Country and policy factors influencing the implementation of primary care-based alcohol screening: A comparison of Colombia, Mexico and Peru

Daša Kokole*, Liesbeth Mercken, Peter Anderson, Juliana Mejía-Trujillo, Augusto Perez-Gomez, Ines Bustamante, Marina Piazza, Guillermina Natera Rey, Miriam Arroyo, Alejandra Pérez De León, Natalia Bautista Aguilar, Perla Sonia Medina Aguilar, Bernd Schulte, Amy O'Donnell, Hein de Vries, Eva Jané-Llopis

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

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.

Original languageEnglish
Article number2207410
Number of pages19
JournalGlobal Public Health
Volume18
Issue number1
DOIs
Publication statusPublished - 2023

Keywords

  • COVID-19/diagnosis
  • Colombia/epidemiology
  • Humans
  • Mexico/epidemiology
  • Pandemics
  • Peru/epidemiology
  • Policy
  • Primary Health Care
  • Context
  • Colombia
  • alcohol screening
  • Mexico
  • Peru

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