Pilot implications for system implementation of motivational interviewing based alcohol screening and brief intervention in primary health care in Slovenia

Tadeja Hočevar, Karmen Henigsman, Pika Založnik, Marko Kolšek

Keywords: alcohol screening and brief intervention, motivational interviewing, primary health care, pilot study

Background:

With widely present wet culture and heavy alcohol burden Slovenia invested in developing and piloting a comprehensive approach for tackling alcohol related problems in the country. One of the six main sets of activities within the national project (2016-2022) was adapting and piloting motivational interviewing based alcohol screening and brief intervention (MI based ASBI) in primary health care.

Research questions:

We wanted to test the applicability of the measure in our primary health care system, addressing specifically the effects of training for and practicing the measure.

Method:

We conducted a cross-sectional study, using self-assessing questionnaires for assessing the effects of the training (data gathered pre-during-post training) and data on registered successful treatments. The latter was compared to the anticipated number of successful treatments, set according to the number needed to treat in alcohol prevention as reported in already existing studies. We studied this in 124 professionals of 5 selected primary health care professions (general practitioner, registered nurse in family medicine practice, community nurse, specialist in occupational, traffic and sports medicine, and preventive programmes facilitator) in 18 community health centres across the country. We conducted the training and piloted the measure within the period of 32 months (2018-2020).

Results:

As self-assessed, ASBI practitioners had higher knowledge of alcohol related issues, used motivational interviewing elements more, thought their effectiveness in using SBI improved with the training, and thought discussing alcohol drinking was more legitimate after the training. Aligned with this, the SBI practitioners all together registered 804 successful treatments, which was 183 % of the anticipated project goal.

Conclusions:

Practitioners of the piloted ASBI benefited from the training and were highly successful in practicing the measure. The study provides data that propose the content and way of successfully training for and practicing the MI based ASBI in selected primary health care professions on the system level.

Points for discussion:

tackling alcohol related problems in wet cultures

aspects of facilitating successful training for practicing MI based ASBI

implementing MI based approaches/brief interventions for behaviour change regarding different risk factors in primary health care