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Researchers and practitioners recognise the importance of context when implementing healthcare interventions, but the influence of wider environment is rarely mapped. This paper identifies the country and policy-related factors potentially explaining the country differences in outcomes of an intervention focused on improving detection and management of heavy alcohol use in primary care in Colombia, Mexico and Peru. Qualitative data obtained through interviews, logbooks and document analysis are used to explain quantitative data on number of alcohol screenings and screening providers in each of the countries. Existing alcohol screening standards in Mexico, and policy prioritisation of primary care and consideration of alcohol as a public health issue in Colombia and Mexico positively contributed to the outcome, while the COVID-19 pandemic had a negative impact. In Peru, the context was unsupportive due to a combination of: political instability amongst regional health authorities; lack of focus on strengthening primary care due to the expansion of community mental health centres; alcohol considered as an addiction rather than a public health issue; and the impact of COVID-19 on healthcare. We found that wider environment-related factors interacted with the intervention implemented and can help explain country differences in outcomes. [ABSTRACT FROM AUTHOR]

Objective. To determine the level of stability or change in topic areas published by public health journals in Latin America and the Caribbean, using keywords and co-word analysis, in order to support evidence-based research planning. Methods. Keywords were extracted from papers indexed in Scopus® that were published by the Revista de Salud Pública (RSP; Colombia), the Salud Pública de México (SPM; Mexico), and the Revista Peruana de Medicina Experimental y Salud Pública (RPMESP; Peru) for three periods: 2005 - 2007, 2008 - 2010, and 2011 - 2013. Co-word analysis was used to examine keywords extracted. Textual information was analyzed using centrality measures (inbetweenness and closeness). The hypothesis of stability/change of thematic coverage was tested using the Spearman's rho correlation coefficient. VOSviewer was used to visualize the co-word maps. Results. A moderate level of change in thematic coverage was observed in 2005 -- 2010, as evidenced by the correlation coefficients for two of the 3-year periods, 2005 -- 2007 and 2008 -- 2010: 0.545 for RSP and 0.593 for SPM. However, in 2008 -- 2013, more keywords remained constant from one period to the next, given the size of the correlation coefficients for the last 3-year periods: 2008 -- 2010 and 2011 -- 2013: 0.727 for RSP and 0.605 for SPM. Conclusion. The research hypothesis was partially accepted given that just two consecutive 3-year periods showed a statistically-significant degree of stability in thematic coverage in public health studies. In that sense, this study provides compelling evidence of the effectiveness of using a combined approach for examining the dynamics of thematic coverage: centrality measures for identifying the main keywords and visual inspection for detecting the structure of textual information. [ABSTRACT FROM AUTHOR]