77.2%的用户表示他们的朋友愿意使用该设备。该试点项目表明，在初级保健实践中实施用于评估不健康饮酒的电子筛查和简短干预设备是可行且可接受的，但如果没有人员支持，其使用范围相当有限。
