[Early screening and brief intervention among excessive alcohol users: mobilizing general practitioners in an...

The program "Boire moins, c'est mieux" (BMCM--"The less alcohol, the better") initiated by the ANPAA offered 550 general practitioners (GPs) in 2003 to follow training courses so as to perform "early screening and brief intervention" (ESBI) in general practice. Phone calls to the medical offices, a financial compensation offer and a media campaign in the immediate environment of general practitioners were used. The study aimed at assessing the respective efficiency of these three methods.

Mailing was the control mobilization method. Phone calls were used in addition to mailing for one GP out of two, according to a previous draw. Financial compensation (2 + for each questionnaire filled out, and 10 + for each BI delivered) was used when GPs were invited a second time to attend the training. Community-based mobilization only occurred in the site in Saint-Quentin-en-Yvelines (France). The primary endpoint was the actual participation to the training evenings. The secondary endpoints were the registration to trainings and the ESBI activity following the training.

Phone calls enabled to multiple by 7 the number of participants attending training sessions, as compared to the impact of mailing only (p < 10-7); phone calls had no proper impact on ESBI activity following the training. Financial compensation had a powerful impact on the level of ESBI activities (p = 10-4); however, announcing it had no effect on registrations and barely modified the impact of phone calls. The proportion of the population benefiting from a screening action doubled in the site where a community-based action occurred (p < 10-7).

A mere phone call was particularly efficient in increasing the number of trained GPs. Financial incentive led to an activity level very close to systematic screening. Community-based approach increased significantly the proportion of the screened population.