Strategies to Overcome Barriers to Implementation of Alcohol Screening and Brief Intervention in General Practice: a Delphi Study Among Healthcare Professionals and Addiction Prevention Experts
Open accessAbstract
Despite the evidence base, alcohol screening and brief intervention (ASBI) have rarely been integrated into routine clinical practice. The aim of this study is to identify strategies that could tackle barriers to ASBI implementation in general practice by involving primary healthcare professionals and addiction prevention experts. A three-round online Delphi study was carried out in the Netherlands. The first-round questionnaire consisted of open-ended questions to generate ideas about strategies to overcome barriers. In the second round, participants were asked to indicate how applicable they found each strategy. Items without consensus were systematically fed back with group median ratings and interquartile range (IQR) scores in the third-round questionnaire. In total, 39 out of 69 (57 %) invited participants enrolled in the first round, 214 participants completed the second round, and 144 of these (67 %) completed the third-round questionnaire. Results show that participants reached consensus on 59 of 81 strategies, such as the following: (1) use of E-learning technology, (2) symptom-specific screening by general practitioners (GPs) and/or universal screening by practice nurses, (3) reimbursement incentives, (4) supportive materials, (5) clear guidelines, (6) service provision of addiction care centers, and (7) more publicity in the media. This exploratory study identified a broad set of strategies that could potentially be used for overcoming barriers to ASBI implementation in general practice and paves the way for future research to experimentally test the identified implementation strategies using multifaceted approaches.
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GPs and nurses often cited improving professional teamwork as a facilitator.
“GPs and nurses often cited improving professional teamwork (e.g. having a practice nurse delivering SBI, having receptionists giving patients screening tools) as a facilitator [39, 41, 54, 70, 71, 73, 76, 80, 91, 93, 97, 99].”
From Factors influencing the implementation of screening and brief interventions for alcohol use in primary care practices: a systematic review using the COM-B system and Theoretical Domains Framework (2021) · cites this paper as [39]
The Discussion says GPs and practice nurses agreed on their roles in delivering screening and brief interventions, supporting the practice-nurse example. But the Results (Second- and Third-Round Results; page not provided) report no consensus on receptionists distributing screening questionnaires, and the Results (Differences Between Groups; page not provided) say GPs and nurses rated that strategy lower than addiction prevention workers. The paper therefore does not support presenting both examples as facilitators often cited by GPs and nurses. (LLM, conf=0.87)
Experimental — accuracy not yet measuredMore time per consultation, more experience in delivering brief interventions, and simplifying the screening process were reported as facilitators.
“More time per consultation, more experience in delivering brief interventions and simplifying the screening process (e.g. short and simple screening tools, giving patients self-report questionnaires) are examples of reported facilitators [39, 43, 93, 97].”
From Factors influencing the implementation of screening and brief interventions for alcohol use in primary care practices: a systematic review using the COM-B system and Theoretical Domains Framework (2021) · cites this paper as [39]
The Results (Second- and Third-Round Results; page unavailable) endorse more time per consultation, short and simple screening instruments, and patient self-report questionnaires. They also endorse expertise-enhancement training, but do not identify more experience delivering brief interventions as a facilitator; training is not the same as delivery experience. (LLM, conf=0.84)
Experimental — accuracy not yet measuredBetter co-operation with specialized services, involving other professionals in general practice, public health educational campaigns, and more media attention were among the most commonly cited facilitators.
“Better co-operation with specialized services [20, 39, 59, 60, 80], involving other professionals in general practice (e.g. an addiction consultant or a specialized nurse) [39, 71, 105], public health educational campaigns [23, 47, 78, 99, 110] and more media attention [39, 110] were among the most commonly cited facilitators.”
From Factors influencing the implementation of screening and brief interventions for alcohol use in primary care practices: a systematic review using the COM-B system and Theoretical Domains Framework (2021) · cites this paper as [39]
The Results (Second- and Third-Round Results; page unavailable) report consensus on improving cooperation with addiction care centers, adding a specialized practice nurse, and increasing media attention. They also explicitly report no consensus on involving an addiction consultant in general practice, so that example is not supported by this source. The public-health-campaign clause does not cite this paper. (LLM, conf=0.88)
Experimental — accuracy not yet measuredThree qualitative studies reported that GPs and nurses would feel incentivized if financial reimbursement for providing alcohol brief interventions was available.
“Three qualitative studies reported that GPs and nurses would feel incentivized if financial reimbursement for providing alcohol brief interventions was available [39, 80, 105];”
More information about the effectiveness of brief interventions and feedback on successful cases were identified as implementation facilitators.
“More information about the effectiveness of brief interventions [23, 36, 39, 47, 78, 84, 87, 92] and feedback on successful cases [71, 109] were identified as implementation facilitators.”
Destigmatizing problematic alcohol use was identified as a facilitator in 1 qualitative study.
“Destigmatizing problematic alcohol use was identified as a facilitator in 1 qualitative study [39].”
Implementing a short questionnaire in the registration system and increasing knowledge that a brief intervention costs little time and can be effective were suggested as facilitators.
“Implementing a short questionnaire in the registration system [39] and increasing knowledge that a brief intervention costs little time and can be effective [39] were suggested as facilitators.”
More time per consultation, more experience in delivering brief interventions, and simpler screening processes were reported as facilitators.
“More time per consultation [39, 70, 80, 92, 97], more experience in delivering brief interventions [93], and simpler screening processes (e.g. short and simple screening tools, giving patients self-report questionnaires) [39] were reported as facilitators.”
Having these resources and displaying information in the waiting room were reported as facilitators in several studies.
“Having these resources and displaying information in the waiting room (e.g. posters) were reported as facilitators in several studies [20, 23, 37, 39, 47, 55, 78, 92].”
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Cites
Michie, S., van Stralen, M. M., & West, R. (2011) · Implementation Science · doi:10.1186/1748-5908-6-42 · Cited by 13,697 · cited 7× · see citing works
“classified in the following BCW intervention functions as described in the BMethods^ section: (1) education, (2) training, (3) environmental restructuring, (4) enablement, (5) incentivization, (6) modeling, (7) persuasion, and the following BCW policy measures: (8) guidelines, (9) regulation, (10) service provision, a…”
BackgroundMethodInfluentialLim, S. S., Vos, T., Flaxman, A. D., Danaei, G., Shibuya, K., Adair-Rohani, H., AlMazroa, M. A., Amann, M., Anderson, H. R., Andrews, K. G., et al. (2012) · The Lancet · doi:10.1016/s0140-6736(12)61766-8 · Cited by 11,805 · cited 1× · see citing works
“Globally, alcohol is the fifth most important risk factor for ill health and premature death (Lim et al. 2012).”
Backgroundthe delphi method: techniques and applications
Linstone, H. A., & Turoff, M. (1975) · Bibliothèque et Archives nationales du Québec (Québec government) · Cited by 5,236 · see citing works
Making sense of implementation theories, models and frameworks
Nilsen, P. (2015) · Implementation Science · doi:10.1186/s13012-015-0242-0 · Cited by 4,447 · cited 2× · see citing works
“The challenge of developing a multifaceted implementation program that targets the most important barriers and uses potentially effective and applicable strategies underscores the need to use theories as a basis for any future implementation program to make the underlying mechanisms which contribute to the implementat…”
BackgroundThe Impact of E-Learning in Medical Education
Ruiz, J. G., Mintzer, M. J., & Leipzig, R. M. (2006) · Academic Medicine · doi:10.1097/00001888-200603000-00002 · Cited by 2,240 · cited 1× · see citing works
“Internet-based learning has been proven to be at least as effective as traditional learning methods (e.g., lectures) (Ruiz et al. 2006).”
BackgroundInternet-Based Learning in the Health Professions
Cook, D., Levinson, A. J., Garside, S., Dupras, D. M., Erwin, P. J., & Montori, V. M. (2008) · JAMA · doi:10.1001/jama.300.10.1181 · Cited by 1,552 · see citing works
The Delphi method: Techniques and applications
Martino, J. P. (1976) · Technological Forecasting and Social Change · doi:10.1016/0040-1625(76)90035-4 · Cited by 1,355 · see citing works
Stigma, social inequality and alcohol and drug use
ROOM, R. (2005) · Drug and Alcohol Review · doi:10.1080/09595230500102434 · Cited by 891 · cited 1× · see citing works
“The endorsement of these items also reflects the underlying issue of problematic alcohol use having a negative connotation and being associated with universal stigma and marginalization (Room 2005).”
BackgroundBertholet, N. (2005) · Archives of Internal Medicine · doi:10.1001/archinte.165.9.986 · Cited by 710 · cited 1× · see citing works
“The scientific literature has provided robust evidence that supports the efficacy and (cost-) effectiveness of alcohol screening and brief interventions (ASBI) in primary healthcare settings (Bertholet et al. 2005; Kaner et al. 2009), Electronic supplementary material The online version of this article (doi:10.”
BackgroundImproving Patient Care: The Implementation of Change in Health Care
(2013) · doi:10.1002/9781118525975 · Cited by 506 · cited 1× · see citing works
“…effective and applicable strategies underscores the need to use theories as a basis for any future implementation program to make the underlying mechanisms which contribute to the implementation of ASBI explicit and to identify Bcore components^ of the strategies (Grol et al. 2013; Nilsen 2015).”
BackgroundThe effectiveness of brief alcohol interventions in primary care settings: A systematic review
KANER, E. F. S., DICKINSON, H. O., BEYER, F., PIENAAR, E., SCHLESINGER, C., CAMPBELL, F., SAUNDERS, J. B., BURNAND, B., & HEATHER, N. (2009) · Drug and Alcohol Review · doi:10.1111/j.1465-3362.2009.00071.x · Cited by 434 · cited 1× · see citing works
“…the efficacy and (cost-) effectiveness of alcohol screening and brief interventions (ASBI) in primary healthcare settings (Bertholet et al. 2005; Kaner et al. 2009), Electronic supplementary material The online version of this article (doi:10.1007/s11121-016-0653-4) contains supplementary…”
BackgroundInfluentialA guiding framework and approach for implementation research in substance use disorders treatment.
Damschroder, L. J., & Hagedorn, H. J. (2011) · Psychology of Addictive Behaviors · doi:10.1037/a0022284 · Cited by 427 · cited 2× · see citing works
“General practice”
BackgroundJohnson, M., Jackson, R., Guillaume, L., Meier, P., & Goyder, E. (2011) · Journal of Public Health · doi:10.1093/pubmed/fdq095 · Cited by 374 · cited 4× · see citing works
“General practice”
BackgroundMethodInfluentialIdentification of behaviour change techniques to reduce excessive alcohol consumption
Michie, S., Whittington, C., Hamoudi, Z., Zarnani, F., Tober, G., & West, R. (2012) · Addiction · doi:10.1111/j.1360-0443.2012.03845.x · Cited by 288 · cited 1× · see citing works
“It is important to ensure that in translating effective interventions to fit into clinical practice, the core effective ingredients of ASBI are retained and not adapted to such an extent that they lose effectiveness (Michie et al. 2012).”
BackgroundBeich, A., Thorsen, T., & Rollnick, S. (2003) · BMJ · doi:10.1136/bmj.327.7414.536 · Cited by 239 · see citing works
Anderson, P., Laurant, M. G. H., Kaner, E., Wensing, M., & Grol, R. P. T. M. (2004) · Journal of Studies on Alcohol · doi:10.15288/jsa.2004.65.191 · Cited by 127 · cited 2× · see citing works
“Although multifaceted implementation strategies targeting provider, patient, and organization factors are considered to be most effective to implement ASBI (Anderson et al. 2004), most studies have found small effects (Funk et al.”
BackgroundSelf-citationWilson, G. B., Lock, C. A., Heather, N., Cassidy, P., Christie, M. M., & Kaner, E. F. S. (2011) · Alcohol and Alcoholism · doi:10.1093/alcalc/agr067 · Cited by 112 · cited 3× · see citing works
“Barriers to ASBI delivery behavior reflecting capability, motivation, or opportunity (COM-B) components were identified in the literature (Burgering and Willems 2013; Johnson et al. 2011; Wilson et al. 2011): (1) lack of knowledge (capability), (2) use of personal reference frames to discuss alcohol (capability), (3)…”
BackgroundResultInfluentialFunk, M., Wutzke, S. E., Kaner, E., Anderson, P., Pas, L., McCormick, R., Gual, A., Barfod, S. M., & Saunders, J. B. (2005) · Journal of Studies on Alcohol · doi:10.15288/jsa.2005.66.379 · Cited by 110 · see citing works
Self-citationvan Orden, M., Hoffman, T., Haffmans, J., Spinhoven, P., & Hoencamp, E. (2009) · Psychiatric Services · doi:10.1176/ps.2009.60.1.74 · Cited by 84 · cited 1× · see citing works
“This might have to do with the fact that, in the Netherlands, the nationwide implementation of the mental health practice nurse in recent years might already have provided enough opportunity for consultation and delivery of more complex alcohol counseling (Van Orden et al. 2009).”
BackgroundPurshouse, R. C., Brennan, A., Rafia, R., Latimer, N. R., Archer, R. J., Angus, C. R., Preston, L. R., & Meier, P. S. (2013) · Alcohol and Alcoholism · doi:10.1093/alcalc/ags103 · Cited by 83 · cited 2× · see citing works
“…Netherlands 5 Erasmus Medical Center, Rotterdam, The Netherlands indicating that ASBI, compared with control conditions, leads to significant reductions in alcohol consumption (average reduction of 38 g a week) as well as savings to healthcare resources (Angus et al. 2014; Purshouse et al. 2013).”
BackgroundKulier, R., Coppus, S. F. P. J., Zamora, J., Hadley, J., Malick, S. M., Das, K., Weinbrenner, S., Meyerrose, B., Decsi, T., Horvath, A. R., et al. (2009) · BMC Medical Education · doi:10.1186/1472-6920-9-21 · Cited by 79 · cited 1× · see citing works
“It enables health professionals to participate at a time and place convenient to them and may therefore provide a more fitting alternative to extensive training programs which might require too much time and effort (Cook et al. 2008; Kulier et al. 2009).”
Tailored implementation of evidence-based practice for patients with chronic diseases
Wensing, M., Huntink, E., van Lieshout, J., Godycki-Cwirko, M., Kowalczyk, A., Jäger, C., Steinhäuser, J., Aakhus, E., Flottorp, S., Eccles, M., et al. (2014) · PLoS ONE · doi:10.1371/journal.pone.0101981 · Cited by 74 · cited 1× · see citing works
“Furthermore, sustainability of implementation over time has been found to be low, which may be due to a failure to match implementation strategies to barriers that are relevant for the continuation of an innovation (Wensing et al. 2014).”
Backgroundvan Beurden, I., Anderson, P., Akkermans, R. P., Grol, R. P. T. M., Wensing, M., & Laurant, M. G. H. (2012) · Addiction · doi:10.1111/j.1360-0443.2012.03868.x · Cited by 73 · cited 2× · see citing works
“General practice”
BackgroundSelf-citationLean, M. E. J., Mann, J. I., Hoek, J. A., Elliot, R., & Schofield, G. (2008) · BMJ · doi:10.1136/bmj.a863 · Cited by 72 · see citing works
Keurhorst, M. N., Anderson, P., Spak, F., Bendtsen, P., Segura, L., Colom, J., Reynolds, J., Drummond, C., Deluca, P., van Steenkiste, B., et al. (2013) · Implementation Science · doi:10.1186/1748-5908-8-11 · Cited by 54 · cited 1× · see citing works
“Although financial incentives for ASBI implementation have been suggested to be potentially effective (Keurhorst et al. 2013), fee-for-service incentives (e.g., monetary fees per screened patient) received little consensual support in our study.”
BackgroundSelf-citationHuijg, J. M., Crone, M. R., Verheijden, M. W., van der Zouwe, N., Middelkoop, B. J., & Gebhardt, W. A. (2013) · BMC Family Practice · doi:10.1186/1471-2296-14-142 · Cited by 54 · cited 2× · see citing works
“Early detection and early treatment can have an important impact on reducing the detrimental effects of problematic alcohol use.”
BackgroundMethodAngus, C., Scafato, E., Ghirini, S., Torbica, A., Ferre, F., Struzzo, P., Purshouse, R., & Brennan, A. (2014) · BMC Family Practice · doi:10.1186/1471-2296-15-26 · Cited by 46 · cited 2× · see citing works
“…Netherlands 5 Erasmus Medical Center, Rotterdam, The Netherlands indicating that ASBI, compared with control conditions, leads to significant reductions in alcohol consumption (average reduction of 38 g a week) as well as savings to healthcare resources (Angus et al. 2014; Purshouse et al. 2013).”
BackgroundMcCormick, R., Docherty, B., Segura, L., Colom, J., Gual, A., Cassidy, P., Kaner, E., & Heather, N. (2010) · Drugs: Education, Prevention and Policy · doi:10.3109/09687630903286800 · Cited by 38 · cited 4× · see citing works
“For instance, in three case studies of ASBI implementation, research conducted in England, New Zealand, and Catalonia, McCormick et al. (2010) provided real-world evidence in support of matching ASBI to the local context and with the skills health professionals already used in practice.”
BackgroundResultInfluentialHeather, N., Dallolio, E., Hutchings, D., Kaner, E., & White, M. J. (2004) · Journal of Substance Use · doi:10.1080/14659890410001665014 · Cited by 36 · cited 4× · see citing works
“In contrast to our findings, the previous Delphi study conducted by Heather et al. (2004) has found strong support for the employment of a specialist alcohol worker to assist in the delivery of ASBI.”
BackgroundMethodResultInfluentialKaner, E. (2010) · Drug and Alcohol Review · doi:10.1111/j.1465-3362.2010.00236.x · Cited by 33 · cited 1× · see citing works
“Fitting ASBI to the local context requires that academics, healthcare practitioners, and addiction prevention experts work together to identify pragmatic implementation strategies (Kaner 2010).”
BackgroundSaitz, R. (2014) · Addiction Science & Clinical Practice · doi:10.1186/1940-0640-9-14 · Cited by 30 · cited 1× · see citing works
“…et al. 2010), the extent to which ASBImay be implemented to fit into clinical practice in a way that can retain its efficacy is currently unclear and highlights the problem of translating ideal-world efficacy trial results into clinically relevant implementation-effectiveness results (Saitz 2014).”
ResultFactors underlying smoking relapse prevention: results of an international Delphi study
Elfeddali, I., Bolman, C. A. W., Mesters, I., Wiers, R. W. H. J., & de Vries, H. (2010) · Health Education Research · doi:10.1093/her/cyq053 · Cited by 23 · cited 1× · see citing works
“Third, response rates were suboptimal, although they are comparable to response rates in other Delphi studies (Elfeddali et al. 2010; Maijala et al. 2016).”
ResultHealth promotion practices delivered by primary health care nurses: Elements for success in Finland
Maijala, V., Tossavainen, K., & Turunen, H. E. (2015) · Applied Nursing Research · doi:10.1016/j.apnr.2015.11.002 · Cited by 23 · cited 3× · see citing works
“Third, response rates were suboptimal, although they are comparable to response rates in other Delphi studies (Elfeddali et al. 2010; Maijala et al. 2016).”
BackgroundMethodResultDifferent Methods of Early Identification of Risky Drinking: A Review of Clinical Signs
Reinholdz, H., Bendtsen, P., & Spak, F. (2011) · Alcohol and Alcoholism · doi:10.1093/alcalc/agr021 · Cited by 21 · cited 3× · see citing works
“related to difficulties with ASBI implementation such as a lack of knowledge about early symptoms of problematic alcohol use (Reinholdz et al. 2011), or lack of knowledge about risk”
BackgroundInfluential
Flagged first, then by citations
1 of the 35 references couldn’t be matched to a known paper.
Research works printed but not linked: 2
- Burgering, E., & Willems, H. (2013). Doctor doesn’t ask enough about alcohol use [in Dutch: Arts vraagt te weinig naar drankgebruik]. Dokter Patient, 68, 795–797.
- Van Dijck, D., & Knibbe, R. A. (2005). The prevalance of problematic alcohol use in the Netherlands [in Dutch: De Prevalentie van Probleemdrinken in Nederland]. Maastricht: Universiteit Maastricht.
Cited by
Sorted by citations
Rosário, F., Santos, M. I., Angus, K., Pas, L., Ribeiro, C., & Fitzgerald, N. (2021) · Implementation Science · doi:10.1186/s13012-020-01073-0 · Cited by 141 · see citing works
“On the one hand, the majority of the GPs in 9 [20, 44, 47, 57, 59, 62, 67, 83, 104], and of the nurses in 3 quantitative studies [20, 59, 84] felt they were not skilled enough to deliver alcohol SBI; on the other hand, the majority of the GPs in 14 [16, 20, 23, 36, 52, 62, 64, 70, 78, 83, 95, 106, 108, Table 3 Themes…”
BackgroundMethodInfluentialMulhall, P., Taggart, L., COATES, V. E., & McAloon, T. (2019) · Clinical Trials · doi:10.1177/1740774519887168 · Cited by 18 · see citing works
“For example, Abidi et al.(17) explored the barriers to the implementation of brief alcohol interventions into primary practice.”
BackgroundSmart, R., & Grant, S. (2021) · International Journal of Drug Policy · doi:10.1016/j.drugpo.2021.103383 · Cited by 17 · see citing works
Conversations about alcohol in healthcare – cross-sectional surveys in the Netherlands and Sweden
Abidi, L., Nilsen, P., Karlsson, N. E., Skagerström, J., & O'Donnell, A. J. (2020) · BMC Public Health · doi:10.1186/s12889-020-8367-8 · Cited by 18 · see citing works
“possible that these individuals would have an increased likelihood of benefiting from discussing their drinking with a health professional [2].”
BackgroundSelf-citationAbidi, L., Oenema, A., van den Akker, M., & van de Mheen, D. (2018) · Current Medical Research and Opinion · doi:10.1080/03007995.2018.1424623 · Cited by 14 · see citing works
Self-citationSatre, D. D., Ly, K., Wamsley, M., Curtis, A., & Satterfield, J. (2017) · JMIR Research Protocols · doi:10.2196/resprot.7070 · Cited by 13 · see citing works
“Even when evidence-based treatments are available and implementation decisions have been made, workforce development and sustained intervention delivery present formidable challenges [1].”
BackgroundRosário, F., Vasiljevic, M., Pas, L., Fitzgerald, N., & Ribeiro, C. (2019) · Family Practice · doi:10.1093/fampra/cmy062 · Cited by 11 · see citing works
Reich, A. L., Milroy, J. J., Wyrick, D. L., & Hebard, S. P. (2021) · Journal of College Counseling · doi:10.1002/jocc.12178 · Cited by 11 · see citing works
Optimizing the delivery of interventions for harmful alcohol use in primary healthcare
Segura, L., Anderson, P., & Gual, A. (2018) · Current Opinion in Psychiatry · doi:10.1097/yco.0000000000000435 · Cited by 11 · see citing works
Self-citationPark, J. J., King, D. L., Wilkinson‐Meyers, L., & Rodda, S. N. (2023) · International Journal of Mental Health and Addiction · doi:10.1007/s11469-023-01010-4 · Cited by 10 · see citing works
“Research on barriers and facilitators to SBIRT in alcohol studies identified the use of technology as an important method of addressing the complex array of presenting issues (Abidi et al., 2016).”
Potthoff, S., O'Donnell, A., Karlsen, A., Brendryen, H., & Lid, T. G. (2022) · Frontiers in Health Services · doi:10.3389/frhs.2022.940383 · Cited by 7 · see citing works
“This reflects the results of a Delphi study conducted in the Netherlands that found strong practitioner support for asking about alcohol when clinically relevant, based on physical, social or psychological symptoms (48).”
ResultAn Ethnographic study of unhealthy alcohol use in a Danish Emergency Department
Sivertsen, D. M., Becker, U., Andersen, O., & Kirk, J. W. (2021) · Addiction Science & Clinical Practice · doi:10.1186/s13722-021-00269-z · Cited by 10 · see citing works
Kokole, D., Mercken, L. A. G., Jané‐Llopis, E., Rey, G. N., Arroyo, M., Medina, P., Pérez‐Gómez, A., Mejía‐Trujillo, J., Piazza, M., Bustamante, I. V., et al. (2021) · Primary Health Care Research & Development · doi:10.1017/s1463423620000675 · Cited by 6 · see citing works
“A large body of literature on barriers to alcohol SBA in PHC exists, suggesting lack of time, lack of training, providers’ attitudes and lack of organisational support, as core factors affecting delivery (Johnson et al., 2011; Rahm et al., 2015; Abidi et al., 2016; Derges et al., 2017; Vendetti et al., 2017), However,…”
BackgroundSelf-citationAbidi, L., Oenema, A., Candel, M. J. J. M., & van de Mheen, D. (2016) · Contemporary Clinical Trials · doi:10.1016/j.cct.2016.10.008 · Cited by 6 · see citing works
Self-citationSchulte, B., Lindemann, C., Buchholz, A., Rosahl, A., Härter, M. C., Kraus, L., Kiefer, F., Frischknecht, U., Hoffmann, S., Wensing, M., et al. (2019) · SUCHT - Zeitschrift für Wissenschaft und Praxis / Journal of Addiction Research and Practice · doi:10.1024/0939-5911/a000629 · Cited by 6 · see citing works
Grigg, J., Arunogiri, S., Manning, V., Phan, V., Campbell, S. C., Frei, M. Y., & Lubman, D. I. (2020) · Drug and Alcohol Review · doi:10.1111/dar.13035 · Cited by 6 · see citing works
Zijlstra, D. N., Hoving, C., Bolman, C. A. W., Muris, J. W. M., & de Vries, H. (2021) · Health Education Research · doi:10.1093/her/cyab022 · Cited by 6 · see citing works
Curtis, A. C., Satre, D. D., Ly, K., Wamsley, M. A., & Satterfield, J. M. (2019) · Journal of the American Association of Nurse Practitioners · doi:10.1097/jxx.0000000000000136 · Cited by 5 · see citing works
Solovei, A., Mercken, L. A. G., Jané‐Llopis, E., Bustamante, I. V., Evers, S., Gual, A., Medina, P., Mejía‐Trujillo, J., Rey, G. N., O'Donnell, A. J., et al. (2021) · Health Promotion International · doi:10.1093/heapro/daab192 · Cited by 5 · see citing works
Self-citationCurtis, A. C., Satre, D. D., Sarovar, V., Wamsley, M. A., Ly, K., & Satterfield, J. M. (2019) · Substance Abuse · doi:10.1080/08897077.2019.1686723 · Cited by 5 · see citing works
Solovei, A., Jané‐Llopis, E., Mercken, L. A. G., Bustamante, I. V., Kokole, D., Mejía‐Trujillo, J., Aguilar, P. S. M., Rey, G. N., O'Donnell, A. J., Piazza, M., et al. (2022) · Prevention Science · doi:10.1007/s11121-021-01329-1 · Cited by 3 · see citing works
Self-citationAuTomaTed Alcohol Misuse INterventions in a Bariatric Surgery Population: The ATTAIN Bariatric Pilot
West, R. W., Davari, S. B., Hammoud, N. M., & Ismail, M. (2023) · The Permanente Journal · doi:10.7812/tpp/22.145 · Cited by 3 · see citing works
Smith, A., Buchanan, R. M., Parkes, J., Stone, H., Tan, Q. Y., & Ibrahim, K. (2023) · International Journal of Pharmacy Practice · doi:10.1093/ijpp/riad071 · Cited by 3 · see citing works
“Staff being able to see and share the positive effects of SBI is believed to improve SBI implementation in primary care [57]. co-conducting the synthesis and contributing author.”
Dubbeldeman, E. M., van der Kleij, R., Brakema, E. A., & Crone, M. R. (2024) · Health Research Policy and Systems · doi:10.1186/s12961-024-01167-x · Cited by 3 · see citing works
“[96].”
de Vries, H., Pajor, E. M., Curfs, K. C. J., Eggers, S. M., & Oenema, A. (2019) · Health Education Research · doi:10.1093/her/cyz017 · Cited by 3 · see citing works
“Although these percentages are not optimal, they are comparable to other Delphi studies [26, 28, 38].”
ResultSelf-citationLemp, J. M., Pengpid, S., Buntup, D., Bärnighausen, T., Geldsetzer, P., Peltzer, K., Rehm, J. T., Sornpaisarn, B., & Probst, C. (2022) · Preventive Medicine Reports · doi:10.1016/j.pmedr.2022.101954 · Cited by 3 · see citing works
Dionisi, T., Vita, V. D., Sario, G. D., Gasbarrini, A., & Addolorato, G. (2026) · European Journal of Internal Medicine · doi:10.1016/j.ejim.2026.106837 · Cited by 2 · see citing works
Prevention Systems: Structure and Challenges: Europe as an Example
Burkhart, G., & Helmer, S. M. (2019) · Advances in prevention science · doi:10.1007/978-3-030-00627-3_26 · Cited by 1 · see citing works
Screening and therapeutic recommendations for patients with alcohol use disorder
Kierski, K., & Maupin, E. J. (2023) · JAAPA · doi:10.1097/01.jaa.0000979456.51155.71 · Cited by 1 · see citing works
Pajor, E. M. (2019) · doi:10.26481/dis.20190911ep · Cited by 1 · see citing works
The development and evaluation of a smoking cessation referral aid for the primary care setting
Zijlstra, D. N. (2022) · doi:10.26481/dis.20220210dz · Cited by 1 · see citing works
Dubbeldeman, E. M., van der Kleij, R., Brakema, E. A., & Crone, M. R. (2023) · doi:10.31219/osf.io/3vq7p · Cited by 1 · see citing works
Public Health Considerations and the Culture of Alcohol in Vietnam
Baquet, D. (2016) · The Medicine Forum
Curtis, A. C. (2018) · Sigma's 29th International Nursing Research Congress
Sunami, T., Kawai, M., Sakurai, J., Shirasaka, T., Tezuka, Y., Nagamine, H., Maesato, H., Yumoto, Y., Yoshimoto, H., Adachi, Y., et al. (2020) · SANGYO EISEIGAKU ZASSHI · doi:10.1539/sangyoeisei.2020-044-w · Cited by 1 · see citing works
Quelch, D. R., Davies, N., Roderique‐Davies, G., Pucci, M., & John, B. (2025) · Journal of Addictive Diseases · doi:10.1080/10550887.2025.2538259
Rosário, F., Santos, M. I., Angus, K., Pas, L., Ribeiro, C., & Fitzgerald, N. (2021) · Figshare · doi:10.6084/m9.figshare.13545356
Rosário, F., Santos, M. I., Angus, K., Pas, L., Ribeiro, C., & Fitzgerald, N. (2021) · Figshare · doi:10.6084/m9.figshare.13545353
Dubbeldeman, E. M., van der Kleij, R., Brakema, E. A., & Crone, M. R. (2024) · Figshare · doi:10.6084/m9.figshare.26757088
Additional file 1 of An Ethnographic study of unhealthy alcohol use in a Danish Emergency Department
Sivertsen, D. M., Becker, U., Andersen, O., & Kirk, J. W. (2021) · Figshare · doi:10.6084/m9.figshare.16726696
Dubbeldeman, E. M., van der Kleij, R., Brakema, E. A., & Crone, M. R. (2024) · Figshare · doi:10.6084/m9.figshare.26757094
Dubbeldeman, E. M., van der Kleij, R., Brakema, E. A., & Crone, M. R. (2024) · Figshare · doi:10.6084/m9.figshare.26757091
Dubbeldeman, E. M., van der Kleij, R., Brakema, E. A., & Crone, M. R. (2024) · Figshare · doi:10.6084/m9.figshare.26757085
Rosário, F., Santos, M. I., Angus, K., Pas, L., Ribeiro, C., & Fitzgerald, N. (2021) · Figshare · doi:10.6084/m9.figshare.13545359
Rosário, F., Santos, M. I., Angus, K., Pas, L., Ribeiro, C., & Fitzgerald, N. (2021) · Figshare · doi:10.6084/m9.figshare.13545362
Nichols, C. (2026) · Substance Use & Misuse · doi:10.1080/10826084.2026.2670603
“…with the intuitive idea that staff who feel well supported and have the necessary leadership and resources, including staffing, equipment, and materials are more likely to implement an EBT (Abidi et al., 2016; Hutchings et al., 2006; Miller et al., 2006; Rosário et al., 2021; Rush et al., 1995).”
Kramer, W., Roelofs, J. J. M., Swildens, W. E., Winters, S., & Gobbens, R. J. J. (2026) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2026.10.037
- Authors
- Abidi, L., Oenema, A., Nilsen, P., Anderson, P., & van de Mheen, D.
- Affiliations
- Maastricht University (NL)
- Corresponding author
- Abidi, L.
- Venue
- Prevention Science
- Published
- 2016-05-11
- Volume
- 17
- Issue
- 6
- Pages
- 689-699
- ISSN
- 1389-4986 (ISSN-L)
- 1573-6695
- PMC
- PMC4938847
- OpenAlex
- W2352373792
- Semantic Scholar
- 4c6b9fab4fc4c0793db4800256ea7488343f5fa2
- Cited by
- 47
- References
- 35
- Citations by year
- 2026: 3 · 2025: 1 · 2024: 5 · 2023: 5 · 2022: 4 · 2021: 12 · 2020: 3 · 2019: 7 · 2018: 4 · 2017: 1 · 2016: 2
- FWCI
- 8.69
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- Prevention Science (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- EUR Research Repository (Erasmus University Rotterdam) (publishedVersion, other-oa)
- EUR Research Repository (Erasmus University Rotterdam) (submittedVersion, other-oa)
- RePub (Erasmus University Rotterdam) (submittedVersion, other-oa)
- KTH Publication Database DiVA (KTH Royal Institute of Technology) (submittedVersion, other-oa)
- Research Publications (Maastricht University) (submittedVersion, cc-by)
- RePub (Erasmus University Rotterdam) (submittedVersion)
- Research Publications (Maastricht University) (submittedVersion, other-oa)
- Newcastle University ePrints (Newcastle Univesity) (cc-by)
- Topics
- Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Health Sciences › Health Professions › General Health Professions › Health Sciences Research and Education
- Keywords
- alcohol screening and brief intervention, implementation barriers, general practice, primary care, implementation strategies, addiction prevention, online learning, reimbursement incentives, practice nurses, clinical guidelines, media publicity, healthcare workers
- MeSH terms
- Alcoholism, Alcohols, Delivery of Health Care, Delphi Technique, Diffusion of Innovation, Humans, Netherlands, Surveys and Questionnaires, General Practice
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
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