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.

Russian Federation

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

Final Country Chapter, January 2006

Collaborative Centre:  

St. Petersburg Medical Academy of Post-graduate Studies (SpbMAPS)

Chief Investigators:  

Prof. Vladislav Medvedev; Ms Tatiana Kryshtal

+ advice and consultation from Professor Nick Heather (Technical Focal Point, WHO Phase IV Study)

Geographical Area in which Implementation Strategy will be Applied:  

North-west Russia (pop. 10 million)

Starting Date:  

1/4/99

Completion Date:  

31/3/04

Project Strands and Milestones:

Strand 1 (Customisation of early identification and brief intervention (EIBI) materials and services/ Development of Communications Strategy/ Building Strategic Alliance) has commenced and is due to be completed on 30/9/2000. An application will then be made to the Know-how Fund for Strand 2 of the study (Demonstration Project). 

Proposed Funding Sources:

Know How Fund (Charities Aid Foundation - UK): Health Sector - Small Partnership Scheme. Grants of £690 (visit to St. Petersburg by Prof. Heather) and £22, 850 (Strand 1) have already been awarded. An application to the Know How Fund for further funding (Strand 2) will be made in due course.

Local Support:

Support from administration of SpMAPS (Vice-Rector of Training, professor Alexander Scherbo)/ Nurses’ Association of St. Petersburg/ St. Petersburg City Geriatric Centre (research accommodation).

CUSTOMIZING MATERIALS AND SERVICES

Focus Groups (FGs) will be run with 5 kinds of primary health care (PHC) health workers: (i) general medical practitioners; (ii) PHC nurses; (iii) school nurses; (iv) school physicians; (v) first aid student volunteers. There will be separate focus groups on early identification and brief intervention (EIBI) materials/ services and on EIBI training.

Brief Intervention Package, including delivery systems:

FGs (see above) will address what changes to the Drink-less early identification and brief intervention (EIBI) package are needed for Russian conditions. Customisation will be carried out for each type of health workers listed above. Barriers and incentives to implementation of EIBI will also be considered.

Early Identification (Screening):

FGs will also consider what changes to the AUDIT questionnaire are needed for Russian primary health care conditions and for each of the types of health care worker listed above.

Brief Intervention Process:

This will be explored in FGs.

Training of Primary Health Care Staff:

Separate FGs with the above health workers will address issues related to the best form of training for each type of worker. Previous work included an Russian adaptation of the Helping People Change package (Health Education Authority, UK) but, given the need for more trainees, further improvement to this adaptation will be sought.

Data Analysis:

FG data will be analysed by the NUDIST programme with the assistance of the Phase IV Focus group Centre (Dr. Leo Pas and colleagues) and Professor Heather and colleagues at the Phase IV Co-ordinating Centre in Newcastle.

REFRAMING UNDERSTANDING OF ALCOHOL ISSUES

Aspects of the Communications Strategy will be developed with the assistance of the Phase IV Co-ordinating Centre in Newcastle

General Public:

To be developed in due course given necessary resources.

Health Professionals:

Prof. Pohkis has developed a Resource Centre for the dissemination of early identification and brief intervention (EIBI) to health professionals. The success of the Resource Centre will be evaluated as part of the Phase IV study. In addition, recommendations for curriculum changes relevant to EIBI have been accepted by 30 departments of SpMAPS and these will be put into place in September, 1999. 10,000 post-graduate physicians per year will be given information on EIBI.

Other Stakeholders:

To be developed.

Media Advocacy:

Articles in journals read by health professionals and by the general public will be prepared. Further advocacy among journalists will developed.

Control of Communications Strategy:

This will be done by the Chief Investigators (see above).

ESTABLISHING LEAD ORGANIZATION(S) AND BUILDING STRATEGIC ALLIANCES

Lead organization(s): 

SpMAPS

Building Strategic Alliances:

  • Nurses’ Association of St. Petersburg

  • St. Petersburg City geriatric centre,

  • St. Petersburg City Secondary School Medical Network

  • Primary health Care organizations of St. Petersburg

  • Social Service system in St. Petersburg

DEMONSTRATION PROJECT(S)

Location(s):

A district in St. Petersburg (to be decided). Estimated population = 500,000 with approximately 200 primary health care doctors.

Projected Start Date:  

1/4/01

Projected Completion Date:

  31/3/04

Design of Project:

Before-after study

Outcome Measures:

To be decided in conjunction with Phase IV Co-ordinating Centre.

Process Measures:

To be decided in conjunction with Phase IV Co-ordinating Centre.

Economic Analysis:

To be decided in conjunction with Phase IV Co-ordinating Centre.

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