5 years ago

NAT 6/08 - THL

NAT 6/08 - THL

Alcohol prevention

Alcohol prevention activity in Swedish primary health care and occupational health services attitudes to and involvement in health promotion and lifestyle counselling. British Journal of General Practice 49: 187–190 Naidoo, J. & Wills, J. (2002): Health Promotion: Foundations for Practice, New York Naidoo, J. & Wills, J. (2000): Health Promotion: Foundations for Practice, 2nd edition. Bailliere and Tindall, Harcourt, Edinburgh Nikkarinen, T. (2002): Evaluation Model for Continuing medical Education: A Case Study. Department of Public Health. University of Helsinki, Helsinki Nilsen, P. & Aalto, M. & Bendtsen, P. & Seppä, K. (2006): Effectiveness of strategies to implement brief alcohol intervention in primary healthcare. Scandinavian Journal of Primary Health Care 24: 5–15 Oxman, A.D. & Thomson, M.A. & Davis, D.A. & Haynes, R.B. (1995): No magic bullets: a systematic review of 102 trials of interventions to improve professional practice. Canadian Medical Association Journal 153 (10): 1423–1431 Richmond, R. & Wodak, A. & Bourne, S. & Heather, N. (1998): Screening for unhealthy lifestyle factors in the workplace. Australian and New Zealand Journal of Public Health 22 (3 Suppl): 324–331 Roche, A.M. & Freeman, T. (2004): Brief interventions: good in theory but weak in practice. Drug and Alcohol Review 23: 11–18 Seppä, K. & Aalto, M. & Raevaara, L. & Peräkylä, A. (2004): A brief intervention for risky drinking-analysis of videotaped consultations in primary health care. Drug and Alcohol Review 23: 167–170 Sibley, J.C. & Sackett, D.L. & Neufeld, V. & Ger- 504 NORDIC STUDIES ON ALCOHOL AND DRUGS V O L . 2 5. 2 0 0 8 . 6 rard, B. & Rudnick, K.V. & Fraser, W. (1982): A randomized trial of continuing medical education. The New England Journal of Medicine 306: 511–515 SOU (2004): Utveckling av god företagshälsovård – ny lagstiftning och andra åtgärder. [The development of good occupational health service – new legislation and other measures], Statens offentliga utredningar 2004: 113. Arbetsmarknadsdepartementet Stange, K.C. & Woolf, S.H. & Gjeltema, K. (2002): One minute for prevention. The power of leveraging to fulfill the promise of health behavior counseling. The American Journal of Medicine 22: 320–323 Statskontoret (2001): Utnyttja företagshälsovården bättre [Make the best of occupational health services]. Publikationer 2001:29. Stockholm. Vanhoorne, M.N. & Vanachter, O.V. & De Ridder, M.P. (2006): Occupational health care for the 21st century: from health at work to workers’ health. International Journal of Occupational and Environmental Health 12 (3): 278–285 Wensing, M. & van der Weijden, T. & Grol, R. (1998): Implementing guidelines and innovations in general practice: which interventions are effective? The British Journal of General Practice 48 (427): 991–997 Vinson, D.C. & Elder, N. & Werner, J.J. & Vorel, L.A. & Nutting, P.A. (2000): Alcohol-related discussions in primary care. The Journal of Family Practice 49: 28–33 Hälso- och sjukvårdsstatistisk årsbok 2002 (2002): (Yearbook of Health and Medical Care 2002) Socialstyrelsen. Stockholm.

Kaija sePPä Martti KuoKKanen Implementing brief alcohol intervention in primary and occupational health care Reflections on two Finnish projects Introduction In this paper we aim to measure the outcome of a two decades-long Finnish implementation of brief alcohol intervention by asking how actively the municipalities joined the nationwide primary health care implementation project (VAltakunnallinen Mini-interventio- Projekti [National Brief Intervention Project] – VAMP) and what was the quality of the two most recent nationwide projects; the VAMPproject and the Occupational Health Care Project. Based on several randomized studies, systematic reviews and meta-analyses (Ballesteros et al. 2004; Whitlock et al. 2004; Bertholet et al. 2005) brief alcohol intervention (BI) on hazardous drinking has been shown to be effective. Compared to other tools available to address alcohol misuse in health and social care, it is has been shown to be the most effective (Österberg & Babor 2005). The latest Cochrane review demonstrates that for one effective BI 7–10 patients need to be treated (Kaner et al. 2007). In spite of the effectiveness of BI, widespread implementation has been difficult (Nilsen et al. 2006). A B S T R A C T K. Seppä & M. Kuokkanen: Implementing brief alcohol intervention in primary and occupational health care. Reflections on two Finnish projects. The article describes the implementing of brief alcohol interventions in primary and occupational health care in Finland by studying the two most recent nationwide projects. These projects build on earlier national and international research results and practical knowledge and are tailored according to the Finnish political and medical culture. we report how actively the municipalities joined with the nationwide implementation project in primary health care and the quality of the primary and occupational health care projects based on recently published quality instructions. Our conclusion is that these two projects have shown that practitioners in health care centres can be activated and thereby also make a widespread implementation of brief alcohol intervention possible. The attitudes to brief alcohol intervention, especially among health care leaders have changed for the positive, and education and training are now actively asked for as well by primary as occupational health centres. KEywORDS brief intervention, BI, implementation, alcohol, primary health care, occupational health care, Finland NORDIC STUDIES ON ALCOHOL AND DRUGS V O L . 25. 2008 . 6 Country report 505

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