Dataset Information

Alcohol consumption in Spanish primary health care providers: a national, cross-sectional study.

ABSTRACT: AIM:To estimate the prevalence of alcohol consumption and analyse the drinking patterns among primary healthcare (PHC) providers. DESIGN:Observational, cross-sectional, descriptive study. SETTING:PHC centres in the Spanish National Health System (SNHS). PARTICIPANTS:Doctors and nurses who completed an online questionnaire which explored their alcohol intake, using the Alcohol Use Disorders Identification Test (AUDIT-C) alcohol assessment tool. The study population was recruited by random sampling stratified by regions of the SNHS PHC centres. PRIMARY AND SECONDARY OUTCOME MEASURES:Frequency of alcohol consumption, number of alcohol drinks on a typical day, frequency of more than six standard drinks (SDs) intake. RESULTS:A total of 1760 PHC providers completed the questionnaire. The frequency of alcohol consumption was: abstention (12%, 95%?CI 10.4% to 13.5%); one or less SDs/month (26%, 95%?CI 23.8% to 27.9%); 2-4 SDs/month (32.2%, 95%?CI 29.7% to 34.1%); 2-3 SDs/week (17.9%, 95%?CI 16.0% to 19.6%); four or more SDs/week (11.9%, 95%?CI 10.3% to 13.3%). The number of drinks on a typical day was: none (45.6%, 95%?CI 42.9% to 47.6%); 1-2 drinks (47.3%, 95%?CI 23.8% to 27.9%); 3-4 drinks (6.5%, 95%?CI 5.3% to 7.6%). The percentage of hazardous drinking, according to AUDIT-C criteria, was 32% (95% CI 26.7 to 37.3), with a greater frequency of intake in older professionals (p<0.001), in contrast to a higher number of drinks consumed on a typical day by younger providers (p<0.001). Intake was higher among males (p<0.001), primary care physicians (p<0.001) and resident trainers (p<0.001). CONCLUSIONS:Our study discloses the most up-to-date portrait of current alcohol consumption among Spanish PHC providers, showing a higher prevalence of alcohol intake, compared with the general population. Preventive strategies should be implemented to improve the awareness and training of PHC professionals towards alcohol consumption.

SUBMITTER: Romero-Rodriguez E

PROVIDER: S-EPMC6377550 | biostudies-literature | 2019 Feb

REPOSITORIES: biostudies-literature

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Alcohol consumption in Spanish primary health care providers: a national, cross-sectional study.

Romero-Rodríguez Esperanza E Pérula de Torres Luis Ángel LÁ Fernández García José Ángel JÁ Parras Rejano Juan Manuel JM Roldán Villalobos Ana A Camarelles Guillén Francisco F

BMJ open 20190219 2

<h4>Aim</h4>To estimate the prevalence of alcohol consumption and analyse the drinking patterns among primary healthcare (PHC) providers.<h4>Design</h4>Observational, cross-sectional, descriptive study.<h4>Setting</h4>PHC centres in the Spanish National Health System (SNHS).<h4>Participants</h4>Doctors and nurses who completed an online questionnaire which explored their alcohol intake, using the Alcohol Use Disorders Identification Test (AUDIT-C) alcohol assessment tool. The study population wa ...[more]

PMID: 30782898

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Project description:BackgroundHealth professionals' training is a key element to address unhealthy alcohol use in Primary Care (PC). Education about alcohol use can be effective in improving PC provider's knowledge and skills addressing alcohol-related problems. The aim of the study was to evaluate the training of health professionals to address unhealthy alcohol use in PC.MethodsAn observational, descriptive, cross-sectional, multicenter study was performed.LocationPC centres of the Spanish National Health System (SNHS).ParticipantsFamily physicians, residents and nurses completed an online questionnaire that inquired about their training (none, basic, medium or advanced), knowledge and preventive practices aimed at reducing unhealthy alcohol use. The study population was recruited via random sampling, stratified by the regions of the SNHS's PC centre, and by email invitation to members of two Spanish scientific societies of Family Medicine.ResultsA total of 1760 professionals participated in the study. Sixty-seven percent (95% CI: 67.5-71.8) reported not having received specific training to address unhealthy alcohol use, 30% (95% CI: 27.4-31.7) reported having received basic training, and 3% (95% CI: 2.3-4.0) medium/advanced training. The training received was greater in younger providers (p < 0.001) who participated in the PAPPS (Preventive Activities and Health Promotion Programme) (p < 0.001). Higher percentages of providers with intermediate or advanced training reported performing screening for unhealthy alcohol use (p < 0.001), clinical assessment of alcohol consumption (p < 0.001), counselling of patients to reduce their alcohol intake (p < 0.001) or to abstain, in the cases of pregnant women and drivers (p < 0.001).ConclusionOur study reveals a low level of training among Spanish PC providers to address unhealthy alcohol use. A higher percentage of screening, clinical assessment and counselling interventions aimed at reducing unhealthy alcohol use was reported by health professionals with an intermediate or advanced level of training.

Project description:BackgroundIntegrated dental services within the Health System, particularly at primary health care, are crucial to reverse the current impact of oral diseases, which are among the most prevalent diseases worldwide. However, the use of dental services is determined by complex phenomena related to the individual, the environment and practices in which care is offered. Therefore, factors associated with dental appointments scheduling can affect positively or negatively the use of dental services. The aim of the present study was to evaluate the indicators for dental appointment scheduling in Primary Health Care (PHC).MethodsThe present is a cross-sectional analytical study that used data from the external assessment of the third cycle of the National Program for Improving Access and Quality in Primary Care (PMAQ-AB), carried out between 2017 and 2018, in Brazil. The final sample consisted of 85,231 patients and 22,475 Oral Health teams (OHTs). The outcome variable was the fact that the user sought for a dental appointment at the Primary Health Care Unit. A multilevel analysis was carried out to verify the association between individual variables (related to users) and contextual variables (related to the OHTs) in relation to the outcome.ResultsOnly 58.1% of the users interviewed at these Primary Health Care Units seek the available dental care. The variables with the greatest effect on the outcome were the patient's age up to 42 years old (OR = 2.03, 95% CI: 1.96-2.10), at individual level, and 'oral health teams that assisted no more than a single family health team (FHT)' (OR = 1.29, 95% CI: 1.23-1.36) at contextual level. Other variables were also associated with the outcome, but with a smaller effect size.ConclusionIn conclusion, users' age and work process of OHT were indicators for dental appointment scheduling. Our results suggest that when OHT put the National Oral Health Policy guidelines into practice, by assisting only one FHT, the chance for PHC users seeking dental appointments is higher than OHTs that assist more than one FHT. Regarding age, patients aged up to 42 years are more likely to seek an appointment with a dentist.

Project description:BACKGROUND: In South Africa, providers are trained on post-rape care by a multitude of organisations, resulting in varied knowledge and skills. In 2007, a national training curriculum was developed and piloted in the country. The objectives of this paper are to identify the factors associated with higher knowledge and confidence in providers at the commencement of the training and to reflect on the implications of this for training and other efforts being made to improve services. METHODS: A cross-sectional study using questionnaires was conducted. Providers who attended the training provided information on socio-demographic background, service provision, training, attitudes, and confidence. Knowledge was measured through multiple choice questions. Bi-variable analysis was carried out in order to test for factors associated with high knowledge and confidence. Variables with a p value of <0.20 were then included in backward selection to develop the final multivariable models. RESULTS: Of the 124 providers, 70% were female and 68% were nurses. The mean age of the providers was 41.7 (24 - 64) years. About 60% of providers were trained in providing post-rape care. The median percentage knowledge score was 37.3% (0% - 65.3%) and the median percentage confidence score was 75.4% (10% - 100%). Having a more appropriate attitude towards rape was associated with higher knowledge, while older providers and nurses had lower odds of having high knowledge levels. Working in a crisis centre in the facility, having examined a survivor in the last 3 months, and seeing more than 60% of survivors who came to the facility were associated with higher confidence. Higher confidence was not associated with greater knowledge. CONCLUSION: The study indicated that although confidence was high, there was poor knowledge in providers, even in those who were previously trained. Knowledge seems to be critically dependant on attitude, which highlights the need for educating providers on rape and the seriousness of the problem. There is a need to train more providers in post-rape care in country, and to ensure that training is comprehensive, and that providers who are trained remain knowledgeable and skilled in current best practices.

Project description:BackgroundImplementation of interventions for the prevention of mother-to-child transmission (PMTCT) of HIV in low- and middle-income countries, faces several barriers including health systems challenges such as health providers' knowledge and use of recommended guidelines. This study assessed PMTCT providers' knowledge of national PMTCT guideline recommendations in Lagos, Nigeria.MethodsThis was a cross-sectional survey of a purposive sample of twenty-three primary health care (PHC) centers in the five districts of Lagos, Nigeria. Participants completed a self-administered 16-item knowledge assessment tool created from the 2016 Nigeria PMTCT guidelines. Research Electronic Data Capture (REDCap) was used for data entry and R statistical software used for data analysis. The Chi square test with a threshold of P < 0.05 considered as significant was used to test the hypothesis that at least 20% of service providers will have good knowledge of the PMTCT guidelines.ResultsOne hundred and thirteen (113) respondents participated in the survey. Most respondents knew that HIV screening at the first prenatal clinic was an entry point to PMTCT services (97%) and that posttest counselling of HIV-negative women was necessary (82%). Similarly, most respondents (89%) knew that early infant diagnosis (EID) of HIV should occur at 6-8 weeks of life (89%). However, only four (3.5%) respondents knew the group counselling and opt-out screening recommendation of the guidelines; 63% did not know that haematocrit check should be at every antenatal clinic visit. Forty-eight (42.5%) service providers had good knowledge scores, making the hypothesis accepted. Knowledge score was not influenced by health worker cadre (p = 0.436), training(P = 0.537) and professional qualification of ≤5 years (P = 0.43).ConclusionService providers' knowledge of the PMTCT guidelines recommendations varied. The knowledge of group counselling and opt-out screening recommendations was poor despite the good knowledge of infant nevirapine prophylaxis. The findings highlight the need for training of service providers.

Project description:BackgroundAdvance care planning (ACP) is a process intended to help ensure people receive medical care that is consistent with their values, goals, and preferences during serious and chronic illness. Barriers to implementing ACP in primary care settings exist. Community-led ACP initiatives exist in British Columbia to engage the public directly. These initiatives may help prepare people for conversations with their primary care providers. The objectives of this study were to elicit primary care providers' perceptions of the utility and desired content of community-led ACP activities and suggestions for integrating community-led ACP activities with primary care.MethodsWe conducted an online cross-sectional survey of primary care providers practicing in British Columbia, Canada in 2021. Both quantitative and qualitative survey questions addressed ACP engagement in practice, the perceived role and desired outcomes of community-led ACP activities, and ways to integrate community-led ACP activities with primary care.ResultsEighty-one providers responded. Over 80% perceived a moderate or greater potential impact of community-led ACP activities. The most common reasons for not referring a patient to a community-led ACP activity were lack of awareness of the option locally (62.1%) and in general (44.8%). Respondents wanted their patients to reflect on their values, wishes and preferences for care, to have at least thought about their goals of care and to have chosen a substitute decision maker in the community. They indicated a desire for a summary of their patient's participation and a follow-up discussion with them about their ACP. They suggested ways to integrate referral to programs into existing health care system structures.ConclusionsCommunity-led ACP activities were perceived to be useful to engage and prepare patients to continue ACP discussions with clinicians. Efforts should be made to establish and integrate community-based ACP initiatives within existing primary care systems to ensure awareness and uptake.

Project description:BackgroundCardiac Infarction/Injury Score (CIIS), an electrocardiographic based scoring system, is a surrogate marker of subclinical myocardial injury (SC-MI) and has shown excellent prognostic value in predicting future cardiovascular mortality. As an association of mild to moderate alcohol consumption with cardiovascular disease (CVD) is conflicting, using an electrocardiographic based scoring system such as CIIS is a simple and cost-effective way to investigate this controversial relationship.MethodsThis analysis included 6090 participants (58.42±13.12 years, 54.2% women) free of CVD from the Third National Health and Nutrition Examination Survey (NHANES III). We used multivariable linear regression analysis to examine the cross-sectional association between each alcohol category (non-drinker (reference), 1-6 drinks/week, 7-13 drinks/week, ≥14 drinks/week, and CIIS. SC-MI was defined as CIIS ≥10 units.ResultsThe prevalence of SC-MI was high among heavy drinkers (≥14 drinks/week) and was lower in participants who were moderate drinkers (7-13 drinks/week). There was a statistically significant and inverse association between moderate alcohol consumption and CIIS (β (95% CI): -0.64 (-1.27, -0.007), P = 0.04) using multivariable linear regression analysis. This inverse association between moderate alcohol consumption and CIIS was more striking among whites compared to non-whites (β (95% CI): -1.06 (-1.93, -0.19) vs. 0.05 (-0.91, 1.00) respectively; interaction p-value = 0.08). Also, the association was stronger among women and older participants, however interaction p-value did not reach statistical significance.ConclusionThere is an inverse association between moderate alcohol consumption and CIIS in participants without manifestations of CVD. As lower CIIS has been associated with low risk of poor outcomes including CVD mortality, these findings further support the existing evidence of the potential benefits of moderate alcohol consumption on cardiovascular health.

Dataset Information

Alcohol consumption in Spanish primary health care providers: a national, cross-sectional study.

Publications

Alcohol consumption in Spanish primary health care providers: a national, cross-sectional study.

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