Impact of Training and Municipal Support on Primary Health Care-Based Measurement of Alcohol Consumption in Three Latin American Countries: 5-Month Outcome Results of the Quasi-experimental Randomized SCALA Trial

Autor: Eileen Kaner, Guillermina Natera Rey, Jakob Manthey, Christiane Sybille Schmidt, Augusto Pérez-Gómez, Gill Rowlands, Inés V. Bustamante, Adriana Solovei, Perla Sonia Medina Aguilar, Juliana Mejía-Trujillo, Jürgen Rehm, Daša Kokole, Antoni Gual, Eva Jané Llopis, Hugo López-Pelayo, Bernd Schulte, Amy O’Donnell, Peter J. Anderson, Marina Piazza, Hein de Vries, Liesbeth Mercken
Přispěvatelé: RS: CAPHRI - R6 - Promoting Health & Personalised Care, Health promotion
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Latin Americans
Primary health care
030508 substance abuse
heavy drinking
Rate ratio
Outcome (game theory)
0302 clinical medicine
Peru
FACILITATORS
IMPLEMENTATION
030212 general & internal medicine
implementation
Original Research
education.field_of_study
Institute for Health Care Improvement
municipal action
GENERAL-PRACTITIONERS
3. Good health
Test (assessment)
PREVALENCE
purl.org/pe-repo/ocde/ford#3.02.27 [https]
0305 other medical science
Alcohol consumption
Adult
medicine.medical_specialty
Alcohol Drinking
STRATEGIES
education
Population
peru
Colombia
measurement of alcohol consumption
03 medical and health sciences
SYSTEMS
Internal Medicine
medicine
DRINKERS
SYSTEMATIC ANALYSIS
Humans
ATTITUDES
Mexico
audit-c
institute for health care improvement
BRIEF INTERVENTIONS
HYPERTENSION
business.industry
Training (meteorology)
brief advice
primary health care
Latin America
Family medicine
AUDIT-C
business
Zdroj: Journal of General Internal Medicine
Journal of General Internal Medicine, 36(9), 2663-2671. Springer, Cham
ISSN: 0884-8734
DOI: 10.1007/s11606-020-06503-9
Popis: Purpose We aimed to test the effects of providing municipal support and training to primary health care providers compared to both training alone and to care as usual on the proportion of adult patients having their alcohol consumption measured. Methods We undertook a quasi-experimental study reporting on a 5-month implementation period in 58 primary health care centres from municipal areas within Bogotá (Colombia), Mexico City (Mexico), and Lima (Peru). Within the municipal areas, units were randomized to four arms: (1) care as usual (control); (2) training alone; (3) training and municipal support, designed specifically for the study, using a less intensive clinical and training package; and (4) training and municipal support, designed specifically for the study, using a more intense clinical and training package. The primary outcome was the cumulative proportion of consulting adult patients out of the population registered within the centre whose alcohol consumption was measured (coverage). Results The combination of municipal support and training did not result in higher coverage than training alone (incidence rate ratio (IRR) = 1.0, 95% CI = 0.6 to 0.8). Training alone resulted in higher coverage than no training (IRR = 9.8, 95% CI = 4.1 to 24.7). Coverage did not differ by intensity of the clinical and training package (coefficient = 0.8, 95% CI 0.4 to 1.5). Conclusions Training of providers is key to increasing coverage of alcohol measurement amongst primary health care patients. Although municipal support provided no added value, it is too early to conclude this finding, since full implementation was shortened due to COVID-19 restrictions. Trial Registration Clinical Trials.gov ID: NCT03524599; Registered 15 May 2018; https://clinicaltrials.gov/ct2/show/NCT03524599
Databáze: OpenAIRE
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