As the SCALA project progresses, you will be able to access all resources and outputs generated by the project, including: publications, reports, presentations, and videos. A number of audiovisual materials developed in Spanish are also available on the Spanish language outputs page.

Main Scala findings

The SCALA Study – tailoring a primary health care programme for alcohol and co-morbid depression:

Tailoring the SCALA programme to local contexts in Perú, Colombia and Mexico:

The SCALA Project in Latin America – Experiences, challenges and lessons from Peru, Colombia and Mexico.

The SCALA Project Outcomes – Can we improve alcohol and depression measurement in primary health care?

The Economic Outcomes – Is it worth investing in alcohol measurement in primary health care?


  • Amy O`Donnell, Bernd Schulte, Jakob Manthey, Christiane Sybille Schmidt, Marina Piazza, Ines Bustamante Chavez, Guillermina Natera, Natalia Bautista Aguilar, Graciela Yazmín Sánchez Hernández, Juliana Mejía-Trujillo, Augusto Pérez-Gómez, Antoni Gual, Hein de Vries, Adriana Solovei, Dasa Kokole, Eileen Kaner, Jurgen Rehm, Peter Anderson and Eva Jane Llopis (2021) Primary care-based screening and management of depression amongst heavy drinking patients: Interim secondary outcomes of a three-country quasi-experimental study in Latin America. Published in press.

SCALA project reports


RAI. Reunión Anual de investigación del Instituto Nacional de Psiquiatría Ramón de la Fuente, Cuidad de Mexico, October 1st, 2021

  • Natalia Bautista Aguilar, Perla Sonia Medina Aguilar, Guillermina Natera Rey, Miriam Arroyo Alejandra Pérez, Sergio Hernández - La gente no va a dejar de tomar por un consejo". Creencias del personal de salud sobre el consumo y la implemenatción de un programa de detección y consejo breve en APS.

  • SCALA Workshop, INEBRIA conference, Lübeck, September 1st, 2021

  • Guillermina Natera, Perla Medina, Jakob Manthey, Dasa Kokole, Eva Jane, Peter Anderson, Miriam Arroyo, Alejandra Pérez - The impact of COVID-19 on alcohol measurement rates in primary health care (PHCCUs) in Mexico.

  • 21st WPA World Congress of Psychiatry, Online August 1st, 2021

  • Natalia Bautista Aguilar, Perla Sonia Medina Aguilar, Janeth Karina Ruíz González, José Antonio, Orozco Mata, Daniela Ríos Alonso, Sergio Alfredo Hernández Hernández, Guillermina Natera Rey - Health personnel' beliefs about the consuption of alcohol in the first level of care.

  • PHCC Jalalpa, Online July 15th, 2021

  • Miriam Arroyo - Alcohol en el embarazo.

  • The Pan American Health Organization (PAHO), SCALA Project: Implementing an Intervention for Alcohol Use Disorders in Latin America, June 28th, 2021

  • Peter Anderson, University of Newcastle, UK and University of Maastricht, Netherlands - The role of primary health care in reducing alcohol consumption

  • Jürgen Rehm, Center for Addiction and Mental Health, PAHO/WHO Collaborating Center, Toronto, Canada - SCALA in the global context. Implementation of screening and brief interventions, costs and benefits

  • Augusto Pérez and Juliana Mejía, Nuevos Rumbos, Colombia - SCALA in Colombia: challenges and achievements.

  • Marina Piazza and Inés Bustamante, Universidad Peruana Cayetano Heredia - Telemedicine and brief intervention of alcohol use disorders in primary care in times of COVID: SCALA project in Peru.

  • Guillermina Natera and Perla Medina, PAHO/WHO Collaborating Center Instituto Nacional de Psiquiatria Ramon de la Fuente Muniz, Mexico D.F., Mexico - From theory to practice, lessons learned. The SCALA experience of Mexico.

  • Peter Anderson, University of Maastricht, Netherlands- Outlook: beyond the implementation period.

  • RAI. Reunión Anual de investigación del Instituto Nacional de Psiquiatría Ramón de la Fuente, August 10th, 2020

  • Arroyo Belmonte Miriam, Natera Rey Guillermina, Sánchez Hernández Graciela Yazmín, Pérez de León Alejandra, Bautista Aguilar Natalia, Medina Aguilar Perla Sonia, López Marroquín Scherezada, Hernández - Poster: Estrategia DIT en el primer nivel de atención para la prevención del consumo de alcohol: factores que favorecen la implementación.

  • INEBRIA conference, Online September 25th, 2020

  • Guillermina Natera - La COVID, el alcohol y la depresión: ¿Qué pasó en México en el primer nivel de atención y las DIT, durante la pandemia?

  • XVII Cayetano Heredia Research Meeting – EPICAH, Lima, Perú, JULY 23rd, 2020

  • Marina Piazza, Inés Bustamante, Liz Valentín - Opportunities and challenges in the implementation in primary care of an intervention to identify and reduce alcohol consumption problems in Colombia, Mexico, and Peru.

  • RAI. Reunión Anual de investigación del Instituto Nacional de Psiquiatría Ramón de la Fuente, October 11th, 2020

  • Arroyo Belmonte Miriam, Natera Rey Guillermina, Medina Aguilar Perla Sonia, Pérez De León Alejandra, López Marroquín Scherezada, Bautista Aguilar Natalia - Poster: ¿Es difícil incorporar la detección e intervención breve del consumo de alcohol en el primer nivel de atención?: Necesidades y creencias del personal de salud.

  • Conmemoración del Día Nacional contra el uso nocivo de bebidas alcohólicas, Mexico, November 14th, 2019

  • Guillermina Natera - Implementación de la detección oportuna del consumo de alcohol y depresión en el primer nivel de atención: una investigación internacional.

  • SCALA Workshop, INEBRIA conference, Lübeck, September 26th, 2019


    Audiovisual material

    Each municipality in the SCALA study has developed audiovisual communication material with the aim of raising awareness about common problems related to alcohol and reducing the stigma of talking about alcohol problems, in order to increase screening, detection of problems and disclosure of information.

    PERU - Images, videos and radio spots related to 3 key themes: tuberculosis, unprotected sex and violence

    Perú alc infographic pic

    Perú Póster TB     Perú Póster ITS     Perú Póster violencia

    Peru - Videos:

    Peru - Radio spots:

    Peru - Peruvian versions of Mexican materials

    Alcohol y riesgo COVID   Covid 19 y alcohol   Cuarentena y consumo de alcohol   Durante la cuarentena

    Alcohol y Violencia Familiar  Baja tu consumo de alcohol mujer  Baja tu consumo de alcohol varón  Beneficios de bajar consumo  

    Bebida estándar  Habla con tus hijos  Reduce tu consumo 2

    Salud del Varón y el alcohol   Salud de la Mujer y el alcohol   Salud Mental y alcohol   Tips para reducir consumo en pandemia

    COLOMBIA - 2 types of videos - 1) short tutorials or 'capsules' explaining key definitions and ideas, and 2) videos with messages integral to the intervention on alcohol and depression

    Colombia - Capsules - standard drinks + signs of depression

    Colombia - Videos - various messages about alcohol, the risks of drinking and indicators of an alcohol problem

  • Colombia - Posters: 

  • COL Picture1   COL Picture2   COL Picture3   COL Picture4


    COL Picture5   COL Picture6   COL Picture7   COL Picture8


    COL Picture9   Evita consumo exesivo poster   usted puedes hablar poster


        MEXICO - Infographics and videos with messages related to alcohol and depression, including the importance of reducing alcohol consumption to prevent COVID-19 infection

        Mexico - Infographics

        Alcohol 1  Alcohol 2  Alcohol 3  

        Alcohol 4  Alcohol 5  Alcohol 6

        Alcohol 7  Alcohol 8  Alcohol 9

        Alcohol 10   Alcohol 11  Alcohol 12

        Alcohol 13  Alcohol 14  Alcohol 15

        Alcohol 16  Alcohol 17  Alcohol 18

        Alcohol 19  Alcohol 20  Alcohol 21


        Mexico - Videos - various messages about alcohol, weekly recommended limits and teh additional risk of drinking during confinement due to the COVID pandemic



    The English versions of SCALA Clinical materials and instruments are available here. (For these in Spanish (and local variations for the 3 study sites), please see the ES outputs page.)

    Baseline Material - English

    Implementation Material - English

    Baseline Instruments - English

    Implementation Instruments - English

    Study arms 1 (control) Study arm 2 (Control with training) Study arms 3 (Short form programme) Study arm 4 (Standard length programme - collapsed with arm 3 in Nov 2020)

    Recruitment Instruments - English

    Phase 2 implements and materials - adjustments to COVID-19 pandemic conditions

    As well as collapsing arms 3 and 4 following evidence of the longer intervention not performing better than the shorter one, a second implementation stage of 6 months (phase 2) started in December 2020 running to May 2021 to recuperate data lost through COVID disruption - given the mental strain put on populations at this time, several of the instruments and clinical materials have been adjusted for this stage to give a greater emphasis to depression screening and support delivery in the intervention package by screening all patients visiting PHC for depression using the PHQ2 instrument (as opposed to only patients identified as heavy drinkers). This necessitated changes to the clinical care pathway, to the short and extended tally sheets, and to the healthcare professional booklet:

    Phase 2 clinical materials
    Phase 2 instruments
    In response to the physical lockdown of PHC units, the SCALA partners in Peru (UPCH) developed online versions of the training and intervention package for future implementation. The telemedicine package uses responsive online versions of the key clinical materials that are accessible and viewable via smartphone as well as web browser (in Spanish):

    The English versions of SCALA training materials are available here. (For these in Spanish, and the train the trainers (TNT) material, please see the ES outputs page.)

    Short form training - Arms 2 & 3 - EN

    Standard form training - Arm 4 - EN

    Training modelling videos

    The SCALA training videos are designed to model the screening and brief intervention approach of the SCALA programme for the management of alcohol problems and co-morbid depression in primary care. The videos are all in Latin American Spanish

    Videos for standard form training:

    SCALA Video 1a - Screening Pedro: +alcohol, - depression +alcohol, - depresión

    SCALA Video 1b - Brief intervention - Pedro: +alcohol, - depression

    SCALA Video 2a - Screening - Paola: +alcohol, + depression

    SCALA Video 2b - Brief intervention - Paola: +alcohol, + depression

    SCALA Video 3 - Feedback and referral - Ana-María: +alcohol, ++ depression

    Videos for short form training:

    SCALA Video A (short form) - Screening negative - Sofia: - alcohol

    SCALA Video B (short form) - Screening and brief advice - Juan: + alcohol, -depression

    SCALA Video C - Javier: patient resists remission/reference - alcohol++

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