Should Drinkaware support IBA?

25 Feb
Whats in your glass kit

Drinkaware’s ‘What’s in your glass?’ kit used in the Berkshire Pharmacy project.

Drinkaware, the industry funded education charity recently held their annual conference and showcased some projects focused on behaviour change. However for several of them I was left wondering ‘where does IBA fit in?’ – a question I think applies more generally to the organisation.

Drinkaware’s activities have come under fire from some groups for not being evidence based, or worse counter productive. Understandable from a policy perspective when ‘educational’ approaches are regarded as among the least effective approaches for reducing alcohol misuse. This is in contrast to IBA, which if delivered well, is probably considered the most effective individual level intervention to affect behaviour change. So why do Drinkaware not recognise it?

On the one hand, it could be argued that IBA as a ‘brief intervention’ is not an educational approach – which Drinkaware cannot extend beyond as a term of their funding. On the other hand, IBA is about supporting informed decision making, so is arguably just a targeted and effective ‘educational approach’. In fact recently Drinkaware included the AUDIT-C on its website which the Chief Exec cited this as one of its recent successes at the conference.

One interesting project claiming to have changed drinking behaviour was something called the ‘What’s in your glass?’ project. Teaming up with Berkshire Public Health,  24,000 ‘What’s in your glass’ kits were distributed by 150 pharmacies across Berkshire. The kits were clearly appealing, well marketed, and … free! The evaluation claimed positive outcomes for people who took the kits, although it used its own questions to assess behaviour change rather than something validated like AUDIT.

But what I couldn’t understand was what should other areas take from this when Pharmacies are increasingly being used as a key opportunity for IBA? I approached the speaker after and she suggested that the kits work well as an engagement tool as staff were often not confident about asking about alcohol. Good point, although shouldn’t we be building Pharmacist’s skills and confidence to ask about alcohol so they realise asking in the right way isn’t a problem? Perhaps there is room for both IBA and ‘engagement tools’, and maybe such tools are even a useful nudge for IBA?

If so, should we welcome such Drinkaware projects that produce resources that might help engage people in alcohol discussion? Although NHS alcohol leaflets can be ordered for free, it does seem as though more access to unit and other resources would support IBA delivery. Or should we be careful of diluting effective IBA with less evidenced ‘educational’ approaches paid for by the industry? Are Pharmacists more likely just to give a ‘What’s in your glass?’ kit to someone and overlook IBA opportunities?

Drinkaware want to build the trust of the health community – perhaps they need to establish an independent working group to decide what Drinkaware’s role is in relation to its projects or resources that may support – or hinder – IBA, and be clear on their position.

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