title: Qualitative process study of community pharmacist brief alcohol intervention effectiveness trial: Can research participation effects explain a null finding?
abstract: OBJECTIVE
  This qualitative process study, nested within a randomised controlled trial evaluating community pharmacist brief alcohol intervention delivery, aims to explore participants' engagement with the trial, so as to identify whether research participation effects may explain why the brief intervention was not found to be effective.
  
  
  METHODS
  Qualitative interviews were conducted with 24 randomly selected participants approximately one month after the end of the trial. Semi structured Interviews were conducted by telephone in which participants were asked to give a chronological account of their trial participation, leading to a discussion of possible impacts. These were digitally recorded, transcribed verbatim, and analysed using the Framework method.
  
  
  RESULTS
  A range of motivations for taking part in the trial were identified, including pharmacy visitors wanting to obtain an assessment of their drinking. Participants in both arms of the trial spoke of the potent effect that screening had on them. All participants were exposed to discussions about alcohol with empathic pharmacists and, as this is an integral intervention component, this constitutes contamination. Participants' pre-existing ideas about the nature of alcohol problems had an important bearing on how relevant they thought the intervention was to them.
  
  
  CONCLUSIONS
  A detailed appreciation of participant engagement with the trial can provide a strong basis for interpretation of trial outcome data, and in this instance does help explain the null finding. Other findings also indicate the need for dedicated studies of public understanding of the nature of alcohol problems, and their implications for receptivity to brief interventions.
authors.affiliation: Centre for Quality Improvement, Royal College of Psychiatrists, London, UK. Electronic address: aquirk@rcpsych.ac.uk.
authors.forename: Alan
authors.initials: A
authors.lastname: Quirk
authors.affiliation: Department of Social and Environmental Health Research, London School of Hygiene and Tropical Medicine, London, UK.
authors.forename: Virginia
authors.initials: V
authors.lastname: MacNeil
authors.affiliation: National Addiction Centre, Institute of Psychiatry, Kings College London, UK.
authors.forename: Ranjita
authors.initials: R
authors.lastname: Dhital
authors.affiliation: School of Medicine, Pharmacy and Health, Durham University, UK.
authors.forename: Cate
authors.initials: C
authors.lastname: Whittlesea
authors.affiliation: Florence Nightingale School of Nursing and Midwifery, Kings College London, UK.
authors.forename: Ian
authors.initials: I
authors.lastname: Norman
authors.affiliation: Department of Social and Environmental Health Research, London School of Hygiene and Tropical Medicine, London, UK; Department of Health Sciences, University of York, UK.
authors.forename: Jim
authors.initials: J
authors.lastname: McCambridge
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000517:prevention & control* / Q000523:psychology; D003157:Community Pharmacy Services; D003376:Counseling; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D009042:Motivation; D010358:Patient Participation / Q000523:psychology*; D036301:Qualitative Research; D016032:Randomized Controlled Trials as Topic / Q000379:methods* / Q000523:psychology*; D013997:Time Factors; D016896:Treatment Outcome
keywords: Alcohol; Brief intervention; Community pharmacist; Process study; Qualitative; Trial