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多方面干预措施提高初级保健中酒精简短干预的实施:混合方法过程分析。

Multifaceted intervention to increase the delivery of alcohol brief interventions in primary care: a mixed-methods process analysis.

机构信息

School of Primary and Allied Health Care, Monash University, Melbourne, Australia.

Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Frankston, Victoria, Australia.

出版信息

Br J Gen Pract. 2023 Sep 28;73(735):e778-e788. doi: 10.3399/BJGP.2022.0613. Print 2023 Oct.

Abstract

BACKGROUND

Brief interventions (BIs) are effective for reducing harmful alcohol consumption, but their use in primary care is less frequent than clinically indicated. The REducing AlCohol- related Harm (REACH) project aimed to increase the delivery of BIs in primary care.

AIM

To assess the effectiveness of the REACH programme in increasing alcohol BIs in general practice and explore the implementation factors that improve or reduce uptake by clinicians.

DESIGN AND SETTING

This article reports on a sequential, explanatory mixed-methods study of the implementation of the REACH project in six general practice clinics serving low-income communities in Melbourne, Australia.

METHOD

Time-series analyses were conducted using routinely collected patient records and semi-structured interviews, guided by the consolidated framework for implementation research.

RESULTS

The six intervention sites significantly increased their rate of recorded alcohol status (56.7% to 60.4%), whereas there was no significant change in the non-intervention practices (344 sites, 55.2% to 56.4%).

CONCLUSION

REACH resources were seen as useful and acceptable by clinicians and staff. National policies that support the involvement of primary care in alcohol harm reduction helped promote ongoing intervention sustainability.

摘要

背景

简短干预(BIs)对于减少有害饮酒是有效的,但在初级保健中的应用频率低于临床需要。REducing AlCohol-相关伤害(REACH)项目旨在增加初级保健中 BI 的提供。

目的

评估 REACH 计划在增加一般实践中酒精 BI 方面的有效性,并探讨提高或降低临床医生接受程度的实施因素。

设计和设置

这篇文章报告了一项在澳大利亚墨尔本为服务低收入社区的六家普通诊所实施 REACH 项目的顺序、解释性混合方法研究。

方法

使用常规收集的患者记录和半结构化访谈进行时间序列分析,以实施研究的综合框架为指导。

结果

六个干预点的记录酒精状况率显著增加(从 56.7%到 60.4%),而非干预实践点则没有显著变化(344 个点,从 55.2%到 56.4%)。

结论

REACH 资源被临床医生和工作人员视为有用和可接受的。支持初级保健参与减少酒精伤害的国家政策有助于促进持续的干预可持续性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5991/10544510/58af957b889e/bjgpoct-2023-73-735-e778-1.jpg

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