abstract: 'Background: Despite global recommendations that brief, task-shared

  interventions are effective for addressing problematic alcohol use in

  primary health care (PHC), low-income countries have made few attempts

  to implement and scale-up these interventions. Aim: To explore

  perspectives and experiences of service users and providers on a brief

  intervention (BI) for alcohol use disorders (AUDs) delivered by

  nonspecialist health workers who are health officers and clinical nurses

  in PHC in a rural Ethiopian district. Methods: The study team conducted

  a qualitative study, comprising in-depth interviews with 26 purposively

  selected participants. The participants were 14 people who had been

  screened for probable AUD and were receiving the brief intervention;

  four caregivers without any intervention; and eight nonspecialist health

  workers who provided a single session brief intervention at four primary

  care health centers in Sodo district, south Ethiopia. The study used

  framework analysis. We grouped findings into five themes: acceptability,

  engagement in and barriers to care, implementation of the service,

  perceived impact of the BI, and unmet needs and expectations. Results:

  Participants perceived the intervention to be useful, and it was

  well-accepted by most service users and relatives. Participants reported

  reductions in alcohol consumption and benefits in terms of their

  capacity to work, increased earnings, less money wasted, and ability to

  provide for their families. However, most did not attend follow-up

  visits, often influenced by the belief that they did not have a serious

  problem and could handle it alone. Some did not believe AUDs to be

  treatable; others did not attend because of lack of money for

  transportation and stigma from peers. Providing BI did not affect PHC

  workers'' routine work. However, they noticed a reluctance from people

  with probable AUD to speak openly about their drinking, and they were

  constrained by a shortage of space. They recommended training and

  involvement from community members, leaders, and health extension

  workers to raise awareness, increase acceptability, refer cases, and

  reduce stigma. Conclusion: The brief intervention that nonspecialist

  health workers in PHC delivered was acceptable, feasible, and perceived

  to have positive benefits. To extend the impact of the intervention, the

  community needs to be involved to address low awareness and to tackle

  stigma.'
affiliation: 'Zewdu, S (Corresponding Author), Addis Ababa Univ, Coll Hlth Sci, Sch
  Med, Dept Psychiat, Addis Ababa, Ethiopia.

  Zewdu, Selamawit; Hanlon, Charlotte; Fekadu, Abebaw; Teferra, Solomon, Addis Ababa
  Univ, Coll Hlth Sci, Sch Med, Dept Psychiat,Who Collaborating Ctr Mental Hlth R,
  Addis Ababa, Ethiopia.

  Zewdu, Selamawit, Debre Markos Univ, Coll Hlth Sci, Debre Markos, Ethiopia.

  Hanlon, Charlotte, Kings Coll London, Ctr Global Mental Hlth, Inst Psychiat Psychol
  \& Neurosci, Hlth Serv \& Populat Res Dept, London, England.

  Hanlon, Charlotte; Fekadu, Abebaw, Addis Ababa Univ, Coll Hlth Sci, Ctr Innovat
  Drug Dev \& Therapeut Trials Africa CD, Addis Ababa, Ethiopia.

  Fekadu, Abebaw, Brighton \& Sussex Med Sch, Global Hlth \& Infect Dept, Brighton,
  E Sussex, England.

  Fekadu, Abebaw, Kings Coll London, Ctr Affect Disorders, Inst Psychiat Psychol \&
  Neurosci, London, England.

  Medhin, Girmay, Addis Ababa Univ, Aklilu Lemma Inst Pathobiol, Addis Ababa, Ethiopia.

  Teferra, Solomon, Harvard TH Chan Sch Publ Hlth, Boston, MA USA.'
article-number: '108636'
author: Zewdu, Selamawit and Hanlon, Charlotte and Fekadu, Abebaw and Medhin, Girmay
  and Teferra, Solomon
author-email: dr.selamawit.zewdu@gmail.com
author_list:
- family: Zewdu
  given: Selamawit
- family: Hanlon
  given: Charlotte
- family: Fekadu
  given: Abebaw
- family: Medhin
  given: Girmay
- family: Teferra
  given: Solomon
da: '2023-09-28'
doi: 10.1016/j.jsat.2021.108636
earlyaccessdate: DEC 2021
eissn: 1873-6483
files: []
issn: 0740-5472
journal: JOURNAL OF SUBSTANCE ABUSE TREATMENT
keywords: 'Alcohol use disorders; Task-shifting; Brief intervention;

  Implementation; Primary health care; and middle-income countries'
keywords-plus: SOUTH-AFRICA; PREDICTORS; MAGNITUDE; DISTRICT
language: English
month: JAN
number-of-cited-references: '38'
orcid-numbers: 'Hanlon, Charlotte/0000-0002-7937-3226

  Medhin, Girmay/0000-0003-2146-4261'
papis_id: 8dc9186a92b3293aa6c9d1044b97b310
ref: Zewdu2022weimproved
researcherid-numbers: 'Hanlon, Charlotte/AAH-7769-2020

  '
times-cited: '0'
title: '``We improved our life because I cut my drinking″: Qualitative analysis of
  a brief intervention for people with alcohol use disorder in Ethiopian primary health
  care'
type: article
unique-id: WOS:000747559800003
usage-count-last-180-days: '1'
usage-count-since-2013: '6'
volume: '132'
web-of-science-categories: Psychology, Clinical; Substance Abuse
year: '2022'