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Support can increase use of the AUDIT-C in Australian Aboriginal Community Controlled Health Services : A cluster randomized trial
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
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
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.
Keywords
alcohol screening, AUDIT-C, brief intervention, data feedback, Indigenous Australians, training
Date
2021
Type
Journal article
Journal
Addiction
Book
Volume
116
Issue
9
Page Range
2304-2315
Article Number
ACU Department
Institute for Positive Psychology and Education
Faculty of Education and Arts
Faculty of Education and Arts
Relation URI
Source URL
Event URL
Open Access Status
License
All rights reserved
File Access
Controlled