Alcohol screening in 22 Australian Aboriginal Community Controlled Health Organisations: Clinical context and who is screened

Teagan J Weatherall; James H Conigrave; K S Kylie Lee; Julia Vnuk; Rowena Ivers; Noel Hayman; Scott Wilson; Dennis Gray; Katherine M Conigrave

doi:10.1111/dar.13851

Alcohol screening in 22 Australian Aboriginal Community Controlled Health Organisations: Clinical context and who is screened

Drug Alcohol Rev. 2024 Apr 19. doi: 10.1111/dar.13851. Online ahead of print.

Authors

Teagan J Weatherall^{1

2}, James H Conigrave^{1

2

3}, K S Kylie Lee^{1

2

4

5

6}, Julia Vnuk^{7

8}, Rowena Ivers⁹, Noel Hayman^{10

11

12}, Scott Wilson^{1

13}, Dennis Gray⁵, Katherine M Conigrave^{1

2

14}

Affiliations

¹ NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, Discipline of Addiction Medicine, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.
² The Edith Collins Centre (Translational Research in Alcohol Drugs and Toxicology), Drug Health Services, Sydney Local Health District, Sydney, Australia.
³ Australian Catholic University, Sydney, Australia.
⁴ Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia.
⁵ National Drug Research Institute, Faculty of Health Sciences, Curtin University, Perth, Australia.
⁶ Burnet Institute, Melbourne, Australia.
⁷ Adelaide Rural Clinical School, The University of Adelaide, Adelaide, Australia.
⁸ Aboriginal Health Council of South Australia, Adelaide, Australia.
⁹ Graduate School of Medicine, University of Wollongong, Wollongong, Australia.
¹⁰ Southern Queensland Centre of Excellence in Aboriginal and Torres Strait Islander Primary Health Care (Inala Indigenous Health Service), Brisbane, Australia.
¹¹ School of Medicine, Griffith University, Gold Coast, Australia.
¹² School of Medicine, University of Queensland, Brisbane, Australia.
¹³ Aboriginal Drug and Alcohol Council of South Australia Inc., Adelaide, Australia.
¹⁴ Drug Health Services, Royal Prince Alfred Hospital, Sydney, Australia.

PMID: 38639392
DOI: 10.1111/dar.13851

Abstract

Introduction: Alcohol screening among Indigenous Australians is important to identify individuals needing support to reduce their drinking. Understanding clinical contexts in which clients are screened, and which clients are more or less likely to be screened, could help identify areas of services and communities that might benefit from increased screening.

Methods: We analysed routinely collected data from 22 Aboriginal Community Controlled Health Organisations Australia-wide. Data collected between February 2016 and February 2021 were analysed using R, and aggregated to describe screening activity per client, within 2-monthly extraction periods. Descriptive analyses were performed to identify contexts in which clients received an Alcohol Use Disorders Identification Test consumption (AUDIT-C) screen. Multi-level logistic regression determined demographic factors associated with receiving an AUDIT-C screen. Three models are presented to examine if screening was predicted by: (i) age; (ii) age and gender; (iii) age, gender and service remoteness.

Results: We observed 83,931 occasions where AUDIT-C was performed at least once during a 2-monthly extraction period. Most common contexts were adult health check (55.0%), followed by pre-consult examination (18.4%) and standalone item (9.9%). For every 10 years' increase in client age, odds of being screened with AUDIT-C slightly decreased (odds ratio 0.98; 95% confidence interval [CI] 0.98, 0.99). Women were less likely to be screened with AUDIT-C (odds ratio 0.95; 95% CI 0.93, 0.96) than men.

Discussion and conclusions: This study identified areas where alcohol screening can be increased (e.g., among women). Increasing AUDIT-C screening across entire communities could help reduce or prevent alcohol-related harms. Future Indigenous-led research could help identify strategies to increase screening rates.

Keywords: AUDIT‐C; Aboriginal and Torres Strait Islander; Indigenous Australians; alcohol; alcohol screen.

Abstract

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