ABSTRACT Alcohol use is rapidly increasing in low- and middle-income countries, where it is inexpensive, readily available, poorly regulated, and there are few resources devoted to promoting safe alcohol use. Like many other limited resource settings, there are few alcohol treatment facilities or addiction practitioners in the Kilimanjaro region of Tanzania. For many in this setting, people only seek care after an emergency condition. Our preliminary work suggests up to 30% of patients in the Emergency Department have harmful or hazardous drinking behaviors. Our team has created a brief negotiational intervention with a text based booster called the “Punguza Pombe Kwa Afya Yako (PPKAY)/ Reduce Alcohol for Your Health.” Our recent pragmatic trial has demonstrated its effectiveness at reducing alcohol use after an acute visit to the Kilimanjaro Christian Medical Center in Moshi, Tanzania. As such, this program planning project plan for the regional implementation of this intervention through mixed method site evaluations and co-design of final intervention, implementation strategy and trial protocols with our Tanzanian partners. This will prepare us to conduct an innovative hybrid implementation trial to implement this culturally adapted, resource appropriate and evidence based intervention.