scholarly journals Implementing primary health care-based measurement, advice and treatment for heavy drinking and comorbid depression at the municipal level in three Latin American countries: final protocol for a quasi-experimental study (SCALA study)

2020 ◽  
Author(s):  
Eva Jane LLopis ◽  
Peter Anderson ◽  
Marina Piazza ◽  
Amy O'Donnell ◽  
Antoni Gual ◽  
...  
Keyword(s):  
Health Care ◽  
Experimental Study ◽  
Primary Health Care ◽  
Alcohol Consumption ◽  
Latin American ◽  
Scale Up ◽  
Heavy Drinking ◽  
Routine Practice ◽  
Primary Health ◽  
Quasi Experimental

Abstract Background : While primary health care-based prevention and management of heavy drinking is clinically effective and cost-effective, it remains poorly implemented in routine practice. Systematic reviews and multi-country studies have demonstrated the ability of training and support programmes for healthcare professionals to increase primary health care-based measurement and brief advice activity to reduce heavy drinking. However, gains have been only modest and short term at best. WHO studies have concluded that a more effective uptake could be achieved by embedding primary health care activity within broader municipal-based support. Methods : A quasi-experimental study will compare primary health care-based prevention and management of heavy drinking in three intervention municipal areas from Colombia, Mexico and Peru with three comparator municipal areas from the same countries. In the implementation municipal areas, primary health care units will receive training embedded within ongoing supportive municipal action over an 18-month implementation test period. In the comparator municipal areas, half the units will receive training, and the other half will continue with practice as usual. The primary outcome is the proportion of the adult population (aged 18+ years) registered with the unit that has their alcohol consumption measured. Return-on-investment analyses and full process evaluation will be undertaken, coupled with an analysis of potential contextual, financial and political-economy influencing factors. Discussion : This multi-country study will test the extent to which embedding primary health care-based prevention and management of heavy drinking within supportive municipal action leads to improved scale-up of more patients having their alcohol consumption measured, and subsequently receiving appropriate advice and treatment.

scholarly journals Scaling-up primary health care-based prevention and management of heavy drinking at the municipal level in middle-income countries in Latin America: Background and protocol for a three-country quasi-experimental study

F1000Research ◽  
2017 ◽  
Vol 6 ◽  
pp. 311
Author(s):  
Peter Anderson ◽  
Amy O'Donnell ◽  
Eileen Kaner ◽  
Antoni Gual ◽  
Bernd Schulte ◽  
...  
Keyword(s):  
Health Care ◽  
Experimental Study ◽  
Primary Health Care ◽  
Scale Up ◽  
Heavy Drinking ◽  
Cost Effective ◽  
Routine Practice ◽  
Primary Health ◽  
Implementation Period ◽  
Quasi Experimental

Background: While primary health care (PHC)-based prevention and management of heavy drinking is clinically effective and cost-effective, it remains poorly implemented in routine practice. Systematic reviews and multi-country studies have demonstrated the ability of training and support programmes to increase PHC-based screening and brief advice activity to reduce heavy drinking. However, gains have been only modest and short term at best. WHO studies have concluded that a more effective uptake could be achieved by embedding PHC activity within broader community and municipal support. Protocol: A quasi-experimental study will compare PHC-based prevention and management of heavy drinking in three intervention cities from Colombia, Mexico and Peru with three comparator cities from the same countries. In the implementation cities, primary health care units (PHCUs) will receive training embedded within ongoing supportive municipal action over an 18-month implementation period. In the comparator cities, practice as usual will continue at both municipal and PHCU levels. The primary outcome will be the proportion of consulting adult patients intervened with (screened and advice given to screen positives). The study is powered to detect a doubling of the outcome measure from an estimated 2.5/1,000 patients at baseline. Formal evaluation points will be at baseline, mid-point and end-point of the 18-month implementation period. We will present the ratio (plus 95% confidence interval) of the proportion of patients receiving intervention in the implementation cities with the proportions in the comparator cities. Full process evaluation will be undertaken, coupled with an analysis of potential contextual, financial and political-economy influencing factors. Discussion: This multi-country study will test the extent to which embedding PHC-based prevention and management of alcohol use disorder with supportive municipal action leads to improved scale-up of more patients with heavy drinking receiving appropriate advice and treatment. Study status: The four-year study will start on 1st December 2017.

scholarly journals Scaling-up primary health care-based prevention and management of alcohol use disorder at the municipal level in middle-income countries in Latin America: Background and pre-protocol for a three-country quasi-experimental study

F1000Research ◽  
2017 ◽  
Vol 6 ◽  
pp. 311 ◽  
Author(s):  
Peter Anderson ◽  
Amy O'Donnell ◽  
Eileen Kaner ◽  
Antoni Gual ◽  
Bernd Schulte ◽  
...  
Keyword(s):  
Health Care ◽  
Experimental Study ◽  
Primary Health Care ◽  
Alcohol Use ◽  
Alcohol Use Disorder ◽  
Heavy Drinking ◽  
Routine Practice ◽  
Primary Health ◽  
Implementation Period ◽  
Quasi Experimental

Background: While primary health care (PHC)-based prevention and management of alcohol use disorder (AUD) is clinically effective and cost-effective, it remains poorly implemented in routine practice. Systematic reviews and multi-country studies have demonstrated the ability of training and support programmes to increase PHC-based screening and brief advice activity to reduce heavy drinking. However, gains have been only modest and short term at best. WHO studies have concluded that a more effective uptake could be achieved by embedding PHC activity within broader community and municipal support. Protocol: A quasi-experimental study will compare PHC-based prevention and management of AUD, operationalized by heavy drinking, in three intervention cities from Colombia, Mexico and Peru with three comparator cities from the same countries. In the implementation cities, primary health care units (PHCUs) will receive training embedded within ongoing supportive municipal action over an 18-month implementation period. In the comparator cities, practice as usual will continue at both municipal and PHCU levels. The primary outcome will be the proportion of consulting adult patients intervened with (screened and advice given to screen positives). The study is powered to detect a doubling of the outcome measure from an estimated 2.5/1,000 patients at baseline. Formal evaluation points will be at baseline, mid-point and end-point of the 18-month implementation period. We will present the ratio (plus 95% confidence interval) of the proportion of patients receiving intervention in the implementation cities with the proportions in the comparator cities. Full process evaluation will be undertaken, coupled with an analysis of potential contextual, financial and political-economy influencing factors. Discussion: This multi-country study will test the extent to which embedding PHC-based prevention and management of alcohol use disorder with supportive municipal action leads to improved scale-up of more patients with heavy drinking receiving appropriate advice and treatment.

scholarly journals Scaling-up primary health care-based prevention and management of alcohol use disorder at the municipal level in middle-income countries in Latin America: Background and pre-protocol for a three-country quasi-experimental study

F1000Research ◽  
2017 ◽  
Vol 6 ◽  
pp. 311 ◽  
Author(s):  
Peter Anderson ◽  
Amy O'Donnell ◽  
Eileen Kaner ◽  
Antoni Gual ◽  
Bernd Schulte ◽  
...  
Keyword(s):  
Health Care ◽  
Experimental Study ◽  
Primary Health Care ◽  
Alcohol Use ◽  
Alcohol Use Disorder ◽  
Heavy Drinking ◽  
Routine Practice ◽  
Primary Health ◽  
Implementation Period ◽  
Quasi Experimental

Background: While primary health care (PHC)-based prevention and management of alcohol use disorder (AUD) is clinically effective and cost-effective, it remains poorly implemented in routine practice. Systematic reviews and multi-country studies have demonstrated the ability of training and support programmes to increase PHC-based screening and brief advice activity to reduce heavy drinking. However, gains have been only modest and short term at best. WHO studies have concluded that a more effective uptake could be achieved by embedding PHC activity within broader community and municipal support. Protocol: A quasi-experimental study will compare PHC-based prevention and management of AUD, operationalized by heavy drinking, in three intervention cities from Colombia, Mexico and Peru with three comparator cities from the same countries. In the implementation cities, primary health care units (PHCUs) will receive training embedded within ongoing supportive municipal action over an 18-month implementation period. In the comparator cities, practice as usual will continue at both municipal and PHCU levels. The primary outcome will be the proportion of consulting adult patients intervened with (screened and advice given to screen positives). The study is powered to detect a doubling of the outcome measure from an estimated 2.5/1,000 patients at baseline. Formal evaluation points will be at baseline, mid-point and end-point of the 18-month implementation period. We will present the ratio (plus 95% confidence interval) of the proportion of patients receiving intervention in the implementation cities with the proportions in the comparator cities. Full process evaluation will be undertaken, coupled with an analysis of potential contextual, financial and political-economy influencing factors. Discussion: This multi-country study will test the extent to which embedding PHC-based prevention and management of alcohol use disorder with supportive municipal action leads to improved scale-up of more patients with heavy drinking receiving appropriate advice and treatment.

scholarly journals Impact of Training and Municipal Support on Primary Health Care–Based Measurement of Alcohol Consumption in Three Latin American Countries: 5-Month Outcome Results of the Quasi-experimental Randomized SCALA Trial

2021 ◽  
Author(s):  
Peter Anderson ◽  
Jakob Manthey ◽  
Eva Jané Llopis ◽  
Guillermina Natera Rey ◽  
Ines V. Bustamante ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Alcohol Consumption ◽  
Latin American ◽  
Adult Patients ◽  
Training Package ◽  
Link Type ◽  
Primary Health ◽  
Quasi Experimental ◽  
And Training

Abstract Purpose We aimed to test the effects of providing municipal support and training to primary health care providers compared to both training alone and to care as usual on the proportion of adult patients having their alcohol consumption measured. Methods We undertook a quasi-experimental study reporting on a 5-month implementation period in 58 primary health care centres from municipal areas within Bogotá (Colombia), Mexico City (Mexico), and Lima (Peru). Within the municipal areas, units were randomized to four arms: (1) care as usual (control); (2) training alone; (3) training and municipal support, designed specifically for the study, using a less intensive clinical and training package; and (4) training and municipal support, designed specifically for the study, using a more intense clinical and training package. The primary outcome was the cumulative proportion of consulting adult patients out of the population registered within the centre whose alcohol consumption was measured (coverage). Results The combination of municipal support and training did not result in higher coverage than training alone (incidence rate ratio (IRR) = 1.0, 95% CI = 0.6 to 0.8). Training alone resulted in higher coverage than no training (IRR = 9.8, 95% CI = 4.1 to 24.7). Coverage did not differ by intensity of the clinical and training package (coefficient = 0.8, 95% CI 0.4 to 1.5). Conclusions Training of providers is key to increasing coverage of alcohol measurement amongst primary health care patients. Although municipal support provided no added value, it is too early to conclude this finding, since full implementation was shortened due to COVID-19 restrictions. Trial Registration Clinical Trials.gov ID: NCT03524599; Registered 15 May 2018; https://clinicaltrials.gov/ct2/show/NCT03524599

The Impact of Primary Health Care on Tuberculosis: A Quasi-Experimental Study Based on a Nationwide Cohort of 7.3 Million Brazilians

2021 ◽  
Author(s):  
Gabriela dos Santos de Jesus ◽  
Julia Moreira Pescarini ◽  
Andréa Silva ◽  
Ana Wieczorek Torrens ◽  
Elzo Pereira Pinto Júnior ◽  
...  
Keyword(s):  
Health Care ◽  
Experimental Study ◽  
Primary Health Care ◽  
Primary Health ◽  
Quasi Experimental ◽  
The Impact

Student and preceptor perceptions of primary health care clinical placements during pre-service education: Qualitative results from a quasi-experimental study

2018 ◽  
Vol 28 ◽  
pp. 224-230 ◽  
Author(s):  
Semakaleng H. Phafoli ◽  
Alice Christensen-Majid ◽  
Laura Skolnik ◽  
Stephanie Reinhardt ◽  
Isabel Nyangu ◽  
...  
Keyword(s):  
Health Care ◽  
Experimental Study ◽  
Primary Health Care ◽  
Clinical Placements ◽  
Primary Health ◽  
Quasi Experimental

scholarly journals Effect of Community Support on the Implementation of Primary Health Care-Based Measurement of Alcohol Consumption

2022 ◽  
Author(s):  
Adriana Solovei ◽  
Eva Jané-Llopis ◽  
Liesbeth Mercken ◽  
Inés Bustamante ◽  
Daša Kokole ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Alcohol Consumption ◽  
Latin American ◽  
Health Care Providers ◽  
Self Efficacy ◽  
Community Support ◽  
Cost Effective ◽  
Care Providers ◽  
Primary Health

AbstractAlcohol measurement delivered by health care providers in primary health care settings is an efficacious and cost-effective intervention to reduce alcohol consumption among patients. However, this intervention is not yet routinely implemented in practice. Community support has been recommended as a strategy to stimulate the delivery of alcohol measurement by health care providers, yet evidence on the effectiveness of community support in this regard is scarce. The current study used a pre-post quasi-experimental design in order to investigate the effect of community support in three Latin American municipalities in Colombia, Mexico, and Peru on health care providers’ rates of measuring alcohol consumption in their patients. The analysis is based on the first 5 months of implementation. Moreover, the study explored possible mechanisms underlying the effects of community support, through health care providers’ awareness of support, as well as their attitudes, subjective norms, self-efficacy, and subsequent intention toward delivering the intervention. An ANOVA test indicated that community support had a significant effect on health care providers’ rates of measuring alcohol consumption in their patients (F (1, 259) = 4.56, p = 0.034, ηp2 = 0.018). Moreover, a path analysis showed that community support had a significant indirect positive effect on providers’ self-efficacy to deliver the intervention (b = 0.07, p = 0.008), which was mediated through awareness of support. Specifically, provision of community support resulted in a higher awareness of support among health care providers (b = 0.31, p < 0.001), which then led to higher self-efficacy to deliver brief alcohol advice (b = 0.23, p = 0.010). Results indicate that adoption of an alcohol measurement intervention by health care providers may be aided by community support, by directly impacting the rates of alcohol measurement sessions, and by increasing providers’ self-efficacy to deliver this intervention, through increased awareness of support. Trial Registration ID: NCT03524599; Registered 15 May 2018; https://clinicaltrials.gov/ct2/show/NCT03524599

Sign in / Sign up

Export Citation Format

Share Document