Short screening tools for risky drinking in Aboriginal and Torres Strait Islander Australians : Modified AUDIT-C and a new approach

Journal article


Lee, K. S. Kylie, Conigrave, James H., Wilson, Scott, Perry, Jimmy, Callinan, Sarah, Room, Robin, Chikritzhs, Tanya N., Slade, Tim, Hayman, Noel, Leggat, Geoffrey and Conigrave, Katherine M.. (2019). Short screening tools for risky drinking in Aboriginal and Torres Strait Islander Australians : Modified AUDIT-C and a new approach. Addiction Science and Clinical Practice. 14(1), p. Article 22. https://doi.org/10.1186/s13722-019-0152-6
AuthorsLee, K. S. Kylie, Conigrave, James H., Wilson, Scott, Perry, Jimmy, Callinan, Sarah, Room, Robin, Chikritzhs, Tanya N., Slade, Tim, Hayman, Noel, Leggat, Geoffrey and Conigrave, Katherine M.
Abstract

Background
Alcohol consumption among Indigenous Australians can involve a stop-start pattern of drinking, with consumption well above recommended guidelines on each occasion. Such intermittent drinking patterns can make screening for risky drinking difficult. This study evaluates the ability of several short alcohol screening tools, contained in the Grog Survey Application, to detect short- or long-term risky drinking as defined by Australian guidelines. Tested tools include a modification of Alcohol Use Disorders Identification Test-Consumption (AUDIT-Cm).

Methods
Alcohol consumption was assessed in current drinkers in the past year (n = 184) using AUDIT-Cm and using the last four drinking occasions (Finnish method). Sensitivity and specificity were assessed relative to the Finnish method, for how AUDIT-Cm score (3 + for women, 4 + for men), and how subsets of AUDIT-Cm questions (AUDIT-1m and AUDIT-2m; and AUDIT-3mV alone) were able to determine short- or long-term risk from drinking. Responses to AUDIT-Cm were used to calculate the average standard drinks consumed per day, and the frequency at which more than four standard drinks were consumed on single occasions. Finally, shorter versions of the Finnish method (1, 2, or 3 occasions of drinking) were compared to the full Finnish method, by examining the percentage of variance retained by shorter versions.

Results
AUDIT-Cm has a high sensitivity in detecting at-risk drinking compared with the Finnish method (sensitivity = 99%, specificity = 67%). The combination of AUDIT-1m and AUDIT-2m was able to classify the drinking risk status for all but four individuals in the same way as the Finnish method did. For the Finnish method, two drinking sessions to calculate drinks per drinking occasion, and four to calculate frequency resulted in nearly identical estimates to data on all four of the most recent drinking occasions (r2 = 0.997).

Conclusions
The combination of AUDIT-1m and AUDIT-2m may offer advantages as a short screening tool, over AUDIT-3mV, in groups where intermittent and high per occasion drinking is common. As an alternative to the full Finnish method, the quantity consumed on the last two occasions and timing of the last four occasions may provide a practical short screening tool.

KeywordsAboriginal; Torres Strait Islander; alcohol; screening; alcohol use disorder; AUDIT-C; Finnish method; consumption
Year2019
JournalAddiction Science and Clinical Practice
Journal citation14 (1), p. Article 22
PublisherBioMed Central
ISSN1940-0640
Digital Object Identifier (DOI)https://doi.org/10.1186/s13722-019-0152-6
PubMed ID31256762
Scopus EID2-s2.0-85068989238
PubMed Central IDPMC6600888
Open accessPublished as ‘gold’ (paid) open access
Page range1-12
FunderNational Health and Medical Research Council (NHMRC)
Publisher's version
License
File Access Level
Open
Output statusPublished
Publication dates
Online01 Jul 2019
Publication process dates
Accepted30 May 2019
Deposited27 Jul 2023
Grant ID1087192
1117198
1117582
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