Full title: Implementing training and support, financial reimbursement, and referral to an internet-based brief advice program to improve the early identification of hazardous and harmful alcohol consumption in primary care (ODHIN): study protocol for a cluster randomized factorial trial

Authors: Myrna N Keurhorst, Peter Anderson, Fredrik Spak, Preben Bendtsen, Lidia Segura, Joan Colom, Jillian Reynolds, Colin Drummond, Paolo Deluca, Ben van Steenkiste, Artur Mierzecki, Karolina Kłoda, Paul Wallace, Dorothy Newbury-Birch, Eileen Kaner, Toni Gual and Miranda GH Laurant.

The European level of alcohol consumption, and the subsequent burden of disease, is high compared to the rest of the world. While screening and brief interventions in primary healthcare are cost-effective, in most countries they have hardly been implemented in routine primary healthcare. In this study, we aim to examine the effectiveness and efficiency of three implementation interventions that have been chosen to address key barriers for improvement: training and support to address lack of knowledge and motivation in healthcare providers; financial reimbursement to compensate the time investment; and internet-based counselling to reduce workload for primary care providers.