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NAT 6/08 - THL

NAT 6/08 - THL

Alcohol prevention

Alcohol prevention activity in Swedish primary health care and occupational health services threshold with or without alcohol-related negative health consequences (alcohol misuse or dependency is not included in this definition). Six background variables were included in the analysis: professional category; sex; age; years in practice; patient encounters per week; and location of the PHC or OHS unit. Activity, i.e. frequency of addressing the alcohol issue with patients, was measured on a five-point Likert scale, from which two categories were assembled: frequently (combined “always” and “often”) and infrequently (combined “occasionally”, “seldom” and “never”) addressing the alcohol issue. Education (apart from regular basic education) was measured on a six-point ordinal scale, from which four categories were assembled: no; half a day or less; 1–2 days, and 3 days or more of training. Skills were assessed on a four-point Likert scale, from which two categories were defined for use in some of the analyses: not very skilful (the two least affirmative answers) and skilful (the two most affirmative answers). Knowledge concerning providing advice was also assessed on a four-point Likert scale. Again, two categories were defined for use in some of the analyses: not very knowledgeable (the two least affirmative answers) and knowledgeable (the two most affirmative answers). The response options for location were rural area, medium-sized city, and major city. Years in practice were expressed on a six-point ordinal scale, from which four categories were assembled: 5 years or less, 6–10 years, 11–20 years, and more than 20 years. The number of patient encounters per week was captured on an interval scale: 0–19, 20–39, 40–59, and 60 or more patients per week. Five age categories were 492 NORDIC STUDIES ON ALCOHOL AND DRUGS V O L . 2 5. 2 0 0 8 . 6 constructed: 45 years or less, 46–50 years, 51–55 years, 56–60 years, and 61 years or older. Age was also converted into a dichotomous variable for use in some of the analyses: 50 years or younger and 51 years or older. � Data analysis Differences in proportions between groups were tested (two-sided test) with Bonferroni adjustment for multiple tests for all pair-wise comparisons within a row. Stepwise backward logistic regression (Odds ratios (OR) and 95% confidence intervals (CI) are presented in Table 2) was used to estimate the relationship between activity (frequency of addressing alcohol; frequently was coded as 1 and infrequently was coded as 0) and the independent variables: sex, age, years in practice, patient encounters per week, location of the PHC or OHS unit, skills, knowledge, and education. These analyses were adjusted for influences between the independent variables. A separate analysis was conducted for each professional category. P-value for removing was 0.10. Interaction terms were also tested but these were not significant. The ORs indicate the effects of the predictor variables with all other variables in the equation/model controlled. SPSS software version 15.0 was used for statistical analyses. Results � Response rates The questionnaire was returned by 313 OHS physicians (response rate 54%), 759 OHS nurses (69%), 1821 PHC physicians (47%), and 3125 PHC nurses (55%). Two hundred and seventeen PHC nurses were excluded because they worked only with children and/or currently did not work

Table 1. Characteristics of the responding professionals in the two settings Occupational Health Services Primary Health Care Physicians n (%) Nurses n (%) Alcohol prevention activity in Swedish primary health care and occupational health services Physicians ses n (%) Nurses n (%) Sex n=309 n=757 n=1788 n=2544 Female 114 (37) 737 (97) 844 (47) 2505 (99) age n=305 n=753 n=1743 n=2531 < 45 years 12 ( 4) 100 (13) 307 (18) 554 (22) 46–50 years 27 ( 9) 122 (16) 304 (18) 528 (21) 51–55 years 58 (19) 183 (24) 409 (23) 635 (25) 56–60 years 98 (32) 225 (30) 480 (28) 547 (22) > 61 years 110 (36) 123 (16) 243 (14) 267 (11) Years in practice n=302 n=736 n=1686 n=2545 < 2 years 17 ( 6) 27 ( 4) 28 ( 2) 53 ( 2) 3-5 years 61 (20) 138 (19) 127 ( 8) 430 (17) 6-10 years 55 (18) 78 (11) 308 (18) 578 (23) 11-20 years 72 (24) 206 (28) 662 (39) 837 (33) > 20 years 97 (32) 287 (39) 561 (33) 647 (25) Patients per week n=302 n=736 n=1772 n=2413 < 20 83 (28) 249 (34) 77 ( 4) 452 (19) 20–39 145 (48) 415 (56) 546 (31) 1088 (45) 40–59 57 (19) 64 ( 9) 883 (50) 653 (27) > 60 17 ( 6) 8 ( 1) 266 (15) 220 ( 9) Location n=304 n=745 n=1771 n=2533 rural-population area 15 ( 5) 82 (11) 433 (24) 795 (31) Medium-sized city 159 (52) 469 (63) 960 (54) 1386 (55) Major citya 130 (43) 194 (26) 378 (21) 352 (14) Skills n=301 n=739 n=1766 n=2474 not particularly skilful 19 ( 6) 40 ( 5) 335 (19) 1045 (42) somewhat skilful 99 (33) 291 (39) 968 (55) 1091 (44) Moderately skilful 148 (49) 339 (46) 424 (24) 298 (12) very skilful 35 (12) 69 ( 9) 39 (2) 40 ( 2) Knowledge n=304 n=753 n=1779 n=2520 not particularly knowledgeable 3 (1) 24 (3) 115 (7) 710 (28) somewhat knowledgeable 39 (13) 190 (25) 592 (33) 1058 (42) Moderately knowledgeable 149 (49) 411 (55) 787 (44) 649 (26) very knowledgeable 113 (37) 128 (17) 285 (16) 103 ( 4) Education n=303 n=740 n=1756 n=2463 none 131 (43) 249 (34) 741 (42) 1557 (63) half a day or shorter 114 (38) 255 (35) 482 (27) 559 (23) 1–2 days 37 (12) 163 (22) 315 (18) 230 ( 9) 3 days or more 21 ( 7) 73 (10) 218 (12) 117 ( 5) a) stockholm, Gothenburg, Malmö, the three biggest cities in sweden (> 250 000 residents) NORDIC STUDIES ON ALCOHOL AND DRUGS V O L . 25. 2008 . 6 493

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