Final Country Chapter, January 2006
Centre for Drug & Alcohol Studies, Department of Psychiatry, University of Queensland & The Prince Charles Hospital & District Alcohol & Drug Service & The Royal Brisbane Hospital Alcohol & Drug Service
John B Saunders – Professor Alcohol & Drug studies, University of Qld. Director, Alcohol & Drug Service, Prince Charles Hospital District Health Service. Director, Royal Brisbane Hospital Alcohol & Drug Service
Nicole K Lee – Research & Development Officer, Prince Charles Hospital District Health Service.Lecturer in Addiction Studies, University of Queensland
Robert Bush, Associate Professor, Centre for Primary Health Care
Chris Del Mar, Professor, Director Centre for General Practice, University of Queensland
Ross Young, Senior Lecture, Department of Psychiatry, University of Queensland
David Kavanagh, Associate Professor, Department of Psychiatry, University of Queensland
David Mooney, Senior Clinical Training Officer, Prince Charles Hospital District Health Service
Linda Jenner, CNC for Dual Diagnosis, Prince Charles Hospital District Health Service
Geographical Area in which Implementation Strategy will be Applied:
Starting Date (i.e., overall Phase IV project):
Involvement from 1997, actual project to begin late 1999
Project Strands and Milestones:
Strand I: Development of study design, customisation of materials and techniques
Strand II: Demonstration project (first waves to begin late 1999/early 2000)
Strand III: Further customisation, refinement of and further demonstration project waves
Proposed Funding Sources:
Queensland Health (infrastructure & personnel)
Department of Psychiatry, University of Qld (personnel)
Applications currently to various funding bodies (NHMRC, Prince Charles Hospital Foundation, General Practice Evaluation Grants, Australian Brewers Foundation) for project funds
Our steering committee is made up of a number of high profile researchers in the general practice, primary care and alcohol fields
We have links with the Divisions of General Practice and are currently negotiating their involvement
We are currently furthering our links with the Alcohol and Other Drug Coordinators throughout Queensland
CUSTOMIZING MATERIALS AND SERVICES
Early Identification (Screening):
We plan to utilise the Australian modified AusAUDIT and further customise the design of this through profession-specific focus groups.
Brief Intervention Package:
We plan to further develop the Drink Less package used in Phase III and further customise this through profession-specific and patient focus groups
Training of Primary Health Care Staff:
We have the access to the services of a senior alcohol and drug clinical trainer who will coordinate the development and customisation of the training package. In addition, he will be involved in the customisation of other materials and services.
A large part of the analyses will be performed by the Investigators and support staff. A specialist will be employed, if necessary, to perform further or complex analyses. We have identified a company for this purpose which has been involved in Phase III.
REFRAMING UNDERSTANDING OF ALCOHOL ISSUES
We are currently working with the Steering Committee and key stakeholders to develop the communications strategy.
ESTABLISHING LEAD ORGANIZATION(S) AND BUILDING STRATEGIC ALLIANCES
The Centre for Drug & Alcohol Studies, Queensland, is currently being formed. A draft charter has been written and support from local, state and federal governments has been sought. The Centre will have three units: Alcohol & Drug Service, Prince Charles Hospital & District Health Service, Royal Brisbane Hospital Alcohol & Drug Service, and the Department of Psychiatry, University of Queensland.
Building Strategic Alliances:
We have a steering committee of researchers who will be involved in developing the design and methods of the project and will be negotiating smaller steering committees who will oversee the project at a community or regional level. These will involve the regional alcohol & drug services and other regional community groups.
We are also currently negotiating with Divisions of General Practitioners for their involvement. Professor Saunders is also a member of a number of alcohol & other drug task forces and committees at the local and state government level.
There are a number of possibilities of location. The most likely is the allocation of control and intervention conditions by local government areas. There are approximately 125 LGAs in Queensland which are centres of government and services. Typically each LGA will service 1-10 towns ranging from very small to very large populations. Each LGA has at least one primary care practice, this may be a General medical practice or a community centre with a GP or primary care nurse. Some remote areas are serviced by a visiting medical practitioner (The Flying Doctor Service). Our sampling will exclude the Brisbane (capital city) area – potentially a separate demonstration project will be implemented there.
Projected Start Date:
Projected Completion Date:
Design of Project:
The study will be a cluster-randomised trial with communities as the unit of randomisation. Potentially some stratification may occur to account for population, GP numbers, community or government support etc. Intervention sites will receive a systematic, community-supported brief intervention in general practice. Control sites will be assessed but will receive no systematic intervention (although for ethical reasons they will not be prevented from introducing screening or brief intervention if they choose to).