Background and Aims Screening and brief interventions (SBI) delivered in primary health care (PHC) are cost-effective
in decreasing alcohol consumption; however, they are underused. This study aims to identify implementation strategies
that focus on SBI uptake andmeasure impact on: (1) heavy drinking and (2) delivery of SBI in PHC.Methods Meta-analysis
was conducted of controlled trials of SBI implementation strategies in PHC to reduce heavy drinking. Key outcomes
included alcohol consumption, screening, brief interventions and costs in PHC. Predictor measures concerned single versus
multiple strategies, type of strategy, duration and physician-only input versus that including mid-level professionals.
Standardized mean differences (SMD) were calculated to indicate the impact of implementation strategies on key outcomes.
Effect sizes were aggregated using meta-regression models. Results The 29 included studies were of moderate
methodological quality. Strategies had no overall impact on patients’ reported alcohol consumption [SMD=0.07; 95%
confidence interval (CI)= –0.02 to 0.16], despite improving screening (SMD=0.53; 95% CI=0.28–0.78) and brief intervention
delivery (SMD=0.64;95% CI=0.27–1.02).Multi-faceted strategies, i.e. professional and/or organizational and/or
patient-orientated strategies, seemed to have strongest effects on patients’ alcohol consumption (P<0.05, compared with
professional-orientated strategies alone). Regarding SBI delivery, combining professional with patient-orientated implementation
strategies had the highest impact (P<0.05). Involving other staff besides physicians was beneficial for screening
(P<0.05). Conclusions To increase delivery of alcohol screening and brief interventions and decrease patients’
alcohol consumption, implementation strategies should include a combination of patient-, professional- and
organizational-orientated approaches and involve mid-level health professionals as well as physicians.