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Identifying opportunities for health promotion and intervention in the ED
  1. Simon Robson1,
  2. Andrew Stephenson2,
  3. Colm McCarthy2,
  4. David Lowe3,
  5. Ben Conlen3,
  6. Alasdair James Gray2,4
  1. 1Department of Emergency Medicine, The University of Edinburgh, Edinburgh Medical School, Edinburgh, UK
  2. 2Department of Emergency Medicine, Royal Infirmary of Edinburgh, Edinburgh, UK
  3. 3Emergency Department, Queen Elizabeth University Hospital, Glasgow, UK
  4. 4Emergency Medicine Research Group Edinburgh (EMERGE), Royal Infirmary of Edinburgh, Edinburgh, UK
  1. Correspondence to Simon Robson, The University of Edinburgh, Edinburgh Medical School, Edinburgh EH8 9YL, UK; simatrob3{at}


Background ED staff assess patients with modifiable risk factors for acute and chronic illness. Health promotion interventions delivered in the ED have been advocated for these patients. The engagement of staff is essential to provide effective screening and brief interventions for patients. This survey aimed to assess if staff support the ED as an environment for health promotion.

Methods A multicentre, structured survey was conducted in four EDs in Scotland from 2017 to 2018. Physician and nursing staff at two teaching and two district general hospitals (n=423) were study eligible and offered a multicomponent survey. Outcomes measured included perceived barriers to practice and risk factor specific ED interventions.

Results Of the 283 respondents, 116 (41%) were physicians and 167 (59%) were nurses. More physicians (86.1%) than nurses (49.7%) reported offering health promotion interventions. Time constraints and a lack of health promotion infrastructure in the ED were cited as challenges to intervention delivery. Staff believed that alcohol (n=170/283, 60.1%) and drug misuse (n=173/283, 61.1%) were more appropriately managed in the ED than primary care. ED staff believed same day brief interventions were more appropriate when alcohol/drug misuse and smoking were directly related to ED presentations.

Discussion and conclusions Staff support the concept of the ED as a potential environment for offering health promotion interventions. ED physicians and nurses have different perspectives on the delivery of health promotion. The role of the ED in health promotion is likely to be multimodal and dependant on the reason for ED attendance.

  • emergency department
  • emergency care systems
  • admission avoidance
  • emergency care systems
  • emergency departments
  • emergency department management

Statistics from


  • Handling editor Roland Merchant

  • Contributors AJG planned the study. SR, AG and DL formulated the survey. SR, AJG, AS, CMC and BC conducted data retrieval. SR wrote the main article. AJG, DL and CMC reviewed the article. SR submitted the study.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval University of Edinburgh Student Research Ethics assessment process.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available upon reasonable request. The data consist of deidentified participant data. Data availability and reuse is available on reasonable request from the corresponding author (

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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