TY - JOUR
T1 - Country and policy factors influencing the implementation of primary care-based alcohol screening
T2 - A comparison of Colombia, Mexico and Peru
AU - Kokole, Daša
AU - Mercken, Liesbeth
AU - Anderson, Peter
AU - Mejía-Trujillo, Juliana
AU - Perez-Gomez, Augusto
AU - Bustamante, Ines
AU - Piazza, Marina
AU - Natera Rey, Guillermina
AU - Arroyo, Miriam
AU - Pérez De León, Alejandra
AU - Bautista Aguilar, Natalia
AU - Medina Aguilar, Perla Sonia
AU - Schulte, Bernd
AU - O'Donnell, Amy
AU - de Vries, Hein
AU - Jané-Llopis, Eva
PY - 2023
Y1 - 2023
N2 - Researchers and practitioners recognise the importance of context when implementing healthcare interventions, but the influence of wider environment is rarely mapped. This paper identifies the country and policy-related factors potentially explaining the country differences in outcomes of an intervention focused on improving detection and management of heavy alcohol use in primary care in Colombia, Mexico and Peru. Qualitative data obtained through interviews, logbooks and document analysis are used to explain quantitative data on number of alcohol screenings and screening providers in each of the countries. Existing alcohol screening standards in Mexico, and policy prioritisation of primary care and consideration of alcohol as a public health issue in Colombia and Mexico positively contributed to the outcome, while the COVID-19 pandemic had a negative impact. In Peru, the context was unsupportive due to a combination of: political instability amongst regional health authorities; lack of focus on strengthening primary care due to the expansion of community mental health centres; alcohol considered as an addiction rather than a public health issue; and the impact of COVID-19 on healthcare. We found that wider environment-related factors interacted with the intervention implemented and can help explain country differences in outcomes.
AB - Researchers and practitioners recognise the importance of context when implementing healthcare interventions, but the influence of wider environment is rarely mapped. This paper identifies the country and policy-related factors potentially explaining the country differences in outcomes of an intervention focused on improving detection and management of heavy alcohol use in primary care in Colombia, Mexico and Peru. Qualitative data obtained through interviews, logbooks and document analysis are used to explain quantitative data on number of alcohol screenings and screening providers in each of the countries. Existing alcohol screening standards in Mexico, and policy prioritisation of primary care and consideration of alcohol as a public health issue in Colombia and Mexico positively contributed to the outcome, while the COVID-19 pandemic had a negative impact. In Peru, the context was unsupportive due to a combination of: political instability amongst regional health authorities; lack of focus on strengthening primary care due to the expansion of community mental health centres; alcohol considered as an addiction rather than a public health issue; and the impact of COVID-19 on healthcare. We found that wider environment-related factors interacted with the intervention implemented and can help explain country differences in outcomes.
KW - COVID-19/diagnosis
KW - Colombia/epidemiology
KW - Humans
KW - Mexico/epidemiology
KW - Pandemics
KW - Peru/epidemiology
KW - Policy
KW - Primary Health Care
KW - Context
KW - Colombia
KW - alcohol screening
KW - Mexico
KW - Peru
U2 - 10.1080/17441692.2023.2207410
DO - 10.1080/17441692.2023.2207410
M3 - Article
C2 - 37156224
SN - 1744-1692
VL - 18
JO - Global Public Health
JF - Global Public Health
IS - 1
M1 - 2207410
ER -