Training primary health care providers in Colombia, Mexico and Peru to increase alcohol screening: Mixed-methods process evaluation of implementation strategy

Daša Kokole, Eva Jané-llopis, Guillermina Natera Rey, Natalia Bautista Aguilar, Perla Sonia Medina Aguilar, Juliana Mejía-trujillo, Katherine Mora, Natalia Restrepo, Ines Bustamante, Marina Piazza, Amy O’donnell, Adriana Solovei, Liesbeth Mercken, Christiane Sybille Schmidt, Hugo Lopez-pelayo, Silvia Matrai, Fleur Braddick, Antoni Gual, Jürgen Rehm, Peter AndersonHein De Vries

Research output: Contribution to journalArticleAcademicpeer-review


Initial results from the SCALA study demonstrated that training primary health care providers is an effective implementation strategy to increase alcohol screening in Colombia, Mexico and Peru, but did not show evidence of superior performance for the standard compared to the shorter training arm. This paper elaborates on those outcomes by examining the relationship of training-related process evaluation indicators with the alcohol screening practice.

A mix of convergent and exploratory mixed-methods design was employed. Data sources included training documentation, post-training questionnaires, observation forms, self-report forms and interviews. Available quantitative data were compared on outcome measure – providers’ alcohol screening.

Training reach was high: three hundred fifty-two providers (72.3% of all eligible) participated in one or more training or booster sessions. Country differences in session length reflected adaptation to previous topic knowledge and experience of the providers. Overall, 49% of attendees conducted alcohol screening in practice. A higher dose received was positively associated with screening, but there was no difference between standard and short training arms. Although the training sessions were well received by participants, satisfaction with training and perceived utility for practice were not associated with screening. Profession, but not age or gender, was associated with screening: in Colombia and Mexico, doctors and psychologists were more likely to screen (although the latter represented only a small proportion of the sample) and in Peru, only psychologists.

The SCALA training programme was well received by the participants and led to half of the participating providers conducting alcohol screening in their primary health care practice. The dose received and the professional role were the key factors associated with conducting the alcohol screening in practice.
Original languageEnglish
Pages (from-to)1-18
Number of pages18
JournalImplementation Research and Practice
Early online date15 Jul 2022
Publication statusPublished - 2022


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