ID-5184 Wonca Abstracts supplement A-K 13-10-23 - Flipbook - Page 261
WONCA 2023 Supplement 1: WONCA 2023 abstracts (A–K)
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Comparison of perceived alcohol screening barriers and
practices between primary care training participants and
controls in Rio de Janeiro, Brazil
E/Prof Sean Haley1, Kali Alves2, Ana de Silva Sudre2, Debora Teixeira2, Daniel Puig2,
Vitor Lobato-Carvalho2, Karen Athie2, Dr Manoela Salgado2, Renata Vargens2, A/Prof Sandra Fortes2
City University of New York’s Graduate School of Public Health and Health Policy, New York City, New
York, 2Interdisciplinary Research Laboratory in Primary Health Care (LIPAPS), State University of Rio de
Janeiro, Rio de Janeiro
1
Background
Screening and brief intervention for harmful alcohol use in primary care reduces alcohol consumption
but is rarely used in Brazil. Trainings on alcohol screening and brief intervention were offered to upperlevel primary care professionals across two regional service areas within Rio de Janeiro’s universal
healthcare system (Sistema Único de Saúde) between November 2018 and February 2019.
Methods
Training was offered to upper-level professionals (eg those with a baccalaureate including physicians,
nurses) using the World Health Organization’s Mental Health Gap Action Program’s field training
manual. A modified Saitz (2002) instrument assessed providers’ perception of alcohol screening and
the AIMS Center’s Patient-Centered Integrated Behavioral Health Care Principles checklist assessed
medical and mental health/substance use integration. Both instruments were administered to
training participants and controls at the initiation of training and readministered to trained participants
approximately three months after training. Saitz responses were analysed using Chi-squared and
McNemar’s tests. AIMS responses were analysed using independent samples t-test for baseline
(participants vs control) responses and pre–post paired t-test for the follow-up of trained participants.
Results
One hundred and one training participants and 102 controls completed the Saitz instrument and 99
training participants and 100 controls completed the AIMS at baseline. Sixty-three trained participants
completed both instruments. AIMS baseline results suggest trained participants had significantly
higher scores on component measures related to screening with a valid instrument, intervention and
care coordination. Few (n = 3) Saitz responses differed at baseline (lack of experience, assessing
behaviour change, confidence providing an alcohol diagnosis), and trained participants expressed
significantly lower barrier concerns, significantly greater changes in alcohol screening practices and
statistically greater average confidence at follow-up.
Conclusion
Alcohol screening and brief intervention training using the WHO’s Mental Health Gap Action Program
can reduce perceived barriers to alcohol screening and treatment among upper-level primary care
professionals in Brazil.
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