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NAT 6/08 - THL

NAT 6/08 - THL

As reflected in Thomas

As reflected in Thomas Babor’s remarks, the findings from these brief intervention projects can be analyzed from a variety of angles. The reader can choose which glasses to put on; more theoretical, or more oriented towards the practice of public health. This issue can be useful for those who have an interest in the history of medicine and particularly the history of public health, where brief intervention may mark a new phase, characterized by education combined with standardized, expert intervention. It contains food for thought for those who have an interest in the organizational aspects of medicine when implementing public health measures. One example relates to recent cuts in resources and the decreased continuity in medical services in the Nordic countries, which conflicts with the increased demands to adopt a preventive public health perspective. The implementation of brief intervention can be analyzed as a gigantic educational effort directed towards the medical profession and some articles 452 NORDIC STUDIES ON ALCOHOL AND DRUGS VOL. 25. 2008 . 6 in this issue provide good documentation of that process. The texts demonstrate the importance of general political support for public health measures within a medical system. They touch upon the difficult but crucial division of labour between medical doctors and other staff in public health programs. The fruitful relation between research and practice is a prominent theme, especially in the South American contributions. And, not least, the issue can be the starting point for an analyses of how “the same” technique and methods will necessarily be remodeled as they adapt to various surroundings. Babor predicts that the relative pessimism of the Nordic contributions and the more optimistic enthusiasm of Latin American articles both contain valid versions of how the future will view screening and brief intervention. Hopefully this volume will contribute more to an optimistic trajectory: to realism and better practices through shared experiences.

Per nilsen eileen Kaner thoMas F. BaBor Brief intervention, three decades on An overview of research findings and strategies for more widespread implementation Introduction The last three decades have seen a paradigm shift with regard to alcohol treatment and prevention, as the disease model of alcoholism has been expanded with the concept of a continuum of use that encompasses a much greater proportion of the population. It has been recognised that the majority of alcoholrelated harm on a population level is attributable to the large group of hazardous and harmful drinkers rather than individuals with severe alcohol-related problems or alcohol dependence. The result has been a shift in attention from treating solely dependent drinkers at one end of the continuum to secondary prevention efforts targeting individuals at risk of alcohol-related harm (Botelho & Richmond 1996; Babor & Higgins-Biddle 2000). This study was supported by grants from the Swedish National Rescue Services Agency. Dr. Babor’s contributions to this article were supported in part by a grant from the US National Institute on Alcohol Abuse and Alcoholism (P60 AA003510). Sincere thanks to Preben Bendtsen, Cheryl Cherpitel, and Kaija Seppä for feedback and comments on earlier drafts of this paper. A B S T R A C T P. Nilsen & E. Kaner & T. F. Babor: Brief intervention, three decades on. An overview of research findings and strategies for more widespread implementation This paper provides an overview of brief intervention (BI) research to date and discusses future research needs as well as strategies for more widespread use of BI. Research has firmly established that significant reductions in drinking can be achieved by BI in a variety of health care settings. Despite convincing evidence, however, diffusion of BI in routine health care has been slow. Alcohol is a complex subject since it is often used moderately, without sideeffects, and in a socially acceptable way. Although research on BI has accumulated rapidly during the last three decades, many important research challenges and development work remain before BI is widely implemented in routine health care. KEywORDS BI, Brief intervention, alcohol, history, implementation, overview NORDIC STUDIES ON ALCOHOL AND DRUGS V O L . 25. 2008 . 6 Overview 453

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