title: Evaluation of an intervention for patients with alcohol-related injuries: results of a mixed methods study.
abstract: OBJECTIVE
  To explore the effect of education and training on the delivery of alcohol screening and brief intervention and referral to high-risk patients in a hospital setting. Main outcome measures included; delivery of training; practice change in relation to staff performing alcohol screening, brief intervention and referrals.
  
  
  METHODS
  Observational study design using mixed methods set in a tertiary referral hospital. Pre-post assessment of medical records and semi-structured interviews with key informants.
  
  
  RESULTS
  Routine screening for substance misuse (9% pre / 71.4% post) and wellbeing concerns (6.6% pre / 15 % post) was more frequent following the introduction of resources and staff participation in educational workshops. There was no evidence of a concomitant increase in delivery of brief intervention or referrals to services. Implementation challenges, including time constraints and staff attitudes, and enablers such as collaboration and visible pathways, were identified.
  
  
  CONCLUSIONS
  Rates of patient screening increased, however barriers to delivery of brief intervention and referrals remained. Implementation strategies targeting specific barriers and enablers to introducing interventions are both required to improve the application of secondary prevention for patients in acute settings.
  
  
  CONCLUSIONS
  Educational training, formalised liaison between services, systematised early intervention protocols, and continuous quality improvement processes will progress service delivery in this area.
authors.affiliation: Menzies School of Health Research, Northern Territory.|Charles Darwin University, Northern Territory.
authors.forename: Megan
authors.initials: M
authors.lastname: Whitty
authors.affiliation: Menzies School of Health Research, Northern Territory.|School of Medicine, Flinders University, South Australia.
authors.forename: Tricia
authors.initials: T
authors.lastname: Nagel
authors.affiliation: Menzies School of Health Research, Northern Territory.
authors.forename: Linda
authors.initials: L
authors.lastname: Ward
authors.affiliation: Menzies School of Health Research, Northern Territory.|Charles Darwin University, Northern Territory.
authors.forename: Rama
authors.initials: R
authors.lastname: Jayaraj
authors.affiliation: School of Psychology and Counselling, Queensland University of Technology.
authors.forename: David
authors.initials: D
authors.lastname: Kavanagh
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000517:prevention & control*; D019973:Alcohol-Related Disorders / Q000175:diagnosis* / Q000453:epidemiology; D001291:Attitude of Health Personnel; D001315:Australia / Q000453:epidemiology; D005260:Female; D006293:Health Promotion / Q000379:methods; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D010343:Patient Admission / Q000706:statistics & numerical data; D036301:Qualitative Research; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D014947:Wounds and Injuries / Q000453:epidemiology* / Q000628:therapy
keywords: Indigenous; alcohol screening; brief intervention; evaluation; implementation