NICE have released new guidance to promote and support individual level behaviour change. The guidance makes seventeen recommendations covering policy, commissioning and practice aspects of implementing individual 'behaviour change' interventions relating to alcohol, diet, physical activity, sex and smoking.
Although 'Behaviour change: individual approaches (PH49)' clearly advocates the importance of brief intervention for all health behaviours, it does not refer explicitly to 'Identification and Brief Advice' (IBA), the most common term for alcohol specific brief intervention in England.
The guidance advocates as recommendation 9 the delivery of very brief, brief, extended brief and high intensity behaviour change interventions and programmes. However questions over the evidence for 'very brief interventions' for alcohol were highlighted by the recent Clarifying Brief Interventions: 2013 update. Although recognising that such 'IBA lite' approaches may be easier to implement, it suggested that full IBA should still be sought as a minimum standard. The NICE guidance is likely to recommend very brief or 'lite' intervention approaches largely on the basis on evidence supporting very brief smoking interventions.
Discussions around improving the delivery of alcohol IBA often include questions over how other behaviours should be addressed. Harmful or risky health behaviours are often closely inter-linked, so front line roles should be able to carry out brief intervention for any of the key health behaviours. This is largely the goal of the 'Making Every Contact Count' (MECC) agenda.
However those championing IBA may point out concerns that alcohol too often gets 'left out', despite alcohol brief intervention probably being the most cost-effective. Practitioners have sometimes reported being less willing to raise the issue of alcohol compared to smoking, diet or exercise. There is some way to go before good quality, individual level behaviour change interventions are routinely carried out, and still lessons to be learned as to what exactly works best.
See here for the Alcohol IBA blog, Alcohol Learning Centre IBA pages, NICE alcohol guidance and NICE Behaviour change: the principles for effective interventions (PH6).
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