title: Large-scale implementation of alcohol brief interventions in new settings in Scotland: a qualitative interview study of a national programme.
abstract: BACKGROUND
  This study aimed to explore experiences of implementation of alcohol brief interventions (ABIs) in settings outside of primary healthcare in the Scottish national programme. The focus of the study was on strategies and learning to support ABI implementation in settings outside of primary healthcare in general, rather on issues specific to any single setting.
  
  
  METHODS
  14 semi-structured telephone interviews were conducted with senior implementation leaders in antenatal, accident and emergency and wider settings and audio-recorded. Interviews were analysed inductively.
  
  
  RESULTS
  The process of achieving large-scale, routine implementation of ABI proved challenging for all involved across the settings. Interviewees reported their experiences and identified five main strategies as helpful for strategic implementation efforts in any setting: (1) Having a high-profile target for the number of ABIs delivered in a specific time period with clarity about whose responsibility it was to implement the target; (2) Gaining support from senior staff from the start; (3) Adapting the intervention, using a pragmatic, collaborative approach, to fit with current practice; (4) Establishing practical and robust recording, monitoring and reporting systems for intervention delivery, prior to widespread implementation; and (5) Establishing close working relationships with frontline staff including flexible approaches to training and readily available support.
  
  
  CONCLUSIONS
  This qualitative study suggests that even with significant national support, funding and a specific delivery target, ABI implementation in new settings is not straightforward. Those responsible for planning similar initiatives should critically consider the relevance and value of the five implementation strategies identified.
authors.affiliation: Institute for Social Marketing, UK Centre for Tobacco and Alcohol Studies, University of Stirling, Stirling, FK9 4LA, , Scotland, UK. niamh.fitzgerald@stir.ac.uk.|Institute for Health and Wellbeing Research, Robert Gordon University, Riverside Campus, Aberdeen, AB10 7GJ, UK. niamh.fitzgerald@stir.ac.uk.
authors.forename: Niamh
authors.initials: N
authors.lastname: Fitzgerald
authors.affiliation: Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK. lucy.platt@lshtm.ac.uk.
authors.forename: Lucy
authors.initials: L
authors.lastname: Platt
authors.affiliation: Glasgow City Community Health Partnership, North-East Sector, Eastbank Health Promotion & Training Centre, Academy Street, Glasgow, G32 9AA, UK. susie.heywood@ggc.scot.nhs.uk.
authors.forename: Susie
authors.initials: S
authors.lastname: Heywood
authors.affiliation: Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK. jim.mccambridge@york.ac.uk.
authors.forename: Jim
authors.initials: J
authors.lastname: McCambridge
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000517:prevention & control*; D003142:Communication; D005260:Female; D006266:Health Education / Q000458:organization & administration*; D006801:Humans; D007407:Interviews as Topic; D011247:Pregnancy; D015397:Program Evaluation; D036301:Qualitative Research; D012606:Scotland