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WHO Alcohol Brief Intervention Training Manual for Primary Care

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WHO Alcohol Brief Intervention Training Manual for Primary Care Header ti te l WHO alcohol brief intervention training manual for primary care a WHO alcohol brief intervention training manual for primary care Abstract Alcohol contributes significantly to the disease and mortality burden in the WHO European Region, and primary health care systems play an important role in reducing the impact of harmful alcohol use. Screening and brief interventions (SBIs) for alcohol are an evidence-informed approach to addressing the needs of the many patients presenting in primary care who may benefit from reducing their alcohol consumption. This manual provides information to plan training and support for primary care practitioners to confidently deliver SBI for alcohol problems to their patients. The manual outlines the background and evidence base for SBI, and gives practical advice on establishing an implementation programme as well as detailed educational materials to develop the knowledge and skills of participants in organized training sessions. Keywords Alcohol drinking – prevention and control Alcoholism – rehabilitation Manuals as topic Address requests about publications of WHO Regional Office for Europe to: Publications WHO Regional Office for Europe UN City Marmorvej 51 DK–2100 Copenhagen Ø, Denmark Alternatively, complete an online request form for documentation, health information, or for permission to quote or translate, on the Regional Office web site (http://www.euro.who.int/pubrequest). © World Health Organization 2017 All rights reserved. The Regional Office for Europe of the World Health Organization welcomes requests for permission to reproduce or translate its publications, in part or in full. The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters. All reasonable precautions have been taken by the World Health Organization to verify the information contained in this publication. However, the published material is being distributed without warranty of any kind, either express or implied. The responsibility for the interpretation and use of the material lies with the reader. In no event shall the World Health Organization be liable for damages arising from its use. The views expressed by authors, editors, or expert groups do not necessarily represent the decisions or the stated policy of the World Health Organization. The copyright of this training manual is shared between WHO and Dr Niamh Fitzgerald. WHO agrees that the work incorporates pre-existing methodologies, tools, models, procedures, knowledge of business principles, analytical concepts, approaches, discoveries, ideas, and formats developed by Dr Fitzgerald. Dr Fitzgerald grants to WHO a perpetual, worldwide, irrevocable, royalty-free, non-exclusive licence to use, execute, reproduce, display, perform, distribute, and prepare derivative works of the toolkit in conjunction with the use of the work for WHO’s needs. Contents Acknowledgements ..................................................................................................................................... v Abbreviations.............................................................................................................................................vii Foreword...................................................................................................................................................viii How to use this manual..............................................................................................................................ix INTRODUCTION FOR TRAINERS ......................................................................................................... 1 What is an alcohol brief intervention? ............................................................................................... 2 Key concept 1. Stages of behaviour change .................................................................................... 3 Key concept 2. Motivational interviewing. ...................................................................................... 4 Types of brief intervention ............................................................................................................ 5 Evidence for the efficacy and effectiveness of brief interventions ....................................................... 7 What works to get ABIs into routine practice? ................................................................................. ..8 Bridging the gap between evidence and practice ............................................................................. 10 Planning for ABI implementation ..................................................................................................... 12 Champions ................................................................................................................................. 12 Services ...................................................................................................................................... 12 System-level planning ................................................................................................................. 12 Planning training for trainers ........................................................................................................... 14 Responsibility for delivering the training for trainers programme .................................................. 14 Individuals to be recruited to attend the training for trainers programme and deliver future practitioner training ........................................................................................ 14 Suggested programme for training for trainers ............................................................................. 15 Planning training sessions for practitioners ...................................................................................... 17 Aim and objectives of the training course for practitioners ............................................................ 18 Suggested programme for practitioner training ........................................................................... 19 TRAINING MATERIALS ..................................................................................................................... 20 Unit 1. Introduction, course overview and group agreement ............................................................ 22 Handout 1.1. Course aim and objectives ....................................................................................... 24 Handout 1.2. Group agreement suggestions ................................................................................. 25 Unit 2. Attitudes to alcohol ............................................................................................................. 26 Handout 2.1. Attitudes to alcohol – worksheet ............................................................................. 28 Handout 2.2. Attitudes to alcohol – notes .................................................................................... 29 Unit 3. Impact, consumption and harms of alcohol .......................................................................... 34 Handout 3.1. Impact of alcohol. ................................................................................................... 36 Handout 3.2. Standard drinks and drinking levels – quiz ................................................................ 40 Handout 3.3. Standard drinks and drinking levels – answers to quiz ............................................... 41 Unit 4. ABIs: goals, skills and practice change ................................................................................... 44 Handout 4.1. What is an alcohol brief intervention? ..................................................................... 47 Handout 4.2. Overcoming challenges ........................................................................................... 50 Unit 5. Beginning a conversation about alcohol................................................................................ 53 Handout 5.1. Beginning the conversation ..................................................................................... 55 Unit 6. Screening and feedback using AUDIT .................................................................................... 57 Handout 6.1. AUDIT-C/AUDIT tool ............................................................................................... 60 Handout 6.2. AUDIT-C/AUDIT screening practitioner unit. ............................................................. 62 Handout 6.3. Screening case studies – patient information ........................................................... 64 Handout 6.4. Screening case studies – answers ............................................................................ 65 Handout 6.5. Responding to dependence ....................................................................................
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