Factors Influencing Patient Receptivity to Brief Alcohol Interventions in Primary Care: An Application of Conjoint Analysis

Abstract

Background: Brief alcohol interventions (BAIs) are an evidence-based practice for addressing hazardous alcohol use in primary care settings. However, numerous barriers to implementation of BAIs in routine practice have been identified, including concerns about patient receptivity to BAIs. Despite this being a commonly identified barrier to BAI implementation, little BAI implementation research has focused on patient receptivity. Objectives: This study aimed to identify the treatment preferences of primary care patients who screened positive for hazardous alcohol use and to evaluate factors that may influence patients’ receptivity to BAIs delivered in primary care. We conducted a mailed survey of primary care patients (N = 245) who screened positive for hazardous alcohol use on annual screening measures based on electronic medical record data. Patients completed measures assessing treatment preferences and a conjoint analysis questionnaire designed to evaluate the relative importance of three factors (focus of the BAI, tailoring of the BAI, and familiarity with the provider delivering the BAI) for patient receptivity. Results: Conjoint analysis results revealed that familiarity with provider (with patients preferring BAIs delivered by providers they have previously met) was the most important factor in predicting patients’ receptivity to BAIs. Additionally, patients preferred to discuss alcohol use in the context of another concern (focus of the BAI) and preferred personalized information tailored based on their specific health concerns (tailoring of the BAI), although these factors were not statistically significant when accounting for familiarity with provider. Conclusions: Findings of the present study have potential to inform future research on implementation of BAIs.

Keywords:

• Primary care
• brief alcohol interventions
• conjoint analysis
• patient receptivity

Acknowledgments

The authors wish to thank the research staff within the Center for Integrated Healthcare SERVICE lab for help in conducting this research and preparation of this manuscript. A portion of the results presented in this article were presented at the 2022 Research Society on Alcoholism annual meeting.

Disclosure statement of interest

The authors report no conflicts of interest. The views expressed in this article are those of the authors and do not represent the position or policy of the Department of Veterans Affairs or the United States government.

Additional information

Funding

This research was supported by the VA Center for Integrated Healthcare Pilot Grant Program and the VA Office of Academic Affiliations Advanced Fellowship Program in Mental Illness Research and Treatment. Dr. Gass is supported by the Department of Veterans Affairs, Veterans Health Administration, Health Services Research and Development Service (HSR&D) Career Development Award-2 (Grant IK2 HX002610). Center for Integrated Healthcare, U.S. Department of Veterans Affairs;