Support can increase use of the AUDIT-C in Australian Aboriginal Community Controlled Health Services : A cluster randomized trial

Journal article


Conigrave, James H., Harrison, Kristie H., Lee, K. S. Kylie, Dobbins, Timothy A., Hummerston, Beth, Hayman, Noel, Perry, Jimmy, Ivers, Rowena, Haber, Paul S., Wilson, Scott, Johnson, David and Conigrave, Katherine M.. (2021). Support can increase use of the AUDIT-C in Australian Aboriginal Community Controlled Health Services : A cluster randomized trial. Addiction. 116(9), pp. 2304-2315. https://doi.org/10.1111/add.15428
AuthorsConigrave, James H., Harrison, Kristie H., Lee, K. S. Kylie, Dobbins, Timothy A., Hummerston, Beth, Hayman, Noel, Perry, Jimmy, Ivers, Rowena, Haber, Paul S., Wilson, Scott, Johnson, David and Conigrave, Katherine M.
Abstract

Background and Aims
Unhealthy alcohol consumption is a key concern for Aboriginal and Torres Strait Islander (‘Indigenous’) communities. It is important to identify and treat at-risk drinkers, to prevent harms to physical or social wellbeing. We aimed to test whether training and support for Aboriginal Community Controlled Health Service (ACCHS) staff would increase rates of alcohol screening and brief intervention.

Design
Cluster randomized trial.

Setting
Australia.

Cases/Intervention/Measurements

Twenty-two ACCHSs that see at least 1000 clients per year and use Communicare as practice management software. The study included data on 70 419 clients, training, regular data feedback, collaborative support and funding for resources ($9000). Blinding was not used. The comparator was waiting-list control (equal allocation). Alcohol Use Disorder Identification Test (AUDIT-C) screening and records of brief interventions were extracted from practice management software at 2-monthly intervals. Observations described the clinical actions taken for clients over each 2-month interval. The baseline period (28 August 2016–28 August 2017) was compared with the post-implementation period (29 August 2017–28 August 2018). We used multi-level logistic regression to test the hypotheses that clients attending a service receiving active support would be more likely to be screened with AUDIT-C (primary outcome) or to receive a brief intervention (secondary outcome).

Findings
We observed an increase in the odds of screening with AUDIT-C for both groups, but the increase was 5.52 [95% confidence interval (CI) = 4.31, 7.07] times larger at services receiving support. We found little evidence that the support programme increased the odds of a recorded brief intervention relative to control services (odds ratio = 2.06; 95% CI = 0.90, 4.69). Differences in baseline screening activity between treatment and control reduce the certainty of our findings.

Conclusions
Providing Aboriginal Community Controlled Health Services with training and support can improve alcohol (AUDIT-C) screening rates.

Keywordsalcohol screening; AUDIT-C; brief intervention; data feedback; Indigenous Australians; training
Year2021
JournalAddiction
Journal citation116 (9), pp. 2304-2315
PublisherWiley-Blackwell Publishing Ltd.
ISSN0965-2140
Digital Object Identifier (DOI)https://doi.org/10.1111/add.15428
PubMed ID33565676
Scopus EID2-s2.0-85100903388
Page range2304-2315
FunderNational Health and Medical Research Council (NHMRC)
Medical Research Future Fund (MRFF), Australian Government
Publisher's version
License
All rights reserved
File Access Level
Controlled
Output statusPublished
Publication dates
Online17 Feb 2021
Publication process dates
Accepted20 Jan 2021
Deposited31 Jul 2023
Grant ID1105339
1087192
1117582
1117198
1155320
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