Mary Jo Larson1, Beth A Mohr, Rachel Sayko Adams, Nikki R Wooten, Thomas V Williams. 1. Mary Jo Larson and Rachel Sayko Adams are with The Heller School for Social Policy & Management, Institute for Behavioral Health, Brandeis University, Waltham, MA. Beth A. Mohr is with The Heller School for Social Policy & Management, Schneider Institutes for Health Policy, Brandeis University. Nikki R. Wooten is with Military Social Work Research and Practice, University of South Carolina College of Social Work, Columbia. Thomas V. Williams is with Methods, Measures, Analyses, Defense Health Cost Assessment and Program Evaluation, Defense Health Agency, Department of Defense, Falls Church, VA.
Abstract
OBJECTIVES: We identified to what extent the Department of Defense postdeployment health surveillance program identifies at-risk drinking, alone or in conjunction with psychological comorbidities, and refers service members who screen positive for additional assessment or care. METHODS: We completed a cross-sectional analysis of 333 803 US Army active duty members returning from Iraq or Afghanistan deployments in fiscal years 2008 to 2011 with a postdeployment health assessment. Alcohol measures included 2 based on self-report quantity-frequency items-at-risk drinking (positive Alcohol Use Disorders Identification Test alcohol consumption questions [AUDIT-C] screen) and severe alcohol problems (AUDIT-C score of 8 or higher)-and another based on the interviewing provider's assessment. RESULTS: Nearly 29% of US Army active duty members screened positive for at-risk drinking, and 5.6% had an AUDIT-C score of 8 or higher. Interviewing providers identified potential alcohol problems among only 61.8% of those screening positive for at-risk drinking and only 74.9% of those with AUDIT-C scores of 8 or higher. They referred for a follow-up visit to primary care or another setting only 29.2% of at-risk drinkers and only 35.9% of those with AUDIT-C scores of 8 or higher. CONCLUSIONS: This study identified missed opportunities for early intervention for at-risk drinking. Future research should evaluate the effect of early intervention on long-term outcomes.
OBJECTIVES: We identified to what extent the Department of Defense postdeployment health surveillance program identifies at-risk drinking, alone or in conjunction with psychological comorbidities, and refers service members who screen positive for additional assessment or care. METHODS: We completed a cross-sectional analysis of 333 803 US Army active duty members returning from Iraq or Afghanistan deployments in fiscal years 2008 to 2011 with a postdeployment health assessment. Alcohol measures included 2 based on self-report quantity-frequency items-at-risk drinking (positive Alcohol Use Disorders Identification Test alcohol consumption questions [AUDIT-C] screen) and severe alcohol problems (AUDIT-C score of 8 or higher)-and another based on the interviewing provider's assessment. RESULTS: Nearly 29% of US Army active duty members screened positive for at-risk drinking, and 5.6% had an AUDIT-C score of 8 or higher. Interviewing providers identified potential alcohol problems among only 61.8% of those screening positive for at-risk drinking and only 74.9% of those with AUDIT-C scores of 8 or higher. They referred for a follow-up visit to primary care or another setting only 29.2% of at-risk drinkers and only 35.9% of those with AUDIT-C scores of 8 or higher. CONCLUSIONS: This study identified missed opportunities for early intervention for at-risk drinking. Future research should evaluate the effect of early intervention on long-term outcomes.
Authors: Robert M Bray; Michael R Pemberton; Marian E Lane; Laurel L Hourani; Mark J Mattiko; Lorraine A Babeu Journal: Mil Med Date: 2010-06 Impact factor: 1.437
Authors: Katharine A Bradley; Emily C Williams; Carol E Achtmeyer; Eric J Hawkins; Alex H S Harris; Madeleine S Frey; Thomas Craig; Daniel R Kivlahan Journal: Subst Abus Date: 2007 Impact factor: 3.716
Authors: Isabel G Jacobson; Margaret A K Ryan; Tomoko I Hooper; Tyler C Smith; Paul J Amoroso; Edward J Boyko; Gary D Gackstetter; Timothy S Wells; Nicole S Bell Journal: JAMA Date: 2008-08-13 Impact factor: 56.272
Authors: Anna D Rubinsky; Daniel R Kivlahan; Robert J Volk; Charles Maynard; Katharine A Bradley Journal: Drug Alcohol Depend Date: 2009-12-29 Impact factor: 4.492
Authors: Eric F Crawford; Jessica J Fulton; Cindy M Swinkels; Jean C Beckham; Patrick S Calhoun Journal: Drug Alcohol Depend Date: 2013-03-07 Impact factor: 4.492
Authors: Rachel Sayko Adams; Deborah W Garnick; Alex H S Harris; Elizabeth L Merrick; Keith Hofmann; Wendy Funk; Thomas V Williams; Mary Jo Larson Journal: J Subst Abuse Treat Date: 2020-05-07
Authors: Tamara L Taillieu; Tracie O Afifi; Mark A Zamorski; Sarah Turner; Kristene Cheung; Murray B Stein; Jitender Sareen Journal: Can J Psychiatry Date: 2020-01-29 Impact factor: 4.356
Authors: Rachel Sayko Adams; John D Corrigan; Beth A Mohr; Thomas V Williams; Mary Jo Larson Journal: J Neurotrauma Date: 2016-12-02 Impact factor: 5.269
Authors: Megan E Vanneman; Alex H S Harris; Cheng Chen; Rachel Sayko Adams; Thomas V Williams; Mary Jo Larson Journal: Psychiatr Serv Date: 2017-04-17 Impact factor: 3.084
Authors: Nikki R Wooten; Jordan A Brittingham; Akhtar Hossain; Laura A Hopkins; Nahid S Sumi; Diana D Jeffery; Abbas S Tavakoli; Hrishikesh Chakraborty; Sue E Levkoff; Mary Jo Larson Journal: Int J Methods Psychiatr Res Date: 2019-08-02 Impact factor: 4.035
Authors: Rachel Sayko Adams; Cindy Parks Thomas; Grant A Ritter; Sue Lee; Mayada Saadoun; Thomas V Williams; Mary Jo Larson Journal: Mil Med Date: 2019-01-01 Impact factor: 1.437
Authors: Megan E Vanneman; Alex H S Harris; Cheng Chen; Beth A Mohr; Rachel Sayko Adams; Thomas V Williams; Mary Jo Larson Journal: Mil Med Date: 2015-10 Impact factor: 1.437