James H Conigrave1, Kristie H Harrison1, K S Kylie Lee1,2, Timothy A Dobbins3, Beth Hummerston4, Noel Hayman5, Jimmy Perry6, Rowena Ivers7,8, Paul S Haber1,9, Scott Wilson1,6, David Johnson4, Katherine M Conigrave1,9. 1. Faculty of Medicine and Health, Central Clinical School, Centre of Research Excellence in Indigenous Health and Alcohol, University of Sydney, Sydney, NSW, Australia. 2. Centre for Alcohol Policy Research, La Trobe University, Melbourne, VIC, Australia. 3. School of Public Health and Community Medicine, University of New South Wales, Sydney, NSW, Australia. 4. Aboriginal Health Council of South Australia, Adelaide, South Australia, Australia. 5. Southern Queensland Centre of Excellence in Aboriginal and Torres Strait Islander Primary Health Care (Inala Indigenous Health Service), QLD, Australia. 6. Aboriginal Drug and Alcohol Council of South Australia Inc., SA, Australia. 7. Illawarra Aboriginal Medical Service, Wollongong, NSW, Australia. 8. School of Medicine and Health, University of Wollongong, Wollongong, NSW, Australia. 9. Royal Prince Alfred Hospital, Drug Health Services, Camperdown, NSW, Australia.
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.
RCT Entities:
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.
Authors: Monika Dzidowska; Jacques E Raubenheimer; Timothy A Dobbins; K S Kylie Lee; Noel Hayman; Julia Vnuk; Paul Haber; Katherine M Conigrave Journal: Addict Sci Clin Pract Date: 2022-02-19
Authors: James H Conigrave; K S Kylie Lee; Paul S Haber; Julia Vnuk; Michael F Doyle; Katherine M Conigrave Journal: Addict Sci Clin Pract Date: 2022-04-05
Authors: Monika Dzidowska; K S Kylie Lee; James H Conigrave; Timothy A Dobbins; Beth Hummerston; Scott Wilson; Paul S Haber; Dennis Gray; Katherine M Conigrave Journal: Addiction Date: 2021-10-20 Impact factor: 7.256