Training primary health care providers in Colombia, Mexico and Peru to increase alcohol screening: Mixed-methods process evaluation of implementation strategy

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dc.contributor.affiliationDepartment of Health Promotion, CAPHRI Care and Public Health Research Institute, Maastricht University, POB 616, 6200 MD, Maastricht, The Netherlands
dc.contributor.emaild.kokole@maastrichtuniversity.nl
dc.creatorKokole, Dašaes_ES
dc.creatorJané-Llopis, Evaes_ES
dc.creatorNatera Rey, Guillerminaes_ES
dc.creatorBautista Aguilar, Nataliaes_ES
dc.creatorMedina Aguilar, Perla Soniaes_ES
dc.creatorMejía-Trujillo, Julianaes_ES
dc.creatorMora, Katherinees_ES
dc.creatorRestrepo, Nataliaes_ES
dc.creatorBustamante, Inéses_ES
dc.creatorPiazza, Marinaes_ES
dc.creatorO'Donnell, Amyes_ES
dc.creatorSolovei, Adrianaes_ES
dc.creatorMercken, Liesbethes_ES
dc.creatorSybille Schmidt, Christianees_ES
dc.creatorLópez-Pelayo, Hugoes_ES
dc.creatorMatrai, Silviaes_ES
dc.creatorBraddick, Fleures_ES
dc.creatorGual, Antonies_ES
dc.creatorRehm, Jürgenes_ES
dc.creatorAnderson, Peteres_ES
dc.creatorVries, Hein dees_ES
dc.date2022
dc.date.accessioned2024-11-27T18:32:01Z
dc.date.accessioned2026-03-27T15:30:40Z
dc.date.available2024-11-27T18:32:01Z
dc.date.issued2022
dc.date.published2022
dc.descriptionBackground: Initial results from the SCALA study demonstrated that training primary health care providers is an effective implementation strategy to increase alcohol screening in Colombia, Mexico and Peru, but did not show evidence of superior performance for the standard compared to the shorter training arm. This paper elaborates on those outcomes by examining the relationship of training-related process evaluation indicators with the alcohol screening practice. Methods: A mix of convergent and exploratory mixed-methods design was employed. Data sources included training documentation, post-training questionnaires, observation forms, self-report forms and interviews. Available quantitative data were compared on outcome measure - providers' alcohol screening. Results: Training reach was high: three hundred fifty-two providers (72.3% of all eligible) participated in one or more training or booster sessions. Country differences in session length reflected adaptation to previous topic knowledge and experience of the providers. Overall, 49% of attendees conducted alcohol screening in practice. A higher dose received was positively associated with screening, but there was no difference between standard and short training arms. Although the training sessions were well received by participants, satisfaction with training and perceived utility for practice were not associated with screening. Profession, but not age or gender, was associated with screening: in Colombia and Mexico, doctors and psychologists were more likely to screen (although the latter represented only a small proportion of the sample) and in Peru, only psychologists. Conclusions: The SCALA training programme was well received by the participants and led to half of the participating providers conducting alcohol screening in their primary health care practice. The dose received and the professional role were the key factors associated with conducting the alcohol screening in practice.Plain Language Summary: Primary health care providers can play an important role in detecting heavy drinkers among their consulting patients, and training can be an effective implementation strategy to increase alcohol screening and detection. Existing training literature predominantly focuses on evaluating trainings in high-income countries, or evaluating their effectiveness rather than implementation. As part of SCALA (Scale-up of Prevention and Management of Alcohol Use Disorders in Latin America) study, we evaluated training as implementation strategy to increase alcohol screening in primary health care in a middle-income context. Overall, 72.3% of eligible providers attended the training and 49% of training attendees conducted alcohol screening in practice after attending the training. Our process evaluation suggests that simple intervention with sufficient time to practice, adapted to limited provider availability, is optimal to balance training feasibility and effectiveness; that booster sessions are especially important in context with lower organizational or structural support; and that ongoing training refinement during the implementation period is necessary.es_ES
dc.formatPDFes_ES
dc.identifierJC70DIEP22es_ES
dc.identifier.doi10.1177/26334895221112693
dc.identifier.eissn2633-4895
dc.identifier.organizacionInstituto Nacional de Psiquiatría Ramón de la Fuente Muñiz
dc.identifier.placeEstados Unidos
dc.identifier.urihttps://doi.org/10.1177/26334895221112693
dc.identifier.urihttps://repositorio.inprf.gob.mx/handle/123456789/8118
dc.language.isoenges_ES
dc.publisherSAGE Publicationses_ES
dc.relation3:26334895221112693
dc.relation.jnabreviadoIMPLEMENT RES PRACT
dc.relation.journalImplementation Research and Practice
dc.rightsAcceso Cerradoes_ES
dc.subject.kwImplementation
dc.subject.kwProcess evaluation
dc.subject.kwTraining
dc.subject.kwAlcohol
dc.subject.kwDepression
dc.subject.kwScreening
dc.subject.kwPrimary health care
dc.subject.kwMiddle-income
dc.titleTraining primary health care providers in Colombia, Mexico and Peru to increase alcohol screening: Mixed-methods process evaluation of implementation strategyes_ES
dc.typeArtículoes_ES

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