Embedding brief interventions for alcohol in general practice: a study protocol for the REACH project feasibility trial

Background Alcohol is a major source of harm in Australia that disproportionately affects low-income communities. Alcohol brief interventions (ABIs) combine an assessment of a person’s alcohol use with advice to reduce health risks. Despite their effectiveness, clinicians do not routinely perform ABIs. This article presents a protocol for a feasibility trial of pragmatic implementation strategies and a new set of resources to support clinicians to complete ABIs in Australian general practices.

Aim To explore the facilitators and barriers to increasing the uptake of ABIs in primary care including acceptability, reach, adoption, fidelity, and sustainability.

Design & setting A mixed-methods evaluation of the uptake of ABIs in general practice clinics serving low-income communities in Melbourne, Australia. The approach is informed by the Consolidated Framework for Implementation Research (CFIR) and Normalisation Process Theory (NPT).

Method The implementation strategies and resources will be trailled in five general practices over 12 months. The primary outcome will be change in the proportion of adult patients with a complete alcohol history in their electronic medical records. Baseline data collection includes a practice survey to describe practice routines for ABIs and de-identified patient medical record data on completed alcohol histories (repeated at 3, 6, 9, and 12-months post-intervention). Survey and interview data will also be collected from clinicians, patients, and primary health network staff to assess acceptability and feasibility of the intervention.

Conclusion The study will explore how the implementation strategies and resources can improve alcohol screening and management among low-income patients in general practice.