Implementación del consejo breve para la reducción del uso de alcohol y tabaco en el primer nivel de atención: un estudio cualitativo

Abstract
Introduction: in Mexico, tobacco and alcohol consumption represent a public health problem. Screening, brief intervention, and treatment models had shown effectiveness to reduce substances use, which is why they have been widely used in a variety of settings. The proximity of trained human resources with consumption problems and diverse situations is one of the most important opportunities they offer. Despite the extensive experience in developing these models, they have been poorly adapted for use by medical and health personnel at the first level of care. Objective: describe barriers and opportunities encountered during the operational implementation of a pilot project for screening, brief counseling and treatment aimed at medical personnel and related to the first level of health care in a Sanitary Jurisdiction of the State of Mexico. Method: two focus groups were carried out on a randomized sample of 15 of 64 certified health professionals who developed practical experience performing interventions with the population of their Health Establishment. Results: communication, personal and organizational barriers were found, however, opportunities that emerged from the implementation of this intervention model were also identified. Discussion and conclusions: the implementation of these interventions in the first level of care has various advantages for the personnel who apply them and the population that receives it, among which the increase in productivity of the screening and brief counseling actions reported in the System of Health Information as well as the opportunity to provide the user a personalized intervention specifically focused on their local population-based problems.