Barriers to Implementing Screening and Brief Interventions in General Practice: Findings from a Qualitative Study in Norway
Abstract
AIMS: The qualitative component of this mixed methods study aimed at obtaining more in-depth information about the barriers of implementation of screening and brief interventions (SBI) in general practice identified in the quantitative component by giving general practitioners (GPs) the opportunity to discuss and report on the particular difficulties they experience in relation to identification and treatment of alcohol problems in their daily work. METHODS: Focus-group interviews were performed with seven groups of GPs in different parts of Norway, encompassing 40 participants. The interviews were transcribed and analyzed using the QDA Miner software. RESULTS: The analysis revealed five major groups of factors influencing GPs' reluctance to use SBI for alcohol problems: (a) perception of alcohol problems, (b) integration of SBI into existing routines, (c) prevention vs. treatment, (d) structural issues and (e) the relationship between practitioner and patient. DISCUSSION: The analysis showed that problems of implementing SBI in general practice are a complex issue. The quantitative part of the project revealed a strong association between knowledge/self-efficacy and the use of SBI. However, in the qualitative study, we were able to look in more detail at some of the findings from the first part. Even if the lack of knowledge of SBI was still significant, the five factors identified in this study appeared important for the GPs' decisions to use SBI in individual cases.
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In 10 qualitative studies, primary health care providers considered asking about alcohol a delicate task because alcohol is viewed as a sensitive issue, making them feel uncomfortable.
“In 10 qualitative studies, primary health care (PHC) providers considered asking about alcohol a delicate task because alcohol is viewed as a sensitive issue, making them feel uncomfortable [37, 41, 54, 77, 89, 91, 97, 99, 109, 115].”
Creating a specific billing code for alcohol-related problems was reported by some Norwegian GPs as a facilitator to increase GPs' awareness of the importance of alcohol-related problems.
“Creating a specific billing code for this area was reported by some Norwegian GPs as a facilitator to increase GPs awareness of the importance of alcohol-related problems [99].”
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- Authors
- Nygaard, P., & Aasland, O. G.
- Affiliations
- University of California, Berkeley (US)
- University of Oslo (NO)
- Corresponding author
- Nygaard, P.
- ORCID
- Aasland, O. G.
- Venue
- Alcohol and Alcoholism
- Publisher
- Oxford University Press (OUP)
- Published
- 2010-11-08
- Volume
- 46
- Issue
- 1
- Pages
- 52-60
- ISSN
- 0735-0414 (ISSN-L)
- 1464-3502
- OpenAlex
- W2172041510
- Cited by
- 77
- References
- 10
- Citations by year
- 2026: 1 · 2024: 5 · 2023: 1 · 2022: 4 · 2021: 13 · 2020: 4 · 2019: 4 · 2018: 4 · 2017: 8 · 2016: 1 · 2015: 7 · 2014: 9 · 2013: 6 · 2012: 8
- FWCI
- 3.72
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Alcohol and Alcoholism (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
- Health Sciences › Medicine › Pathology and Forensic Medicine › Alcohol Consumption and Health Effects
- Keywords
- screening and brief intervention, alcohol problems, general practitioners, implementation barriers, alcohol screening, alcohol treatment, prevention versus treatment, practitioner-patient relationship, self-efficacy, primary care
- MeSH terms
- Alcoholism, Attitude of Health Personnel, Communication, Female, Humans, Interviews as Topic, Male, Norway, Psychotherapy, Brief, Substance Abuse Detection, Focus Groups, Self Efficacy, Qualitative Research, General Practice
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