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Implementing training and support, financial reimbursement, and referral to an internet-based brief advice program to improve the early identification of hazardous and harmful alcohol consumption in primary care (ODHIN): study protocol for a cluster randomized factorial trial
Radboud University of Nijmegen, Netherlands.
Newcastle University, United Kingdom.
University of Gothenburg, Sweden.
Linköping University, Department of Medical and Health Sciences, Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Acute Health Care in Linköping. Östergötlands Läns Landsting, Local Health Care Services in West Östergötland, Department of Medical Specialist in Motala.
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2013 (English)In: Implementation Science, ISSN 1748-5908, Vol. 8Article in journal (Refereed) Published
Abstract [en]


The European level of alcohol consumption, and the subsequent burden of disease, is high compared to the rest of the world. While screening and brief interventions in primary healthcare are cost-effective, in most countries they have hardly been implemented in routine primary healthcare. In this study, we aim to examine the effectiveness and efficiency of three implementation interventions that have been chosen to address key barriers for improvement: training and support to address lack of knowledge and motivation in healthcare providers; financial reimbursement to compensate the time investment; and internet-based counselling to reduce workload for primary care providers.


In a cluster randomized factorial trial, data from Catalan, English, Netherlands, Polish, and Swedish primary healthcare units will be collected on screening and brief advice rates for hazardous and harmful alcohol consumption. The three implementation strategies will be provided separately and in combination in a total of seven intervention groups and compared with a treatment as usual control group. Screening and brief intervention activities will be measured at baseline, during 12 weeks and after six months. Process measures include health professionals’ role security and therapeutic commitment of the participating providers (SAAPPQ questionnaire). A total of 120 primary healthcare units will be included, equally distributed over the five countries. Both intention to treat and per protocol analyses are planned to determine intervention effectiveness, using random coefficient regression modelling.


Effective interventions to implement screening and brief interventions for hazardous alcohol use are urgently required. This international multi-centre trial will provide evidence to guide decision makers.

Place, publisher, year, edition, pages
BioMed Central , 2013. Vol. 8
Keyword [en]
Alcohol, Screening, Brief interventions, Primary healthcare, Training and support, Financial reimbursement, Internet, Implementation
National Category
Medical and Health Sciences
URN: urn:nbn:se:liu:diva-93870DOI: 10.1186/1748-5908-8-11ISI: 000318414200002OAI: diva2:627321

Funding Agencies|European Communitys Seventh Framework Program|259268|The Netherlands Organisation for Health Research and Development (ZonMW)|200310017|FP7 EC Grant||

Available from: 2013-06-11 Created: 2013-06-11 Last updated: 2014-04-01

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Bendtsen, Preben
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Social Medicine and Public Health ScienceFaculty of Health SciencesDepartment of Acute Health Care in LinköpingDepartment of Medical Specialist in Motala
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Implementation Science
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