RESUMEN
BACKGROUND: Several health organizations have adopted the 5A's brief intervention model (Ask, Advise, Assess, Assist, Arrange), based on evidence-based guidelines for smoking cessation. We examine individual, cognitive, behavioral, and organizational factors associated with the 5A's performance among clinical healthcare workers in Catalonia. We also investigate how these factors interact and potentially predict the implementation of each component of the 5A's. METHODS: A cross-sectional survey was conducted among clinical health workers enrolled in an online smoking cessation training course (n = 580). The survey included questions about individual characteristics as well as cognitive, behavioral, and organizational factors previously identified in research. We assessed self-reported performance of the 5A's, assessed on a scale from 0 to 10, and used Multivariate regression to examine factors associated with its performance. RESULTS: The performance means (standard deviation) were moderate for the first 3A's [Ask: 6.4 (3.1); Advise: 7.1 (2.7); Assess: 6.3 (2.8)] and low for the last 2A's [Assist: 4.4 (2.9); Arrange: 3.2 (3.3)]. We observed a high correlation between Assist and Arrange (r = 0.704, p < 0.001). Having positive experiences and feeling competent were positively associated with performing the 5A's model and having organizational support with Assist and Arrange. Personal tobacco use among healthcare workers was negatively associated with Advice and Arrange. CONCLUSIONS: Our study found that clinical healthcare workers do not perform the 5A's completely. The main barriers identified suggest the need of training and making available practical guidelines in healthcare services. Organizational support is essential for moving towards the implementation of Assist and Arrange.
RESUMEN
INTRODUCTION AND AIMS: A website for implementing screening and brief intervention on alcohol was launched in Barcelona, Spain, in October 2006. Its aim was to reach hazardous drinkers who probably would not ask for advice. This article describes use of the site, profiles users and discusses limitations concerning screening. DESIGN AND METHODS: The website included screening, advice and information. Demographic and self-screening data (typical weekly consumption and the Alcohol Use Disorders Identification Test, AUDIT) were examined. RESULTS: In a 12 month period, 12,138 visitors entered the website, 2574 started self-assessment, 1342 completed the table and 724 of these participants completed the AUDIT. These users had a mean age of 27.6 years, one-third of them drank above recommended weekly limits and 84.1% of those who completed the AUDIT (n = 724) scored positive (> or =5); a total of 70.3% of identified at-risk drinkers entered the advice section. Among visitors to the site, risk factors for hazardous drinking were: being male, > or =35 years of age, and drinking heavily at weekends. DISCUSSION AND CONCLUSIONS: The percentage of hazardous drinkers accessing the site was high, and visitors reported that they liked the design, that it was easy to use and that it provided relevant information. Most of those who had sought advice considered it to be helpful. The website seems to be an accessible and useful tool for young people and might be used in youth centres as well as in health-care settings, such as primary care and emergency centres, where it could contribute to health promotion and constitute an easier alternative to screening and brief intervention given by the staff.