Sök artiklar i SveMed+

Tidskrift

Sammanfattning

In this paper, we present some historical aspects of the dissemination of alcohol screening and brief intervention (SBI) in Brazil in the Brazilian states of São Paulo and Paraná. Primary health care (PHC) professionals (N = 174) from the Brazilian cities of Sao Paulo (N = 140) and Curitiba (N = 34) were trained in the use of the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST), and in the use of standard brief intervention procedures. In spite of following the training, few of them incorporated the procedures into their daily routine. In Sao Paulo some health professionals conducted the screening. In contrast, in Curitiba, only researchers at the Federal University of Paraná screened patients and delivered BI in primary care units. Considering both cities, 2665 patients were screened. We observed a higher frequency of high risk alcohol users in Curitiba (13.3%) than in S. Paulo (6.8%), perhaps due to differences in the level of motivation between the health professionals and the researchers who applied the screening. Half of the patients who scored within the high risk range received a brief intervention. The remaining patients (control group) received an intervention 3 months later, when all patients returned for a follow-up evaluation, during which the ASSIST was re-administered. On average, the group that received brief intervention had significantly lower risk scores at follow-up than the control group. After presenting these results to the health system managers, they showed more interest and motivation for implementing screening and brief intervention techniques than at the beginning of the project. It is concluded that data on the effectiveness of SBI procedures can be influential in convincing health managers to adopt early intervention programs. Besides the level of motivation and skills training of the health professionals, inner organizational and outer societal contexts also influenced SBI adoption in the Brazilian PHC system.

MeSH