World Health Organization Collaborative Project on Identification and Management of Alcohol-related Problems
in Primary Health Care: Phase IV
Development of Country-wide Strategies for Implementing Early Identification and Brief Alcohol Intervention in Primary Health Care.
Franco Marcomini, Drug and Alcohol Addiction Service, NHS, Local Health Unit, Padova
Vanna Cerrato, EUROCARE Italia, Padova
Tiziana Codenotti, EUROCARE Italia, Padova
Daniele Berto, Drug and Alcohol Addiction Service, NHS, Local Health Unit, Padova
Valentino Patussi, Research Centre for Alcohol Studies, Florence
Gloriana Bartoli, Research Centre for Alcohol Studies, Florence
Emanuele Scafato, National Institute of Health, Rome
Sonia Calzavara, Drug and Alcohol Addiction Service, NHS, Local Health Unit, Padova
Nicoletta Carotti, Drug and Alcohol Addiction Service, NHS, Local Health Unit, Padova
Oreste Bazzani , Research Centre for Alcohol Studies Florence
Stefania Polvani (Epidemiological Office, Addiction Dep., NHS) Florence
Elena Paolizzi, National Health System, Local Unit Po Delta area
Andrea Volterrani, DUSS, University of Florence Florence
Geographical Area in Which Implementation Strategy will be Applied:
The City of Padova and 19 small municipalities included in the Padova Local Health Unit (about 400.000 inhabitants)
March 2001: in reference to Strand I – Customizing package, it has been completed in collaboration with the Florence North-west subproject, with which common materials have been agreed.
Expected December 2003
Project Strands and Milestones:
Strand I: - Customisation of early identification and brief intervention package, training (24 months)
Strand II: - Demonstration Project (36 months)
Strand III: - Evaluation and Outcome Measures (12 months)
The Strategic Alliances will be developed from the beginning of the project and implemented during the process. The communication strategy should be linked to the Demonstration Project(s). The Strands are not placed in a chronological order because they pursue overlapping objectives.
Proposed Funding Sources:
It could be possible to revise the Questionnaire used for the Phase III, Strand I, in a shorter form much more linked to the objectives of the present project. This questionnaire should include some questions about attitudes to early identification and brief intervention and willingness to take part in the project. The revised form of the questionnaire could constitute a baseline measures and the way to involve GPs in the project.
Brief Intervention Package:
Method of delivery:
Brief Intervention Process:
Early identification and brief intervention should include different levels of action and it could be composed of three phases:
The different brief intervention options should be clarified and defined considering level of alcohol related problems, indicators of physical, psychological and social factors, patient’s ‘stage of change’.
Training of Primary Health Care Staff:
Communication Strategy is mainly based on the Educational Training Programme applied by the Clubs of Treated Alcoholics, Social Ecological Approach, Hudolin's Method. Additionally a mass media campaign could be delivered at later stages in the study. Finally, public conferences called ‘Sensibilization Meetings’ will be organised in local theatres and schools
Create a link with the Local Mass Media (Radio, TV, Newspapers) to persuade them to give information on Alcohol Issues
Control of Communication Strategy:
Qualitative data on the response to the initiatives done Pre and Post questionnaire for the different Sensibilization Courses and Meetings proposed
Indicators of the effectiveness of the communication strategy such as: Diffusion of Communication Strategy, Visibility of the Project in the Community, Change on perception about ARPP in the local community and Change on social response about ARPP.
‘Steering Group’ with representatives of GP’s associations (SIMG) and other primary health care Professionals Groups, representatives of voluntary associations (ACAT, AA, Al-Anon, Al-Ateen), representatives of the local government, Media Expert and representatives of local media
Building Strategic Alliances:
Indicators of the effectiveness of the development of the strategic alliances such as: Diffusion of the Alliances and Building of new spontaneous network within the community.
The City of Padova and 19 small municipalities included in the Padova Local Health Unit (total population of 400.000 inhabitants)
50.000-100.000 corresponding to 1 city district
Representative and stable population with an high sense of responsibility and identity with the local community.
No. of Primary Health Care Facilities:
To be defined
Projected Start Date:
Projected Completion Date:
End of 2003
Design of Project:
Before After Study with baseline and outcome measures
Baseline and follow-up measures on:
Pre and Post Questionnaire about: knowledge on alcohol issues, skills and attitude towards early identification and brief intervention
Qualitative analysis of patients responses to the early identification and brief intervention.
Structured or semi-structured questionnaire including process indicators with indexes convergence between primary health care workers and patients.