title: A multicountry controlled trial of strategies to promote dissemination and implementation of brief alcohol intervention in primary health care: findings of a World Health Organization collaborative study.
abstract: OBJECTIVE
  This study examines the impact of marketing strategies on the dissemination of a brief alcohol intervention program to general practitioners (GPs). The marketing strategy was tested to determine the most effective way to promote awareness about and consideration of a brief alcohol intervention program. The study also examines the impact of training and support strategies to promote the program's implementation in routine primary care.
  
  
  METHODS
  A pragmatic trial was carried out in Australia, Belgium (Flanders), Denmark, England, New Zealand and Spain (Catalonia) in which GPs were randomly allocated into one of three marketing conditions (direct mail, telemarketing and academic detailing [personal visits]). The GPs who requested a brief intervention program and agreed to use it were stratified by previous marketing condition and randomly allocated into one of three implementation strategy groups: written guidance, outreach training and outreach training plus ongoing telephone support.
  
  
  RESULTS
  Acceptance of the brief intervention program was more effective with use of telemarketing (65%) and academic detailing (67%) than with direct mail (32%) for promoting awareness about and consideration of a brief alcohol intervention program. The median proportion of patients screened was higher for trained GPs (6%) and supported GPs (9%) than for control GPs (1%), who received only written guidance on how to conduct brief intervention. Similarly, the median rate for giving advice to at-risk patients was higher for trained GPs (3%) and supported GPs (3%) than for control GPs (0%).
  
  
  CONCLUSIONS
  The adoption of more direct approaches for disseminating evidence-based intervention programs to GPs is a necessary first step for changing practice behavior. However, outreach training was required to promote actual use of a new procedure in routine practice.
authors.affiliation: Department of Mental Health and SubstanceAbuse, WHO, 20OAvenueAppia, CH-1211 Geneva 27, Switzerland. funkm@who.int
authors.forename: Michelle
authors.initials: M
authors.lastname: Funk
authors.forename: Sonia
authors.initials: S
authors.lastname: Wutzke
authors.forename: Eileen
authors.initials: E
authors.lastname: Kaner
authors.forename: Peter
authors.initials: P
authors.lastname: Anderson
authors.forename: Leo
authors.initials: L
authors.lastname: Pas
authors.forename: Ross
authors.initials: R
authors.lastname: McCormick
authors.forename: Antoni
authors.initials: A
authors.lastname: Gual
authors.forename: Sverre
authors.initials: S
authors.lastname: Barfod
authors.forename: John
authors.initials: J
authors.lastname: Saunders
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006293:Health Promotion; D006801:Humans; D007391:International Cooperation; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011320:Primary Health Care; D011614:Psychotherapy, Brief; D014944:World Health Organization