Melbourne School of Population and Global Health - Theses
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ItemPrimary health care workers’ perspectives on the introduction of an alcohol brief intervention program in Chile( 2013)This is a study of a brief intervention (BI) program addressing risky drinking in Chile, introduced in 2011. It investigates health workers’ attitudes to BI, implementation contexts and training needs. It aims to identify enablers and barriers for BI implementation in Primary Health Care (PHC) settings. This topic has not been examined in Chile. Data collection included responses to an online survey from 374 Chilean PHC workers and telephone interviews with six key informants from Chilean health departments. As a mixed-method research project, survey data were subjected to quantitative descriptive analysis and qualitative inductive content analysis, and the interview transcripts were analysed qualitatively. The study shows that while health workers welcome the program, successful implementation is contingent on organisational support, continuous training, on-site supervision and changes in how alcohol-related harm and population-based interventions are understood. Among the most common enablers identified in the study were the positive attitudes towards and good experiences of BI that health staff have, particularly non-professionals, the linkage of BI with existing PHC programs, the opportunity of specific BI training, and the team approach of BI. Conversely, the most frequently mentioned barriers were time constraints and the need for a supportive environment, mainly from workers’ closest contexts (managers and team of the health centre). The study stresses the need to consider system and organisational support to encourage and ensure both sustainability of individual staff changes and integration of the BI program in PHC clinical practices. It suggests that, in order to promote implementation of BI in PHC settings, both the BI training package for health staff and the BI delivery should consider diversity of health workers' needs, keeping a team approach; and also that health non-professionals require additional alcohol-specific and skill-based training and additional support. The study’s findings will be of particular relevance to the design of implementation of BI programs in other countries of similar characteristics like low and middle income and places where a substantial proportion of the health workforce comprises non-professional technicians.