Archive | October, 2015

Briefing on IBA & LGBT people – a key group to ‘target’?

9 Oct

LGBT IBAA short briefing highlights the potential for IBA to reduce alcohol related harm amongst lesbian, gay, bisexual and transgender (LGB&T) people. It describes LGBT groups as a ‘high-risk group’ for alcohol misuse given research that shows higher prevalence.

The briefing provides a short background of IBA as a short alcohol intervention, and considerations for ensuring IBA can reach LGBT people. For those already seeking IBA implementation, it may highlight another setting or area to consider engaging front line roles with training and support, or opportunity to build IBA into service commissioning.

Of course the debate about which wider settings should IBA be sought in goes on, and the challenges may not be wholly different from many other settings where IBA is sought. At the same time, it urges all staff delivering IBA to ‘ensure their approach is culturally sensitive and LGB & T-inclusive’, given discrimination that LGB&T service users often report when using mainstream services.

The briefing though may be of most use in encouraging LGBT specific services to incorporate IBA as something to potentially benefit their service users. As the briefing advises, ‘IBAs can readily be incorporated into initial screening and triage for new service users; into case or care plan reviews with existing service users; or into outreach interventions in LGBT social settings.’

Of course any practitioner delivering IBA should show key skills that both underpin brief intervention and non-judgmental person-centred approaches relevant for ensuring people of any sexual orientation feel well treated . The reality though is that more training, support and resources are needed for quality IBA to be adopted more widely. And with LGBT people likely to make up between 1.5 – 7% of the adult population, as a ‘high risk’ group for alohol misuse it makes sense to support LGBT services specifically in IBA delivery.

 

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IBA and the wider ‘workforce’ – will it happen?

2 Oct

Wider workforce RSPHEarlier this year the Royal Society for Public Health (RSPH) generated headlines following a report saying  ‘15 million workers including firemen, hairdressers and postal workers could form part of “wider public health workforce”.’

With the ‘core’ public health workforce totalling only 40,000 people, they are unlikely to be able to deliver widespread health behaviour interventions to much of the population. As such, the report calls for anyone who has “the opportunity or ability to positively impact health and wellbeing through their work” to join the wider public health workforce.

Whilst the media focused on the idea of bar maids and hairdressers giving out health ‘tips’, it’s certainly true that many areas have sought to extend well beyond healthcare for IBA delivery. A recent review into IBA in non-health settings found settings like schools, criminal justice, pharmacies and universities have shown promise in terms of the feasibility of IBA delivery, although most of these wider settings including the workplace still lacked evidence.

Healthy conversations

“Healthy conversations”

Another report from the RSPH, ‘Healthy Conversations and the Allied Health Professionals’, highlights Allied Health Professionals (AHPs) as an auxiliary Public Health workforce of around 170,000, made up of 12 professions including Physiotherapists, Occupational Therapists, paramedics and dietitians.

The AHP workforce certainly seem a realistic workforce for delivering brief interventions than perhaps hairdressers or posties, and indeed some areas have already been seeking to engage AHP roles in IBA. The report itself specifically gives some examples of AHPs delivering alcohol IBA or other support, and also some insights into AHP’s attitudes and experiences.

Of particular note may be the findings on AHP’s confidence to discuss different ‘health conversations’ by topic. This may be of relevance given that barriers to delivering alcohol IBA are often related to patient or practitioner beliefs about alcohol. In some areas ‘Making Every Contact Count’ (MECC) approaches have been adopted to try to facilitate widespread health conversations, but the level of alcohol IBA activity specifically is unclear.

Indeed it seems that when compared to smoking, diet, exercise and weight, AHP’s felt more confident to discuss these than alcohol. However AHPs did feel more confident to discuss alcohol than areas such as dementia, domestic violence or sexual health, though perhaps unsurprising.

Wider workforce RSPH

What does this mean for IBA? We know alcohol brief intervention is effective, and possibly more so than for other health topics. But it may also be that quality alcohol brief interventions may be at risk of getting lost or diluted within the wider ‘healthy conversations’ agenda.