2023-09-28 14:46:10 +00:00
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abstract: 'Background: Despite global recommendations that brief, task-shared
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interventions are effective for addressing problematic alcohol use in
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primary health care (PHC), low-income countries have made few attempts
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to implement and scale-up these interventions. Aim: To explore
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perspectives and experiences of service users and providers on a brief
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intervention (BI) for alcohol use disorders (AUDs) delivered by
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nonspecialist health workers who are health officers and clinical nurses
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in PHC in a rural Ethiopian district. Methods: The study team conducted
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a qualitative study, comprising in-depth interviews with 26 purposively
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selected participants. The participants were 14 people who had been
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screened for probable AUD and were receiving the brief intervention;
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four caregivers without any intervention; and eight nonspecialist health
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workers who provided a single session brief intervention at four primary
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care health centers in Sodo district, south Ethiopia. The study used
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framework analysis. We grouped findings into five themes: acceptability,
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engagement in and barriers to care, implementation of the service,
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perceived impact of the BI, and unmet needs and expectations. Results:
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Participants perceived the intervention to be useful, and it was
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well-accepted by most service users and relatives. Participants reported
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reductions in alcohol consumption and benefits in terms of their
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capacity to work, increased earnings, less money wasted, and ability to
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provide for their families. However, most did not attend follow-up
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visits, often influenced by the belief that they did not have a serious
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problem and could handle it alone. Some did not believe AUDs to be
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treatable; others did not attend because of lack of money for
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transportation and stigma from peers. Providing BI did not affect PHC
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workers'' routine work. However, they noticed a reluctance from people
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with probable AUD to speak openly about their drinking, and they were
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constrained by a shortage of space. They recommended training and
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involvement from community members, leaders, and health extension
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workers to raise awareness, increase acceptability, refer cases, and
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reduce stigma. Conclusion: The brief intervention that nonspecialist
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health workers in PHC delivered was acceptable, feasible, and perceived
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to have positive benefits. To extend the impact of the intervention, the
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community needs to be involved to address low awareness and to tackle
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stigma.'
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affiliation: 'Zewdu, S (Corresponding Author), Addis Ababa Univ, Coll Hlth Sci, Sch
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Med, Dept Psychiat, Addis Ababa, Ethiopia.
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Zewdu, Selamawit; Hanlon, Charlotte; Fekadu, Abebaw; Teferra, Solomon, Addis Ababa
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Univ, Coll Hlth Sci, Sch Med, Dept Psychiat,Who Collaborating Ctr Mental Hlth R,
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Addis Ababa, Ethiopia.
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Zewdu, Selamawit, Debre Markos Univ, Coll Hlth Sci, Debre Markos, Ethiopia.
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Hanlon, Charlotte, Kings Coll London, Ctr Global Mental Hlth, Inst Psychiat Psychol
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\& Neurosci, Hlth Serv \& Populat Res Dept, London, England.
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Hanlon, Charlotte; Fekadu, Abebaw, Addis Ababa Univ, Coll Hlth Sci, Ctr Innovat
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Drug Dev \& Therapeut Trials Africa CD, Addis Ababa, Ethiopia.
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Fekadu, Abebaw, Brighton \& Sussex Med Sch, Global Hlth \& Infect Dept, Brighton,
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E Sussex, England.
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Fekadu, Abebaw, Kings Coll London, Ctr Affect Disorders, Inst Psychiat Psychol \&
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Neurosci, London, England.
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Medhin, Girmay, Addis Ababa Univ, Aklilu Lemma Inst Pathobiol, Addis Ababa, Ethiopia.
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Teferra, Solomon, Harvard TH Chan Sch Publ Hlth, Boston, MA USA.'
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article-number: '108636'
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author: Zewdu, Selamawit and Hanlon, Charlotte and Fekadu, Abebaw and Medhin, Girmay
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and Teferra, Solomon
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author-email: dr.selamawit.zewdu@gmail.com
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author_list:
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- family: Zewdu
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given: Selamawit
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- family: Hanlon
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given: Charlotte
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- family: Fekadu
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given: Abebaw
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- family: Medhin
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given: Girmay
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- family: Teferra
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given: Solomon
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da: '2023-09-28'
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doi: 10.1016/j.jsat.2021.108636
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earlyaccessdate: DEC 2021
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eissn: 1873-6483
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files: []
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issn: 0740-5472
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journal: JOURNAL OF SUBSTANCE ABUSE TREATMENT
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keywords: 'Alcohol use disorders; Task-shifting; Brief intervention;
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Implementation; Primary health care; and middle-income countries'
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keywords-plus: SOUTH-AFRICA; PREDICTORS; MAGNITUDE; DISTRICT
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language: English
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month: JAN
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number-of-cited-references: '38'
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orcid-numbers: 'Hanlon, Charlotte/0000-0002-7937-3226
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Medhin, Girmay/0000-0003-2146-4261'
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papis_id: 8dc9186a92b3293aa6c9d1044b97b310
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ref: Zewdu2022weimproved
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researcherid-numbers: 'Hanlon, Charlotte/AAH-7769-2020
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'
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times-cited: '0'
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title: '``We improved our life because I cut my drinking″: Qualitative analysis of
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a brief intervention for people with alcohol use disorder in Ethiopian primary health
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care'
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2023-10-01 08:15:07 +00:00
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type: article
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2023-09-28 14:46:10 +00:00
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unique-id: WOS:000747559800003
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usage-count-last-180-days: '1'
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usage-count-since-2013: '6'
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volume: '132'
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web-of-science-categories: Psychology, Clinical; Substance Abuse
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year: '2022'
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