World Health Organization Collaborative Project on Identification and Management of Alcohol-related Problems

 in Primary Health Care: Phase IV

 

Development of Country-wide Strategies for Implementing Early Identification and Brief Alcohol Intervention in Primary Health Care.

Hungary

[Customisation] [Communications] [Strategic Alliance] [Demonstration Project]

Collaborative Centre:

National Institute of Primary Health Care, Budapest, Hungary

Chief Investigators:

Miklós Fodor MD, Chairman of College of Hungarian General Practitioners

Katalin Megyesi MD, National Institute of Primary Health Care

Geographical Area in which Implementation Strategy will be applied:

Hungary

Starting Date

:

 September 1999

Completion Date:

  

Expected: December 2003

Project Strands and Milestones

:
  • Planning: development of study design, customisation of materials and intervention methods, techniques – December 1999
  • Testing in circles of General Practitioners ( Focus Groups)
  • Recommendation to GPs, training of GPs
  • Further customisation, evaluation, follow-up and report
  • Demonstration Project – 2001

Proposed Funding Sources

:
  • National Institute of Primary Health Care (infrastructure, staff)
  • Ministry of Health (project funds)
  • Scientific Society of Hungarian General Practitioners (personnel – only promised)
  • National Health Insurance Company (fund is promised but has not received yet)

Local Support:
  • Semmelweis Medical University of Budapest – links to high profile researchers in alcohol fields
  • Alcohol and Drug Coordinators –Budapest – scientific support
  • Volunteer Associations

    • CUSTOMISING MATERIALS AND SERVICES

    Participants:
    • General Practitioners
    • Primary Health Care workers

    Methods:
    • Focus Groups – consist primarily health care professionals
    • Structured Questionnaires – for General Practitioners
    • Early identification and brief intervention instructions for staff
    • Hand out for patients (including risky limits) The following Phase III materials will be used in the study: "AUDIT questionnaire", patient booklet, information sheet for GPs, information sheet for medical nurses. These materials have been prepared and translated in Hungarian language during Phase III.
    • "Training the trainers": GPs will be trained on early detection and brief intervention
    • Focus Group meetings with health care professionals (General Practitioners, General Practitioner Trainees, District Nurses…) will be organised and
    • Interviews will be also conducted with health professionals both in Budapest and County Pest

    Early Identification (Screening):
    • Use of AUDIT-questionnaire / GPs
    • Focus Group Meetings

    Brief Intervention Process:

    We plan further develop of the Drink Less package (Hungarian translation of the drink-less package has been done already)

    Focus Group Meetings

    Training of Primary Health Care Staff:
  • Focus Group Meetings
  • We are currently developing access to a professional alcohol & drug trainer to co-ordinate the development of a training package.
  • QA circles

    • Data analysis:
  • Investigators and staff
  • Consultant help from Central Research Unit from the Ministry of Welfare

    • REFRAMING UNDERSTANDING OF ALCOHOL ISSUES

    Strategy is based on training programmes and on different mass media campaigns. Local Radio, Local TV and Local Papers will be contacted and will be informed about risky drinking, posters and AUDIT questionnaires will be distributed in the general practitioners waiting rooms.

    General Public:

    Posters and leaflets on alcohol issues and health status.

    Health Professionals-Stakeholders:

    Our special focus will be on those health professionals where we can expect significant change in behaviour. We would like to involve local volunteer associations.

    Media Advocacy:

    Give information on alcohol related problems, issues. (Journalists of County Pest have been contacted already, and information concerning alcohol issues, alcohol use and misuse, alcohol consumption… will be discussed in the local paper.)

    ESTABLISHING LEAD ORGANISATIONS AND BUILDING STRATEGIC ALLIANCES

    Lead organisations:

    We are involving the following organisations in the project:

    • Semmelweis Medical University Budapest – Psychiatric dept. / Dr. Béla Buda
    • Semmelweis Medical University Budapest – Public Health dept. / Prof. Tamás Simon
    • Hungarian Institute of Alcohol and Drug Abuse / Dr. Mária Holzberger

    We would like to establish a cooperation between these organisations. (Chief investigator + co-investigators)

    Building Strategic Alliances:
  • GP’s Associations
  • Volunteer Associations
  • Local media, national media
  • Local Municipalities
  • Addiction Service
  • Association of Self-Help Groups / Anonym Alcoholists
  • District Psychiatry Centres

    • Method:

    We would like to involve both public and private associations, to implement collaboration between them and promote community action projects within the community.

    DEMONSTRATION PROJECT(S)

    Location(s):

    Part of County Pest area, with population base of 100 000 – 150 000 inhabitants.

    Project Start Date:

    Beginning of year 2001

    Project Completion Date:

    December 2003

    Design of the project:

    Before & After study with baseline and outcome measures.

    Outcome Measures:

    Baseline and follow-up measures on number of participants involved and trained, number of patients screened and number of counselling performed.

    After – Before Questionnaires: for staff and for patients about knowledge on alcohol related issues and attitudes towards early identification and brief intervention (EIBI).

    Qualitative analysis of responses on the EIBI.

    Economic Analysis:

    A Health economist will be involved in the analysis. Official statistics of alcohol sales and data related to alcohol consumption will be measured and analysed before and after demonstration project.

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