Pragmatic approaches for addressing alcohol in general practice: Development of a tailored implementation...

Area of Science:

• Public Health
• General Practice
• Behavioral Science

Background:

• Alcohol consumption is a major global health risk.
• Screening and brief interventions (SBI) for alcohol are effective but underutilized in primary care.
• Universal screening by general practitioners (GPs) is resource-intensive and faces implementation challenges.

Purpose of the Study:

• To develop a tailored, theory-based training intervention for GPs.
• To enhance GPs' ability to address alcohol use and manage alcohol-related health problems pragmatically.
• To align alcohol intervention strategies with GPs' clinical roles and relevance.

Main Methods:

• Qualitative study using focus groups and questionnaires with GPs in Norway.
• Behavioral analysis based on the Capability, Opportunity, Motivation, and Behavior (COM-B) model and the Behavior Change Wheel.
• Iterative framework analysis of qualitative data to inform intervention development.

Main Results:

• Identified four key areas where GPs need additional support: understanding alcohol-health links, initiating conversations, addressing issues, and follow-up.
• Developed a four-session interactive training program and a digital intervention for patient support.
• GPs (n=55) participated, with 25 attending focus groups.

Conclusions:

• Pragmatic, relevance-based clinical strategies are more effective for alcohol intervention in primary care than universal screening.
• The developed training intervention addresses identified GP needs and supports SBI implementation.
• This approach aligns with GPs' skill sets, potentially increasing widespread adoption of SBI in routine care.