Screening and brief intervention for alcohol and other drug use in primary care: associations between organizational climate and practice

Abstract

BackgroundNumerous studies have demonstrated that positive organizational climates contribute to better work performance. Screening and brief intervention (SBI) for alcohol, tobacco, and other drug use has the potential to reach a broad population of hazardous drug users but has not yet been widely adopted in Brazil’s health care system. We surveyed 149 primary health care professionals in 30 clinics in Brazil who were trained to conduct SBI among their patients. We prospectively measured how often they delivered SBI to evaluate the association between organizational climate and adoption/performance of SBI.MethodsOrganizational climate was measured by the 2009 Organizational Climate Scale for Health Organizations, a scale validated in Brazil that assesses leadership, professional development, team spirit, relationship with the community, safety, strategy, and remuneration. Performance of SBI was measured prospectively by weekly assessments during the three months following training. We also assessed self-reported SBI and self-efficacy for performing SBI at three months post-training. We used inferential statistics to depict and test for the significance of associations.ResultsTeams with better organizational climates implemented SBI more frequently. Organizational climate factors most closely associated with SBI implementation included professional development and relationship with the community. The dimensions of leadership and remuneration were also significantly associated with SBI.ConclusionsOrganizational climate may influence implementation of SBI and ultimately may affect the ability of organizations to identify and address drug use.

The role of training in IBA implementation beyond primary health care settings in the UK

“…Nilsen, 2010; Schmidt et al, undated). Importantly, organisational “climate” has been suggested as key to strengthening workforce commitment to IBA delivery (Cruvinel, Richter, Bastos, & Ronzani, 2013), but there has been little research examining organisational factors or research looking at the links between organisational factors, professional behaviour and work context.…”

Evaluation of the Implementation of Brief Interventions to Substance Abuse in a Socieducative Context

“…When analyzed the predictors of adherence to the course, having a prior specific course in the field reduced the chances to adhere to the intervention. This is an important issue due to the training offered on SBI field can enhance performance both in quality and in quantity of applications of ASSIST and brief interventions carried out in primary care services (Cruvinel, Richter, Bastos, & Ronzani, 2013). In our study, the logistic model indicated that those who reported some difficulties to implement an SBI program on their CDCs feel lees motivated to perform SBI on their routine practices.…”

Together Achieving More: Primary Care Team Communication and Alcohol-Related Healthcare Utilization and Costs

“…Current efforts to improve quality of alcohol-related care for excessive alcohol drinkers in primary care call for teams of clinicians and staff who perform interdependent tasks to deliver alcohol-related care for patients (Sullivan et al, 2011, Israel et al, 1996, Cruvinel et al, 2013, Aspy et al, 2008, Reiff-Hekking et al, 2005). Notably, in 2011, a joint Office of National Drug Control Policy, Substance Abuse and Mental Health Services Administration, and Health Resources and Services Administration meeting asked for more investment in team training for the primary care workforce to properly integrate alcohol services delivery in primary care (Dilonardo, 2011).…”