Table 6 Key findings for the implementation of interventions

ALCOHOL INTERVENTIONS: Intervention deliverers and training

 Barata et al., (2017) [18]

• Physicians, medical students, mid-level providers, nurses, social workers, psychologists, community outreach workers and health promotion advocates

• Staff training included reading materials about the assessment of adverse consequences of alcohol abuse, structured sessions to teach and practice the principles and techniques of SBIRT; ED staff nurses less fully engaged with SBIRT implementation when the ED was extremely busy

 Diestelkamp et al., (2016) [19]

• Trained counsellors and psychologists or research staff most of whom had received special training (durations ranging from to 30 h)

 Elzerbi et al., (2015) [20]

• Trained nurse, alcohol health worker, research assistants, research social worker, clinical ED staff, psychologist

 Elzerbi et al., (2017) [21]

• Research social worker; Research assistants; Psychologist; Nurse clinician; Peer educators; Clinical ED staff; Alcohol health workers; Health promotion advocates

 Gargaritano et al., (2020) [31]

• ED staff including physicians, nurses, directors, and coordinators

 Kohler & Hofmann (2015) [23]

• Peer educators < 25 years old; bachelor's to master's level staff members with 1 to 2 years of experience; Research social workers; Bachelor’s and master’s level clinicians with previous experience; psychologist junior researchers (post-graduate or Master students) and one senior psychologist; Bachelor’s and master’s level interventionists with 1 to 2 years of clinical research experience

• Training varied and included ‘extensive’ MI training; MI training (~ 24 h) that included readings, viewing videotapes, practicing MI techniques in training sessions led by doctoral and pre-doctoral supervisors, and participating in role-play interviews

 Landy et al., (2016) [24]

• Physicians; nurses; social workers; emergency medical technician (EMTs); Residents; ED clinicians; peer educators; research social workers; research fellows; alcohol health workers; alcohol nurse specialist; psychologists; ED nurse; surgical nurses; surgeons; health promotion advocates; ED staff; degree level staff with 1–2 years’ experience; Master’s level clinicians and students; triage nurses; research staff

 McGinnes et al., (2016) [25]

• Research social workers; Research assistant; Physicians; residents; physician associates; emergency physician; nurses; ED nurses and doctors; Staff nurses; research staff

• Studies that used ED clinicians resulted in a high rate of refusal and significant loss to follow up; when research assistants performed the intervention, follow-up rates approached 80%

 Newton et al., (2013) [26]

• Therapists, computers, peer educators, research team members

 Schmidt et al., (2016) [27]

• External interventionists were employed (mainly research staff), Internal interventionists, ED personnel or trained nurses

Simioni et al., (2015) [28]

• Psychiatrist/social worker; Research assistants; ED Doctors; ED providers

ALCOHOL INTERVENTIONS: Patient acceptance, participation, retention and adherence

 Diestelkamp et al., (2016) [19]

Participation rates (11 studies):

• On average, 68.8% of eligible youth agreed to take part in the BI

• Participation rates ranged from 21.7% to 97.8%

Acceptance (3 studies):

• 75.9% of participants rated their overall impression of the intervention as ‘very good’, ‘good’ or ‘satisfactory’ immediately following the BI

• Participants rated the BI as ‘helpful’; at 1-month follow-up, ratings were slightly lower for perceiving the BI as ‘helpful’

• 77.5% of participants reported they would recommend the BI to a friend in a similar situation; 60% of clinic staff rated the BI programme as being a valuable addition to ED standard care

• Study participants rated counsellor’s perceived empathy, rapport and self-efficacy enhancement with generally positive ratings of 3.7–3.8 on a 4-point scale ranging from 1 (strongly disagree) to 4 (strongly agree)

 Pedersen et al., (2011) [32]

Acceptance:

• Screening acceptance rate: median 83% (range 31–98%)

• Number of patients accepting intervention reported in all 28 studies; however, not all had information on number of eligible AUD patients

• Acceptance rate for intervention among the eligible patients was 67% (21–96%)

• Number needed to screen (NNS) to identify one eligible AUD patient = seven

Adherence:

• All but one trial conducted one or more follow-up visits; one-month follow-up visit—adherence rate was 62% (1 study); adherence rate after three months was 67% (54–96%) (10 studies); after six months 72% (45–89%) (15 studies) and 67% (27–92%) after twelve months

 Schmidt et al., (2016) [27]

Retention rates:

• Range 38 and 89.5%; median 75%

ALCOHOL INTERVENTIONS: Barriers to delivering brief interventions

 Gargaritano et al., (2020) [31]

• Lack of time (76% of studies), personal discomfort through healthcare worker concern about the effect on nurse–patient relationship, or patient demographics (60%), lack of knowledge (60%), lack of resources such as lack of screening tools and referral resources (52%), and patient presentation/condition such as time of injury, altered mental status, or unconscious state (44%)

SMOKING INTERVENTIONS: Intervention time taken

 Pelletier et al., (2014) [34]

Intervention time:

• Time required for a faxed referral intervention alone (3 min)

• Time required for brief advice, approximately 5-min brief advice intervention

• Time required for motivational interviewing-based interventions, reporting a mean intervention time of 37 min

• No study reviewed reported time required for pamphlet administration