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. 2014 Nov 11;5:161. doi: 10.3389/fpsyt.2014.00161

Table 2.

SBI programs characteristics.

Finlanda Sweden Scotlandb England Italy Catalonia/Spain
Origin Late 90s. Phase IV of the WHO Collaborative Projectc. PHC and occupational health Early 80s Malmö study. Risky drinking Project (2004–2010) in PHC, maternity and occupational health care Early 80s DRAM Study. Scotland performance management target (H4:Heat target)d Late 80s. Phase II of the WHO collaborative project. SIPS trials (PHC, emergency departments and criminal justice settings Early 90s. Phase III strand I of the WHO Collaborative Project Mid 90s. Phase III-strand III of the WHO Collaborative Project. Phase IV on implementation started in 2002
National guidelines Yes. Part of other clinical care guidelines Yes. Stand alone guidelines (GP) Yes. Stand alone guidelines (GP and nurses). The management of harmful drinking and alcohol dependence in primary caref Yes. Stand alone guidelines (GP and nurses) NICE guidance on the prevention of hazardous and harmful drinking plus a Nationally Directed Enhanced service Yes. Stand alone guidelines (GP). PHEPAe adapted at national level Yes. Stand alone guidelines (GP and nurses). PHEPAe adapted at national level and PAPPSf
Professionals Both GP (1,000) and nurses (2,000) Both GP, residents in family medicine and district nurses GP and other PHC professionals (practice and community nurses and health visitors) Both GP and nurses GPs, psychiatrists, family advice bureau from PHC; psychologists, professional from the Ser.T.S. and workplace Both GP and nurses
Screening Opportunistic screening with AUDIT AUDIT Clinical presentations and new registrations. Abbreviated forms of AUDIT (e.g., FAST), or CAGE plus two consumption questions, should be used in primary care when alcohol is a possible contributory factor Targeted screening with AUDIT and AUDIT-C Targeted screening with AUDIT and AUDIT-C on a voluntary basis Universal with existing tools (quantity and frequency) in medical records and AUDIT (voluntary)
Brief intervention FRAMES adapted BI Feedback and BI. MI-principles FRAMES adapted BI (10 min) Simple structured advice and brief behavioral counseling Based on PHEPA guidelines (FRAMES adapted BI) FRAMES adapted BI
Trainingg Both vocational and continuing medical education (GP and nurses) Only vocational training (GP). During the project: half and whole day information seminars and network meetings Training of trainers (100). NHS health Scotland trained over 3200 practitioners (Training manual, DVD and a national competency Partially available vocational training and continuing medical education (GP and nurses). During the project: training of trainers (How much is too much package) Only vocational training (GP). During the project: training of trainers (PHEPA training manual) and continuing medical education (ECM) Both vocational and continuing medical education (GP and nurses) Training by peers in the PHC (Beveu Menys package)
Incentives or part of normal salaryg Part of normal salary Incentives Incentives Part of normal salary Part of normal salary Small incentives
Support for managing SDA in specialized treatment facilities Yes Yes Yes. Access to relapse prevention treatments Yes. Evidence-based care pathway for different levels of alcohol-related risk harm and dependence Yes Yes. Strategy on coordination between PHC and specialist services for alcohol dependence
Monitoring and evaluation Pre-post. Mailed questionnaire to all PHC physicians (2002–2007). Face-to-face interviews (2008) (self-report measures). 25% of Finnish population but concerted attempt to cover the whole country Pre-post. Telephone-administered questionnaire to general population (2006–2009) (self-report measures) Trials, case studies to assess extend of adoption and reach National audit office report. annual care quality commission report Not on SBI implementation but on alcohol consumption, mortality, attributable hospital discharges and on public specialist alcohol service activities (125/2001 law on alcohol) Annual screening rates (contract with PHC providers)
Governmental funding for services for HHAC Yes Yes Yes No Yes Yes
Specific national policy Yes. Finnish alcohol program (2004–2007) Government initiative Health service target of delivering 149,449 BI 2008/2009–2010/2011 National alcohol strategies (2 since 2004) Frame law on alcohol 125/2001 National alcohol and health plan (PNAS) National prevention plan (PNP) National health plan (PSN) No but included in the health Plan (2012–2016) and in the drug prevention plan
Presence of country coalition for the management of HHAC Yes Yes. Cooperation with 21 county councils. Supervision by the professional organizations, local authorities, Hospitals, etc – Yes Yes. National Observatory on Alcohol – CNESPS, Istituto Superiore di Sanità (with funding from the MoH and the Presidency of the Council of the Ministries, Dept of antidrugs policies) Yes. Program on Substance Abuse of the Department of Health (full time nurse and half time administration staff) in collaboration with PHC providers and Catalan Society of Family and Community Physicians and Nurses
General and family practice availability and accessibility Mean = 6g Mean Mean – Below Below Above
Professionals accountability GP Mean = 5.4 Nurses Mean = 4.5g Above/above Below/below – Below/above Below/below Above/above

aWHO-Phase IV, Finland report – http://www.gencat.cat/salut/phaseiv/finland.htm

fPrograma de actividades preventivas y de promoción de la salud (PAPPS) – http://www.papps.org/upload/file/Grupo_Expertos_PAPPS_2_2.pdf

gODHIN assessment tool – report – A description of the available services for the management of hazardous and harmful alcohol consumption (2013) – http://www.odhinproject.eu/project-structure/wp6.html