Division of Psychology, Northumbria University & Centre for Health Services Research, University of Newcastle upon Tyne
Professor Nick Heather and Dr Eileen Kaner
Geographical Area in which Implementation Strategy will be Applied:
Project Strands and Milestones:
Strand 1 of the study has been completed.
A grant has been received to carry out a Demonstration Project (Strand 2). This will take the form of a pilot implementation of early identification and brief intervention (EIBI) in at least one primary health care facilitiy in each of the five areas of the Health Action Zone.
Strand 3 is planned to continue after the completion of the Demonstration Project and will consist of an interative process aimed at furthering the promotion of EIBI in primary health care in England, taking advantage of the recently published Alcohol Harm Reduction Strategy for England.
Proposed Funding Sources:
The Alcohol Education and Research Council funded Strand 1 and the Tyne and Wear Health Action Zone has funded Strand 2. Further funding will be sought from various bodies during the course of Strand 3.
A Local Steering Committee has been established. The support of the Local Medical Committee (General Practitioners) has been obtained, as has the support of the Head of Primary Care Development for the Newcastle and North Tyneside Health Authority (Dr. I an Spencer). Assistance has also been obtained from personnel with relevant expertise in several departments of the University of Newcastle and the University of Northumbria. Tyne and Wear is also a Health Action Zone and support for the study has also been received from this source. Professor Christine Godfrey and her colleagues from the Centre for Health Economics, University of York will assist with the economic evaluation of the study.
Brief Intervention Package, including delivery systems:
Focus groups (FGs) have been conducted with primary health care teams in the local area, including those who did not take part in WHO Strand 3/Phase III and those with positive and negative attitudes to EIBI. FGs were also conducted with patients. Groups have considered possible improvements to the Drink-less Programme and ways in which identified barriers to the routine and enduring implementation of the programme can be overcome. A paper reporting the findings from FGs is currently under editorial consideration and will be available on this web site as soon as it has been published. A Delphi study of expert opinion on screening and brief intervention in primary health care has also been conducted, with the aim of achieving a concensus of opinion on how best to implement screening and brief intervention for excessive drinkers in primary health care in England. The findings of this study have been published in the Journal of Substance Use and can be accessed below.
Nick Heather, Emma Dallolio, Deborah Hutchings, Eileen Kaner & Martin White; “Implementing routine screening and brief alcohol intervention in Primary Health Care: A Delphi survey of expert opinion”; Journal of Substance Use, April 2004, 9(2):68-85.(format pdf)
Training of Primary Health Care Staff:
Training issues were covered in the FGs and Delphi study as described above.
FG data were analysed by systematic coding of emergent themes into dominant categories plus content analysis (NUD*IST) and thematic analysis using a grounded approach. An attempt at triangulation will be made by feeding back themes and interpretations to participants, where possible, to seek confirmation and/or clarification of the analysis. Methods of analysis in the Delphi study are described in the published paper.
The Communications Strategy (CS) will be part of a multi-faceted implementation programme involving primary health care professionals. The CS will be evaluated by pre- and post-strategy measures of the extent to which respondents understand and accept the concept of ‘risky drinking’ and other related matters. If successful, the CS will be disseminated in all parts of the country.
A mass media campaign among the general public will be postponed until later stages of the study when it may become clear what resources are available for such a campaign
This will be the initial focus of the CS. It will be directed at (i) developing messages that are most likely to have an impact on their intended audience (medical practitioners, nurses, etc.); (ii) identifying the best means of delivering these messages (word, graphics, audio, video or multimedia), and (iii) the most appropriate communication vehicles (mail, telephone, TV, radio, Internet, newspapers, billboards, posters in waiting rooms, etc.) for each of the messages. The delivery of specific messages will be piloted and tested and the results fed back into a co-ordinated strategy.
This will be carried out in conjunction with the CS for health professionals and will include influential figures in the health services, social services, local government authorities, volunteer groups and other organizations and institutions with the power to affect the dissemination process.
There has been a range of media advocacy, including a number of local television and radio interviews, articles in Journals & local newspapers and also the development of the Phase IV website.
Control of Communication Strategy:
A Communications Strategy working group was established to advise on and oversee the CS. This group includes individuals with relevant expertise from university departments and other sources. The group has produced a Marketing Strategy for EIBI in England which was published by the national NGO, Alcohol Concern and is available below.
Debora Hutchings, Paul Cassidy, Catherine Lock, Ray Lowry, Mitchell Ness, Sue Reay & Nick Heather; “Marketing Strategy for Screening and Brief Intervention in Primary Health Care” Development of a Strategy for Implementing Screening and Brief Intervention in Primary Health Care in England (Project funded by the Alcohol Education & Research Council). (format pdf)
The Centre for Alcohol & Drug Studies
University of Newcastle upon Tyne
The project has been endorsed by a number of organisations and individual, for example;
- The Department of Health
- Alcohol Education & Research Council
- Alcohol Concern
- Health Development Agency
- The Royal College of General Practitioners
- The Royal College of Nurses Association
- Alcohol Counselling and Prevention Services
- Alcohol Problems Advisory Service
- Leeds Addiction Service
- Medical Council on Alcoholism
- National Association of Primary Care
- Nursing Council on Alcohol
- UK Alcohol Forum
The design and methods of the Demonstration Project are available on request to Professor Nick Heather <firstname.lastname@example.org>
At least one primary health care practice in each of the 5 areas of the Tyne & Wear Health Action Zone( Gateshead, Newcastle, North Tyneside, South Tyneside, Sunderland)
Projected Start Date:
Projected Completion Date:
Design of Project:
Methods of screening and brief intervention will be piloted in each general practice using the PDSA cycle (Plan/ Do/ Study/ Act) and regular feedback in meeting with the investigators. In this way optimal procedures for implementing early identification and brief interventions will be arrived at.
Changes in amount and kind of EIBI activity taken from practice records before and after the implementation period
Qualitative data elicited from participating health professionals. Economic Analysis: To be developed with the assistance of Professor Christine Godfrey.
To be developed with the assistance of Professor Christine Godfrey.