Factors Influencing the Implementation of Screening and Brief Interventions for Alcohol Use in Primary Care Practices: A Systematic Review Protocol

Introduction: Alcohol is a leading risk factor contributing to the global burden of disease. National and international agencies recommend evidence-based screening and brief interventions in primary care settings in order to reduce alcohol consumption. However, the majority of primary care professionals do not routinely deliver such interventions.Objective: To identify factors influencing general practitioners/family physicians’ and primary care nurses’ routine delivery of alcohol screening and brief intervention in adults.Material and Methods: A systematic literature search will be carried out in the following electronic databases: Medline, CINAHL, CENTRAL, and PsycINFO. Two authors will independently abstract data and assess study quality using the NIH National Heart, Lung, and Blood Institute quality assessment tools for quantitative studies, and the CASP checklist for qualitative studies. A narrative synthesis of the findings will be provided, structured around the barriers and facilitators identified. Identified barriers and facilitators will be further analysed using the Behavioural Change Wheel/Theoretical Domains Framework.Discussion: This review will describe the barriers to, and facilitators for, the implementation of alcohol screening and brief interventions by general practitioners/family physicians and nurses at primary care practices. By mapping the barriers and facilitators to the domains of the Behavioural Change Wheel/Theoretical Domains Framework, this review will also provide implementation researchers with a useful tool for selecting promising practitioner-oriented behavioural interventions for improving alcohol screening and brief intervention delivery in primary care.Conclusion: This review will provide important information for implementing alcohol screening and brief intervention in primary health care.Systematic Review Registration: PROSPERO CRD42016052681

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Examining the sustainability potential of a multisite pilot to integrate alcohol screening and brief intervention within three primary care systems

Translational Behavioral Medicine ◽

10.1093/tbm/ibx020 ◽

2018 ◽

Vol 8 (5) ◽

pp. 776-784 ◽

Cited By ~ 1

Author(s):

D K King ◽

S J Gonzalez ◽

J A Hartje ◽

B L Hanson ◽

C Edney ◽

...

Keyword(s):

Primary Care ◽

Brief Intervention ◽

Alcohol Screening ◽

Screening And Brief Intervention ◽

Care Systems

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Evaluation of Alcohol Screening and Brief Intervention in Routine Practice of Primary Care Nurses in Vhembe District, South Africa

Croatian Medical Journal ◽

10.3325/cmj.2008.3.392 ◽

2008 ◽

Vol 49 (3) ◽

pp. 392-401 ◽

Cited By ~ 20

Author(s):

Karl Peltzer ◽

Gladys Matseke ◽

Matevha Azwihangwisi ◽

Tom Babor

Keyword(s):

South Africa ◽

Primary Care ◽

Brief Intervention ◽

Alcohol Screening ◽

Routine Practice ◽

Screening And Brief Intervention ◽

Primary Care Nurses ◽

Vhembe District

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The Evolving Role of Medical Assistants in Primary Care Practice: Divergent and Concordant Perspectives from MAs and Family Physicians

Medical Care Research and Review ◽

10.1177/1077558720966148 ◽

2020 ◽

pp. 107755872096614

Author(s):

Erin P. Fraher ◽

Allison Cummings ◽

Dana Neutze

Keyword(s):

Primary Care ◽

Patient Education ◽

Population Health ◽

Low Cost ◽

Family Physicians ◽

Direct Patient Care ◽

Care Practice ◽

Medical Assistants ◽

Care Practices ◽

Primary Care Practices

Medical assistants (MAs) are a flexible and low-cost resource for primary care practices and their roles are swiftly transforming. We surveyed MAs and family physicians in primary care practices in North Carolina to assess concordance in their perspectives about MA roles, training, and confidence in performing activities related to visit planning; direct patient care; documentation; patient education, coaching or counseling; quality improvement; population health and communication. For most activities, we did not find evidence of role confusion between MAs and physicians, physician resistance to delegate tasks to properly trained MAs, or MA reluctance to pursue training to take on new roles. Three areas emerged where the gap between the potential and actual implementation of MA role transformation could be narrowed—population health and panel management; patient education, coaching, and counseling; and scribing. Closing these gaps will become increasingly important as our health care system moves toward value-based models of care.

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