Recommendations for implementing digital alcohol interventions in primary care: lessons learned from a Norwegian...

Area of Science:

• Digital health interventions
• Primary care implementation science
• Alcohol use disorder treatment

Background:

• Excessive alcohol consumption is a major global health risk.
• Digital alcohol interventions are effective but adoption is slow.
• Normalization Process Theory (NPT) can explain implementation barriers.

Purpose of the Study:

• To identify factors promoting or inhibiting the implementation of a digital alcohol intervention in Norwegian primary care.
• To assess the perceived normalization of the "Endre" digital intervention using NPT.
• To understand challenges faced by general practitioners (GPs) and support staff.

Main Methods:

• A mixed-methods feasibility study in four GP practices.
• Quantitative data: intervention usage logs, GP surveys, NoMAD survey for staff.
• Qualitative data: semi-structured group interviews analyzed with NPT.

Main Results:

• Low normalization scores indicated "Endre" was not fully embedded.
• Staff reported some confidence but noted lack of tailored support, involvement, and feedback.
• The COVID-19 pandemic further limited intervention use.

Conclusions:

• Real-world implementation of digital alcohol interventions faces significant challenges.
• Involving support staff in development and implementation is crucial for workflow compatibility.
• Enhanced features like clinician dashboards could improve integration.