Improving access to primary health care for chronic drug users: an innovative systemic intervention for providers

An intervention was designed to improve access to primary care for chronic drug users (CDUs) by enhancing health care providers' knowledge and skills. Using a case study method, three study sites were systematically selected for intervention implementation: a primary care clinic (PC), an emergency department (ED), and a drug treatment (DT) facility. Participants completed pre- and postintervention tests of knowledge, skills, and intentions to practice. Compared with pretest scores, participants had significantly higher posttest scores concerning knowledge of CDUs' health care needs. Postintervention evaluations indicated intentions to practice skills learned in the intervention. As hypothesized, the PC and ED subsequently instituted formal screening mechanisms to identify CDUs. This intervention revealed potential to build bridges between health care providers and CDUs. By overcoming provider resistance, primary care access can be realized for this and other disadvantaged populations.