Health Organization Collaborative Project on Identification and Management
of Alcohol-related Problems in Primary
of Country-wide Strategies for Implementing Early Identification and Brief Alcohol Intervention in
Primary Health Care.
Materials and Procedures
In Phase III
of the WHO Project, the brief intervention programme under study was the Drink-less
Programme used in conjunction with the AUDIT screening questionnaire.
This programme was originally designed and tested on GPs in Australia. However,
to meet the aim of Phase IV of achieving a widespread implementation of early
identification and brief intervention (EIBI) in
the particular primary health care setting of each participating country, it is clearly
necessary to adjust the EIBI package to each country’s particular needs and
circumstances. In addition, in the course of conducting Phase III of the WHO
Project, investigators in many of the participating countries noted various
recommendations from GPs and other health professionals regarding the specific
form and contents of the EIBI package, comments that stemmed mainly from the
varying circumstances in which primary health care was organized and delivered in each country.
Finally, research findings on EIBI have accumulated since the WHO Phases I and
II, on which the AUDIT Questionnaire and the Drink-less Programme were
based, and these new findings provide the opportunity to improve important
features of the EIBI package.
Aspects of the EIBI package that
could be revised in Phase IV include early identification methods, length of
intervention, intervention procedures, intervention materials, responsible
personnel, training methods and the strategy used to reframe understandings of
The main research method to be
used in the customisation process is the focus group. Groups will consist
primarily of health care professionals who would be asked to discuss barriers to
the implementation of EIBI in primary health care, how these barriers might best be overcome and
how an EIBI package should be developed to facilitate dissemination and
implementation in the conditions of primary health care of the country in question. Groups can
either be composed of single professional or mixed professional affiliations and
both single and mixed groups could be used in a participating country.
Another type of focus group that
might be run is with potential recipients of the EIBI package, i.e., patients
attending primary health care facilities or simply members of the general public who sometime
make use of primary health care.
The information from focus groups
could be supplemented by a set of one-to-one interviews with a convenience
sample of primary health care professionals. These interviews should include the full range of
professional affiliations that might be involved in EIBI work, a full
representation of types of primary health care delivery applying in the country in question
(e.g. solo and group practices, urban and rural settings), and a mixture of
gender, age and experience of primary health care workers.
In some participating countries,
structured questionnaires will be used to supplement information obtained from
focus groups and semi-structured interviews. This applies particularly to
countries that did not take part in the questionnaire study forming part of
Phase III (i.e., Strand 1).
A Delphi study may also be used
as this method has potential usefulness in the Phase IV study as a method
of soliciting the views of, and forming a consensus among, all those with expert
knowledge of EIBI in each participating country.
To find out more about the
components of Phase IV, please follow the links below:
[ Customisation ] [ Communications ] [ Strategic Alliance ] [ Demonstration Project ]