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Impact of primary healthcare providers' initial role security and therapeutic commitment on implementing brief interventions in managing risky alcohol consumption: a cluster randomised factorial trial

Lookup NU author(s): Professor Peter Anderson, Professor Eileen Kaner, Professor Dorothy Newbury-Birch, Dr Kathryn Parkinson

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This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


Abstract

Background: Brief interventions in primary healthcare are cost-effective in reducing drinking problems but poorly implemented in routine practice. Although evidence about implementing brief interventions is growing, knowledge is limited with regard to impact of initial role security and therapeutic commitment on brief intervention implementation.Methods: In a cluster randomised factorial trial, 120 primary healthcare units (PHCUs) were randomised to eight groups: care as usual, training and support, financial reimbursement, and the opportunity to refer patients to an internet-based brief intervention (e-BI); paired combinations of these three strategies, and all three strategies combined. To explore the impact of initial role security and therapeutic commitment on implementing brief interventions, we performed multilevel linear regression analyses adapted to the factorial design.Results: Data from 746 providers from 120 PHCUs were included in the analyses. Baseline role security and therapeutic commitment were found not to influence implementation of brief interventions. Furthermore, there were no significant interactions between these characteristics and allocated implementation groups.Conclusions: The extent to which providers changed their brief intervention delivery following experience of different implementation strategies was not determined by their initial attitudes towards alcohol problems. In future research, more attention is needed to unravel the causal relation between practitioners' attitudes, their actual behaviour and care improvement strategies to enhance implementation science.


Publication metadata

Author(s): Keurhorst M, Anderson P, Heinen M, Bendtsen P, Baena B, Brzózka K, Colom J, Deluca P, Drummond C, Kaner E, Kłoda K, Mierzecki A, Newbury-Birch D, Okulicz-Kozaryn K, Palacio-Vieira J, Parkinson K, Reynolds J, Ronda G, Segura L, Słodownik L, Spak F, van Steenkiste B, Wallace P, Wolstenholme A, Wojnar M, Gual A, Laurant M, Wensing M

Publication type: Article

Publication status: Published

Journal: Implementation Science

Year: 2016

Volume: 11

Online publication date: 16/07/2016

Acceptance date: 07/07/2016

Date deposited: 12/10/2016

ISSN (electronic): 1748-5908

Publisher: BioMed Central Ltd.

URL: http://dx.doi.org/10.1186/s13012-016-0468-5

DOI: 10.1186/s13012-016-0468-5


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