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Moecke DP, Holyk T, Beckett M, Chopra S, Petlitsyna P, Girt M, Kirkham A, Kamurasi I, Turner J, Sneddon D, Friesen M, McDonald I, Denson-Camp N, Crosbie S, Camp PG. Scoping review of telehealth use by Indigenous populations from Australia, Canada, New Zealand, and the United States. J Telemed Telecare 2024; 30:1398-1416. [PMID: 36911983 PMCID: PMC11411853 DOI: 10.1177/1357633x231158835] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/14/2023]
Abstract
INTRODUCTION Telehealth has the potential to address health disparities experienced by Indigenous people, especially in remote areas. This scoping review aims to map and characterize the existing evidence on telehealth use by Indigenous people and explore the key concepts for effective use, cultural safety, and building therapeutic relationships. METHODS A search for published and gray literature, written in English, and published between 2000 and 2022 was completed in 17 electronic databases. Two reviewers independently screened retrieved records for eligibility. For included articles, data were extracted, categorized, and analyzed. Synthesis of findings was performed narratively. RESULTS A total of 321 studies were included. The most popular type of telehealth used was mHealth (44%), and the most common health focuses of the telehealth interventions were mental health (26%) and diabetes/diabetic retinopathy (13%). Frequently described barriers to effective telehealth use included concerns about privacy/confidentiality and limited internet availability; meanwhile, telehealth-usage facilitators included cultural relevance and community engagement. Although working in collaboration with Indigenous communities was the most frequently reported way to achieve cultural safety, 40% of the studies did not report Indigenous involvement. Finally, difficulty to establish trusting therapeutic relationships was a major concern raised about telehealth, and evidence suggests that having the first visit-in-person is a potential way to address this issue. CONCLUSION This comprehensive review identified critical factors to guide the development of culturally-informed telehealth services to meet the needs of Indigenous people and to achieve equitable access and positive health outcomes.
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Affiliation(s)
- Débora Petry Moecke
- University of British Columbia (UBC), Vancouver, Canada
- Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Travis Holyk
- Carrier Sekani Family Services, Prince George, Canada
| | - Madelaine Beckett
- University of British Columbia (UBC), Vancouver, Canada
- Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Sunaina Chopra
- University of British Columbia (UBC), Vancouver, Canada
- Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | | | - Mirha Girt
- Faculty of Medicine, University of Queensland, Brisbane, Australia
| | | | - Ivan Kamurasi
- University of British Columbia (UBC), Vancouver, Canada
- Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Justin Turner
- University of British Columbia (UBC), Vancouver, Canada
- Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Donovan Sneddon
- University of British Columbia (UBC), Vancouver, Canada
- Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | | | - Ian McDonald
- University of British Columbia (UBC), Vancouver, Canada
| | | | | | - Pat G Camp
- University of British Columbia (UBC), Vancouver, Canada
- Faculty of Medicine, University of British Columbia, Vancouver, Canada
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Conigrave JH, Wilson S, Conigrave KM, Perry J, Hayman N, Chikritzhs TN, Wilson D, Zheng C, Weatherall TJ, Lee KSK. Countering stereotypes: Exploring the characteristics of Aboriginal Australians who do not drink alcohol in a community representative sample. Drug Alcohol Rev 2024; 43:1523-1533. [PMID: 39042571 DOI: 10.1111/dar.13907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 06/06/2024] [Accepted: 06/27/2024] [Indexed: 07/25/2024]
Abstract
INTRODUCTION Contrary to stereotypes, Aboriginal and Torres Strait Islander Australians are more likely to abstain from drinking than other Australians. We explored characteristics and experiences of Aboriginal and Torres Strait Islander Australians who do not drink alcohol. METHOD We conducted a cross-sectional, representative survey of 775 Aboriginal and Torres Strait Islander Australians (16+ years) in remote and urban South Australia. We explore correlates of not drinking alcohol using multi-level logistic regression. We describe reasons for non-drinking and harms participants experienced in past 12 months from others' drinking. RESULTS Non-drinking participants were more likely to be older (OR 1.35 [95% CI 1.21, 1.50] per decade) and unemployed (OR 2.72 [95% CI 1.77, 4.20]). Participants who spoke Aboriginal Australian languages at home were three times more likely to be lifetime abstainers from drinking (OR 3.07 [95% CI 1.52, 6.21]). Common reasons for not drinking alcohol were health and family. Most did not report harms from others' alcohol consumption (79.6%, 76.9%, urban and remote respectively). Stress from others' alcohol consumption was the most reported harm by non-drinkers (14.5% and 23.1%, urban and remote, respectively). DISCUSSION AND CONCLUSIONS Culture such as speaking Aboriginal Australian languages might have protective effects that promote abstaining but was rarely explicitly cited as a reason for not drinking. A greater understanding of local values held by people who do not drink alcohol could help inform health messaging and other interventions to reduce alcohol-related harms. Understanding local reasons for abstaining can help tailor health messaging to suit local contexts.
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Affiliation(s)
- James H Conigrave
- Faculty of Medicine and Health, Central Clinical School, The University of Sydney, Sydney, Australia
- The Edith Collins Centre (Translation Research in Alcohol, Drugs and Toxicology), Sydney Local Health District, Sydney, Australia
- Institute of Positive Psychology and Education, Australian Catholic University, Sydney, Australia
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
| | - Scott Wilson
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
- Aboriginal Drug and Alcohol Council South Australia, Adelaide, Australia
| | - Katherine M Conigrave
- Faculty of Medicine and Health, Central Clinical School, The University of Sydney, Sydney, Australia
- The Edith Collins Centre (Translation Research in Alcohol, Drugs and Toxicology), Sydney Local Health District, Sydney, Australia
- Royal Prince Alfred Hospital, Drug Health Services, Sydney, Australia
| | - Jimmy Perry
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
- Aboriginal Drug and Alcohol Council South Australia, Adelaide, Australia
| | - Noel Hayman
- Southern Queensland Centre of Excellence in Aboriginal and Torres Strait Islander Primary Health Care, Inala Indigenous Health Service, Brisbane, Australia
- School of Medicine, Griffith University, Brisbane, Australia
- School of Medicine, University of Queensland, Brisbane, Australia
| | - Tanya N Chikritzhs
- Faculty of Health Sciences, National Drug Research Institute, Curtin University, Perth, Australia
| | - Dan Wilson
- Alice Springs Hospital, NT Health, Alice Springs, Australia
| | - Catherine Zheng
- Faculty of Medicine and Health, Central Clinical School, The University of Sydney, Sydney, Australia
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
| | - Teagan J Weatherall
- Faculty of Medicine and Health, Central Clinical School, The University of Sydney, Sydney, Australia
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
| | - K S Kylie Lee
- Faculty of Medicine and Health, Central Clinical School, The University of Sydney, Sydney, Australia
- The Edith Collins Centre (Translation Research in Alcohol, Drugs and Toxicology), Sydney Local Health District, Sydney, Australia
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
- Faculty of Health Sciences, National Drug Research Institute, Curtin University, Perth, Australia
- Burnet Institute, Melbourne, Australia
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3
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Chelberg GR, Goodman Aboriginal From Iningai Country A, Musuwadi C, Lawler S, Caffery LJ, Mahoney Bidjara R. Towards a best practice framework for eHealth with Aboriginal and Torres Strait Islander peoples - important characteristics of eHealth interventions: a narrative review. Med J Aust 2024. [PMID: 39177008 DOI: 10.5694/mja2.52419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 07/15/2024] [Indexed: 08/24/2024]
Abstract
This narrative review discusses the important characteristics of electronic health (eHealth) interventions and critiques the cultural quality of eHealth research with Aboriginal and Torres Strait Islander peoples. Thirty-nine publications reporting on a variety of eHealth modalities to address health challenges with Aboriginal and Torres Strait Islander people were identified. Content analysis signified authentic co-design, governance and strong partnerships as foundational qualities of eHealth interventions that are culturally safe and sustainable. The pragmatics of eHealth setting, content and engagement must be underscored by trust, responsiveness and cultural values. The application of the Aboriginal and Torres Strait Islander Quality Appraisal Tool (QAT) revealed higher scores for studies with two or more Aboriginal and Torres Strait Islander authors. This narrative review is fundamental to the development of a best practice framework for eHealth interventions with Aboriginal and Torres Strait Islander people that are culturally safe, sustainable and effective. With a foundation of Aboriginal and Torres Strait Islander governance with strong partnerships for authentic co-design, eHealth interventions are more likely to meet the priorities and values of the Aboriginal and Torres Strait Islander communities for which they are intended.
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Affiliation(s)
- Georgina R Chelberg
- Australian eHealth Research Centre, Commonwealth Scientific and Industrial Research Organisation (CSIRO), Brisbane, QLD
- Centre for Ageing Research and Translation, University of Canberra, Canberra, ACT
| | | | - Charankarthi Musuwadi
- Australian eHealth Research Centre, Commonwealth Scientific and Industrial Research Organisation (CSIRO), Brisbane, QLD
| | | | - Liam J Caffery
- Centre for Online Health, Centre for Health Services Research, University of Queensland, Brisbane, QLD
| | - Ray Mahoney Bidjara
- Australian eHealth Research Centre, Commonwealth Scientific and Industrial Research Organisation (CSIRO), Brisbane, QLD
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Lee KSK, Conigrave JH, Wilson S, Perry J, Hayman N, Chikritzhs T, Room R, Weatherall TJ, Zheng C, Conigrave KM. Deeper understandings of patterns of drinking among Aboriginal and Torres Strait Islander Australians: Informing policy and practice. Health Promot J Austr 2023; 34:883-888. [PMID: 36740591 PMCID: PMC10946760 DOI: 10.1002/hpja.696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 01/09/2023] [Accepted: 01/23/2023] [Indexed: 02/07/2023] Open
Affiliation(s)
- K. S. Kylie Lee
- NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, Discipline of Addiction Medicine, Faculty of Medicine and HealthThe University of SydneyCamperdownAustralia
- The Edith Collins Centre (Translational Research in Alcohol Drugs and Toxicology), Sydney Local Health DistrictSydneyAustralia
- National Drug Research Institute, Faculty of Health SciencesCurtin UniversityPerthAustralia
- Burnet InstituteMelbourneAustralia
- Centre for Alcohol Policy ResearchLa Trobe UniversityBundooraAustralia
| | - James H. Conigrave
- NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, Discipline of Addiction Medicine, Faculty of Medicine and HealthThe University of SydneyCamperdownAustralia
- The Edith Collins Centre (Translational Research in Alcohol Drugs and Toxicology), Sydney Local Health DistrictSydneyAustralia
| | - Scott Wilson
- NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, Discipline of Addiction Medicine, Faculty of Medicine and HealthThe University of SydneyCamperdownAustralia
- The Edith Collins Centre (Translational Research in Alcohol Drugs and Toxicology), Sydney Local Health DistrictSydneyAustralia
- Aboriginal Drug and Alcohol Council South AustraliaUnderdaleSouth AustraliaAustralia
| | - Jimmy Perry
- Aboriginal Drug and Alcohol Council South AustraliaUnderdaleSouth AustraliaAustralia
| | - Noel Hayman
- Southern Queensland Centre of Excellence in Aboriginal and Torres Strait Islander Primary Health Care, InalaAustralia
- School of MedicineGriffith UniversityAustralia
- School of MedicineUniversity of QueenslandAustralia
| | - Tanya Chikritzhs
- National Drug Research Institute, Faculty of Health SciencesCurtin UniversityPerthAustralia
| | - Robin Room
- Centre for Alcohol Policy ResearchLa Trobe UniversityBundooraAustralia
- Centre for Social Research on Alcohol and Drugs, Department of Public Health SciencesStockholm UniversityStockholmSweden
| | - Teagan J. Weatherall
- NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, Discipline of Addiction Medicine, Faculty of Medicine and HealthThe University of SydneyCamperdownAustralia
- The Edith Collins Centre (Translational Research in Alcohol Drugs and Toxicology), Sydney Local Health DistrictSydneyAustralia
| | - Catherine Zheng
- NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, Discipline of Addiction Medicine, Faculty of Medicine and HealthThe University of SydneyCamperdownAustralia
- The Edith Collins Centre (Translational Research in Alcohol Drugs and Toxicology), Sydney Local Health DistrictSydneyAustralia
| | - Katherine M. Conigrave
- NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, Discipline of Addiction Medicine, Faculty of Medicine and HealthThe University of SydneyCamperdownAustralia
- The Edith Collins Centre (Translational Research in Alcohol Drugs and Toxicology), Sydney Local Health DistrictSydneyAustralia
- Drug Health Service, Royal Prince Alfred HospitalCamperdownAustralia
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5
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Bowden J, Harrison NJ, Caruso J, Room R, Pettigrew S, Olver I, Miller C. Which drinkers have changed their alcohol consumption due to energy content concerns? An Australian survey. BMC Public Health 2022; 22:1775. [PMID: 36123667 PMCID: PMC9484340 DOI: 10.1186/s12889-022-14159-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 09/08/2022] [Indexed: 11/10/2022] Open
Abstract
Background Alcohol is a discretionary, energy dense, dietary component. Compared to non-drinkers, people who consume alcohol report higher total energy intake and may be at increased risk of weight gain, overweight, and obesity, which are key preventable risk factors for illness. However, accurate consumer knowledge of the energy content in alcohol is low. To inform future behaviour change interventions among drinkers, this study investigated individual characteristics associated with changing alcohol consumption due to energy-related concerns. Methods An online survey was undertaken with 801 Australian adult drinkers (18–59 years, 50.2% female), i.e. who consumed alcohol at least monthly. In addition to demographic and health-related characteristics, participants reported past-year alcohol consumption, past-year reductions in alcohol consumption, frequency of harm minimisation strategy use (when consuming alcohol), and frequency of changing alcohol consumption behaviours because of energy-related concerns. Results When prompted, 62.5% of participants reported changing alcohol consumption for energy-related reasons at least ‘sometimes’. Women, those aged 30–44 years, metropolitan residents, those with household income $80,001–120,000, and risky/more frequent drinkers had increased odds of changing consumption because of energy-related concerns, and unemployed respondents had reduced odds. Conclusions Results indicate that some sociodemographic groups are changing alcohol consumption for energy-related reasons, but others are not, representing an underutilised opportunity for health promotion communication. Further research should investigate whether messaging to increase awareness of alcohol energy content, including through systems-based policy actions such as nutritional/energy product labelling, would motivate reduced consumption across a broader range of drinkers.
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Affiliation(s)
- Jacqueline Bowden
- National Centre for Education and Training on Addiction (NCETA), Flinders Health and Medical Research Institute, Flinders University, GPO Box 2100, Adelaide, SA, 5001, Australia.,Health Policy Centre, South Australian Health and Medical Research Institute, Adelaide, SA, Australia
| | - Nathan J Harrison
- National Centre for Education and Training on Addiction (NCETA), Flinders Health and Medical Research Institute, Flinders University, GPO Box 2100, Adelaide, SA, 5001, Australia. .,Health Policy Centre, South Australian Health and Medical Research Institute, Adelaide, SA, Australia.
| | - Joanna Caruso
- Health Policy Centre, South Australian Health and Medical Research Institute, Adelaide, SA, Australia
| | - Robin Room
- Centre for Alcohol Policy Research, School of Psychology & Public Health, La Trobe University, Bundoora, VIC, Australia.,Department of Public Health Sciences, Centre for Social Research On Alcohol and Drugs, Stockholm University, Stockholm, Sweden
| | - Simone Pettigrew
- The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia.,The National Drug Research Institute, Curtin University, Bentley, WA, Australia
| | - Ian Olver
- School of Psychology, The University of Adelaide, Adelaide, SA, Australia
| | - Caroline Miller
- Health Policy Centre, South Australian Health and Medical Research Institute, Adelaide, SA, Australia.,School of Public Health, The University of Adelaide, Adelaide, SA, Australia
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6
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Wiemker V, Neufeld M, Bunova A, Danquah I, Ferreira-Borges C, Konigorski S, Rastogi A, Probst C. Digital Assessment Tools Using Animation Features to Quantify Alcohol Consumption: Systematic App Store and Literature Review. J Med Internet Res 2022; 24:e28927. [PMID: 35319472 PMCID: PMC8987963 DOI: 10.2196/28927] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Revised: 11/08/2021] [Accepted: 12/06/2021] [Indexed: 01/28/2023] Open
Abstract
Background Accurate and user-friendly assessment tools for quantifying alcohol consumption are a prerequisite for effective interventions to reduce alcohol-related harm. Digital assessment tools (DATs) that allow the description of consumed alcoholic drinks through animation features may facilitate more accurate reporting than conventional approaches. Objective This review aims to identify and characterize freely available DATs in English or Russian that use animation features to support the quantitative assessment of alcohol consumption (alcohol DATs) and determine the extent to which such tools have been scientifically evaluated in terms of feasibility, acceptability, and validity. Methods Systematic English and Russian searches were conducted in iOS and Android app stores and via the Google search engine. Information on the background and content of eligible DATs was obtained from app store descriptions, websites, and test completions. A systematic literature review was conducted in Embase, MEDLINE, PsycINFO, and Web of Science to identify English-language studies reporting the feasibility, acceptability, and validity of animation-using alcohol DATs. Where possible, the evaluated DATs were accessed and assessed. Owing to the high heterogeneity of study designs, results were synthesized narratively. Results We identified 22 eligible alcohol DATs in English, 3 (14%) of which were also available in Russian. More than 95% (21/22) of tools allowed the choice of a beverage type from a visually displayed selection. In addition, 36% (8/22) of tools enabled the choice of a drinking vessel. Only 9% (2/22) of tools allowed the simulated interactive pouring of a drink. For none of the tools published evaluation studies were identified in the literature review. The systematic literature review identified 5 exploratory studies evaluating the feasibility, acceptability, and validity of 4 animation-using alcohol DATs, 1 (25%) of which was available in the searched app stores. The evaluated tools reached moderate to high scores on user rating scales and showed fair to high convergent validity when compared with established assessment methods. Conclusions Animation-using alcohol DATs are available in app stores and on the web. However, they often use nondynamic features and lack scientific background information. Explorative study data suggest that such tools might enable the user-friendly and valid assessment of alcohol consumption and could thus serve as a building block in the reduction of alcohol-attributable health burden worldwide. Trial Registration PROSPERO International Prospective Register of Systematic Reviews CRD42020172825; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020172825
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Affiliation(s)
- Veronika Wiemker
- Heidelberg Institute of Global Health, Medical Faculty and University Hospital, Heidelberg University, Heidelberg, Germany
| | - Maria Neufeld
- WHO European Office for the Prevention and Control of Noncommunicable Diseases, Moscow, Russian Federation
| | - Anna Bunova
- National Medical Research Center for Therapy and Preventive Medicine of the Ministry of Health of the Russian Federation, Moscow, Russian Federation
| | - Ina Danquah
- Heidelberg Institute of Global Health, Medical Faculty and University Hospital, Heidelberg University, Heidelberg, Germany
| | - Carina Ferreira-Borges
- WHO European Office for the Prevention and Control of Noncommunicable Diseases, Moscow, Russian Federation
| | - Stefan Konigorski
- Digital Health Center, Hasso Plattner Institute for Digital Engineering, University of Potsdam, Potsdam, Germany.,Hasso Plattner Institute for Digital Health at Mount Sinai, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Ankit Rastogi
- Heidelberg Institute of Global Health, Medical Faculty and University Hospital, Heidelberg University, Heidelberg, Germany
| | - Charlotte Probst
- Heidelberg Institute of Global Health, Medical Faculty and University Hospital, Heidelberg University, Heidelberg, Germany.,Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
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7
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Wiemker V, Bunova A, Neufeld M, Gornyi B, Yurasova E, Konigorski S, Kalinina A, Kontsevaya A, Ferreira-Borges C, Probst C. Pilot study to evaluate usability and acceptability of the 'Animated Alcohol Assessment Tool' in Russian primary healthcare. Digit Health 2022; 8:20552076211074491. [PMID: 35251679 PMCID: PMC8891874 DOI: 10.1177/20552076211074491] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 01/03/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND AND AIMS Accurate and user-friendly assessment tools quantifying alcohol consumption are a prerequisite to effective prevention and treatment programmes, including Screening and Brief Intervention. Digital tools offer new potential in this field. We developed the 'Animated Alcohol Assessment Tool' (AAA-Tool), a mobile app providing an interactive version of the World Health Organization's Alcohol Use Disorders Identification Test (AUDIT) that facilitates the description of individual alcohol consumption via culturally informed animation features. This pilot study evaluated the Russia-specific version of the Animated Alcohol Assessment Tool with regard to (1) its usability and acceptability in a primary healthcare setting, (2) the plausibility of its alcohol consumption assessment results and (3) the adequacy of its Russia-specific vessel and beverage selection. METHODS Convenience samples of 55 patients (47% female) and 15 healthcare practitioners (80% female) in 2 Russian primary healthcare facilities self-administered the Animated Alcohol Assessment Tool and rated their experience on the Mobile Application Rating Scale - User Version. Usage data was automatically collected during app usage, and additional feedback on regional content was elicited in semi-structured interviews. RESULTS On average, patients completed the Animated Alcohol Assessment Tool in 6:38 min (SD = 2.49, range = 3.00-17.16). User satisfaction was good, with all subscale Mobile Application Rating Scale - User Version scores averaging >3 out of 5 points. A majority of patients (53%) and practitioners (93%) would recommend the tool to 'many people' or 'everyone'. Assessed alcohol consumption was plausible, with a low number (14%) of logically impossible entries. Most patients reported the Animated Alcohol Assessment Tool to reflect all vessels (78%) and all beverages (71%) they typically used. CONCLUSION High acceptability ratings by patients and healthcare practitioners, acceptable completion time, plausible alcohol usage assessment results and perceived adequacy of region-specific content underline the Animated Alcohol Assessment Tool's potential to provide a novel approach to alcohol assessment in primary healthcare. After its validation, the Animated Alcohol Assessment Tool might contribute to reducing alcohol-related harm by facilitating Screening and Brief Intervention implementation in Russia and beyond.
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Affiliation(s)
- Veronika Wiemker
- Heidelberg Institute of Global Health, Heidelberg University, Heidelberg, Germany
| | - Anna Bunova
- National Medical Research Center for Therapy and Preventive Medicine of the Ministry of Health of the Russian Federation, Moscow, Russian Federation
| | - Maria Neufeld
- WHO European Office for the Prevention and Control of Noncommunicable Diseases (NCD Office), Moscow, Russian Federation
- Institute of Clinical Psychology and Psychotherapy, Dresden University of Technology, Dresden, Germany
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Boris Gornyi
- National Medical Research Center for Therapy and Preventive Medicine of the Ministry of Health of the Russian Federation, Moscow, Russian Federation
| | - Elena Yurasova
- WHO Office in the Russian Federation, Moscow, Russian Federation
| | - Stefan Konigorski
- Digital Health Center, Hasso Plattner Institute for Digital Engineering, University of Potsdam, Potsdam, Germany
- Hasso Plattner Institute for Digital Health at Mount Sinai, Icahn School of Medicine at Mount Sinai, NY, USA
| | - Anna Kalinina
- National Medical Research Center for Therapy and Preventive Medicine of the Ministry of Health of the Russian Federation, Moscow, Russian Federation
| | - Anna Kontsevaya
- National Medical Research Center for Therapy and Preventive Medicine of the Ministry of Health of the Russian Federation, Moscow, Russian Federation
| | - Carina Ferreira-Borges
- WHO European Office for the Prevention and Control of Noncommunicable Diseases (NCD Office), Moscow, Russian Federation
| | - Charlotte Probst
- Heidelberg Institute of Global Health, Heidelberg University, Heidelberg, Germany
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
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8
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Fitts MS, Burchill R, Wilson S, Palk GR, Clough AR, Conigrave KM, Slade T, Shakeshaft A, Lee KSK. Drink driving among Aboriginal and Torres Strait Islander Australians: What has been done and where to next? Drug Alcohol Rev 2021; 41:1412-1417. [PMID: 34927302 PMCID: PMC9544182 DOI: 10.1111/dar.13418] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 10/09/2021] [Accepted: 11/13/2021] [Indexed: 11/26/2022]
Abstract
The Australian Government will set the direction for addressing road safety over the next decade with its 2021–2030 National Road Safety Strategy. This road map will detail objectives and goals agreed upon by all Australian states and territories. Similar to previous national strategies, Aboriginal and Torres Strait Islander (Indigenous) Australians are a high priority population. Indigenous Australians are over‐represented in serious injury and fatal road crashes, with alcohol a leading factor. Therapeutic and educational programs are a major strategy among the suite of measures designed to reduce and prevent drink driving in Australia. The release of this new strategy provides a timely opportunity to reflect on what is known about drink driving among Indigenous Australians and to consider the suitability of existing therapeutic and educational drink driving programs for Indigenous Australian contexts. Here, we summarise factors that contribute to drink driving in this population and identify outstanding knowledge gaps. Then, we present an overview of drink driving programs available for Indigenous Australians along with suggestions for why tailored programs are needed to suit local contexts. The response to address drink driving among Indigenous Australians has been fragmented Australia‐wide. A coordinated national response, with ongoing monitoring and evaluation, would improve policy effectiveness and inform more efficient allocation of resources. Together this information can help create suitable and effective drink driving programs for Indigenous drivers and communities Australia‐wide.
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Affiliation(s)
- Michelle S Fitts
- Institute for Culture and Society, Western Sydney University, Sydney, Australia.,Menzies School of Health Research, Charles Darwin University, Alice Springs, Australia.,James Cook University, Australian Institute of Tropical Health and Medicine, Cairns, Australia
| | | | - Scott Wilson
- Aboriginal Drug and Alcohol Council SA Aboriginal Corporation, Adelaide, Australia.,Faculty of Medicine and Health, Discipline of Addiction Medicine, NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, The University of Sydney, Sydney, Australia.,The Edith Collins Centre (Translational Research in Alcohol Drugs and Toxicology), Sydney Local Health District, Sydney, Australia
| | - Gavan R Palk
- Australian Institute for Suicide Research and Prevention, School of Applied Psychology, Griffith University, Brisbane, Australia
| | - Alan R Clough
- James Cook University, Australian Institute of Tropical Health and Medicine, Cairns, Australia
| | - Katherine M Conigrave
- Faculty of Medicine and Health, Discipline of Addiction Medicine, NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, The University of Sydney, Sydney, Australia.,The Edith Collins Centre (Translational Research in Alcohol Drugs and Toxicology), Sydney Local Health District, Sydney, Australia.,Drug Health Services, Royal Prince Alfred Hospital, Sydney, Australia
| | - Tim Slade
- Faculty of Medicine and Health, The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Anthony Shakeshaft
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
| | - K S Kylie Lee
- Faculty of Medicine and Health, Discipline of Addiction Medicine, NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, The University of Sydney, Sydney, Australia.,The Edith Collins Centre (Translational Research in Alcohol Drugs and Toxicology), Sydney Local Health District, Sydney, Australia.,Faculty of Health Sciences, National Drug Research Institute, Curtin University, Perth, Australia.,Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia.,Burnet Institute, Melbourne, Australia
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9
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Conigrave JH, Conigrave KM, Wilson S, Lee KSK. Indigenous Australian drinking risk: Comparing risk categorisations based on recall of recent drinking occasions to AUDIT-C screening in a representative sample. Drug Alcohol Rev 2021; 41:616-624. [PMID: 34750926 PMCID: PMC9299218 DOI: 10.1111/dar.13403] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 09/23/2021] [Accepted: 10/11/2021] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Aboriginal and Torres Strait Islander (Indigenous) Australians have identified alcohol consumption as an area of concern. Accurate screening tools are required to help detect and assist at-risk drinkers, and to provide accurate data to policy makers. The Finnish method (determining drinking patterns based on the last two to four drinking occasions), has been proposed as a culturally appropriate and effective screening tool for detecting Indigenous Australians at risk from alcohol consumption. While it has been found to be valid and acceptable for use with Indigenous Australians, the Finnish method has not been compared to the three-item Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) which is currently recommended by the Australian government for use in Aboriginal community-controlled health services. METHODS We compared the performance of the AUDIT-C and Finnish method as screening tools for detecting harms experienced from alcohol in a representative, cross-sectional, sample of Indigenous Australians. RESULTS AUDIT-C was substantially faster for participants to complete than the Finnish method. Metrics derived from both the AUDIT-C and Finnish method were similarly linked to the frequency of self-reported International Classification of Diseases, 11th revision dependence symptoms and harms. DISCUSSION AND CONCLUSIONS The AUDIT-C is likely most appropriate for use in clinical settings due to its speed and ease of use. The Finnish method provides relatively detailed information about drinking and is better suited to population surveys.
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Affiliation(s)
- James H Conigrave
- Faculty of Medicine and Health, Central Clinical School, Centre of Research Excellence in Indigenous Health and Alcohol, The University of Sydney, Sydney, Australia.,The Edith Collins Centre (Translational Research in Alcohol, Drugs and Toxicology), Drug Health Services, Sydney Local Health District, Sydney, Australia
| | - Katherine M Conigrave
- Faculty of Medicine and Health, Central Clinical School, Centre of Research Excellence in Indigenous Health and Alcohol, The University of Sydney, Sydney, Australia.,The Edith Collins Centre (Translational Research in Alcohol, Drugs and Toxicology), Drug Health Services, Sydney Local Health District, Sydney, Australia.,Drug Health Service, Royal Prince Alfred Hospital, Sydney, Australia
| | - Scott Wilson
- Faculty of Medicine and Health, Central Clinical School, Centre of Research Excellence in Indigenous Health and Alcohol, The University of Sydney, Sydney, Australia.,Aboriginal Drug and Alcohol Council SA Aboriginal Corporation, Adelaide, Australia
| | - K S Kylie Lee
- Faculty of Medicine and Health, Central Clinical School, Centre of Research Excellence in Indigenous Health and Alcohol, The University of Sydney, Sydney, Australia.,The Edith Collins Centre (Translational Research in Alcohol, Drugs and Toxicology), Drug Health Services, Sydney Local Health District, Sydney, Australia.,Faculty of Health Sciences, National Drug Research Institute, Curtin University, Perth, Australia.,Burnet Institute, Melbourne, Australia.,Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
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10
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Weatherall TJ, Conigrave JH, Conigrave KM, Perry J, Wilson S, Room R, Chikritzhs T, Kylie Lee KS. Alcohol dependence in a community sample of Aboriginal and Torres Strait Islander Australians: harms, getting help and awareness of local treatments. Addict Sci Clin Pract 2021; 16:65. [PMID: 34715909 PMCID: PMC8555222 DOI: 10.1186/s13722-021-00274-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 10/21/2021] [Indexed: 11/10/2022] Open
Abstract
Background Few studies have examined links between current alcohol dependence and specific harms among Indigenous Australians. We investigated these associations as well as help seeking for drinking, awareness of local treatments and recommendations to help family or friends cut down or stop drinking in two Indigenous communities. Methods A representative sample of Indigenous Australians was surveyed in one urban and one remote community in South Australia. Data were collected via the Grog Survey App. Participants were dependent if they reported two or more symptoms of alcohol dependence (ICD-11). Pearson chi-square tests were used to describe relationships between employment by gender, and dependence by awareness of medicines and local treatment options. Multivariate logistic regressions were used to predict the odds of dependent drinkers experiencing harms and getting help for drinking, controlling for age, gender, schooling and income. Results A total of 775 Indigenous Australians took part in the study. After controlling for confounders, dependent drinkers were nearly eight times more likely to report a harm and nearly three times more likely to get help for their drinking—compared with non-dependent drinkers. Participants recommended accessing local support from an Aboriginal alcohol and other drugs worker, or a detoxification/ rehabilitation service. Discussion and conclusions More support and funding is needed for Indigenous Australians to ensure local treatment options for dependent drinkers are readily available, appropriate and accessible. Involvement of local Aboriginal or Torres Strait Islander health professionals in delivery of care can help ensure that it is appropriate to an individual’s culture and context.
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Affiliation(s)
- Teagan J Weatherall
- Faculty of Medicine and Health, Discipline of Addiction Medicine, NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, The University of Sydney, Sydney, NSW, Australia. .,The Edith Collins Centre (Translational Research in Alcohol Drugs and Toxicology), Sydney Local Health District, Sydney, NSW, Australia. .,Faculty of Medicine and Health, Discipline of Addiction Medicine, Indigenous Health and Substance Use, NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, The University of Sydney, King George V Building, 83-117 Missenden Road, Camperdown, NSW, 2050, Australia.
| | - James H Conigrave
- Faculty of Medicine and Health, Discipline of Addiction Medicine, NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, The University of Sydney, Sydney, NSW, Australia.,The Edith Collins Centre (Translational Research in Alcohol Drugs and Toxicology), Sydney Local Health District, Sydney, NSW, Australia
| | - Katherine M Conigrave
- Faculty of Medicine and Health, Discipline of Addiction Medicine, NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, The University of Sydney, Sydney, NSW, Australia.,The Edith Collins Centre (Translational Research in Alcohol Drugs and Toxicology), Sydney Local Health District, Sydney, NSW, Australia.,Drug Health Services, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
| | - Jimmy Perry
- Aboriginal Drug and Alcohol Council South Australia, Underdale, SA, Australia
| | - Scott Wilson
- Faculty of Medicine and Health, Discipline of Addiction Medicine, NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, The University of Sydney, Sydney, NSW, Australia.,The Edith Collins Centre (Translational Research in Alcohol Drugs and Toxicology), Sydney Local Health District, Sydney, NSW, Australia.,Aboriginal Drug and Alcohol Council South Australia, Underdale, SA, Australia
| | - Robin Room
- Centre for Alcohol Policy Research, La Trobe University, Bundoora, VIC, Australia.,Department of Public Health Sciences, Centre for Social Research on Alcohol and Drugs, Stockholm University, Stockholm, Sweden
| | - Tanya Chikritzhs
- National Drug Research Institute, Faculty of Health Sciences, Curtin University, Perth, WA, Australia
| | - K S Kylie Lee
- Faculty of Medicine and Health, Discipline of Addiction Medicine, NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, The University of Sydney, Sydney, NSW, Australia.,The Edith Collins Centre (Translational Research in Alcohol Drugs and Toxicology), Sydney Local Health District, Sydney, NSW, Australia.,Centre for Alcohol Policy Research, La Trobe University, Bundoora, VIC, Australia.,National Drug Research Institute, Faculty of Health Sciences, Curtin University, Perth, WA, Australia.,Burnet Institute, Melbourne, VIC, Australia
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11
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Zheng C, Conigrave JH, Conigrave KM, Wilson S, Perry J, Chikritzhs TN, Fitts MS, Lee KSK. Patterns of drinking in Aboriginal and Torres Strait Islander peoples as self-reported on the Grog Survey App: A representative urban and remote sample. Drug Alcohol Rev 2021; 41:114-124. [PMID: 34153145 DOI: 10.1111/dar.13333] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 05/03/2021] [Accepted: 05/21/2021] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Measuring self-reported alcohol use is challenging in any population, including when episodic drinking may be common. Drinking among Indigenous Australians has been shown to vary greatly within and between communities. However, most survey methods assume 'regular' patterns of drinking. National estimates have also been shown to underestimate alcohol use among this group. This paper describes drinking patterns in two representative community samples (urban and remote). METHODS Indigenous Australians (aged 16+ years) in two South Australian sites were recruited to complete the Grog Survey App. The App is a validated, interactive tablet-based survey tool, designed to help Indigenous Australians describe their drinking. Drinking patterns were described using medians and interquartile ranges; gender and remoteness were compared using Wilcoxon rank-sum tests. Spearman correlations explored the relationship between drinking patterns and age. Logistic regressions tested if beverage or container preference differed by remoteness or gender. RESULTS Three-quarters of participants (77.0%, n = 597/775) were current drinkers. Median standard drinks per occasion was 7.8 (78 g), 1.3 drinking occasions per month (median). Three-quarters of current drinkers (73.7%) reported a period without drinking (median: 60 days). Remote drinkers were more likely to drink beer. Improvised containers were used by 40.5% of drinkers. DISCUSSION AND CONCLUSIONS Episodic drinking with extended 'dry' periods and from non-standard drinking containers was common in this representative sample of Indigenous Australians. The diversity of container use and beverage preference, by gender and remoteness, illustrates nuances in drinking patterns between communities. It shows the importance of community-level data to inform local strategies addressing alcohol misuse.
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Affiliation(s)
- Catherine Zheng
- The University of Sydney, Faculty of Medicine and Health, Discipline of Addiction Medicine, NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, Sydney, Australia
| | - James H Conigrave
- The University of Sydney, Faculty of Medicine and Health, Discipline of Addiction Medicine, NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, Sydney, Australia
| | - Katherine M Conigrave
- The University of Sydney, Faculty of Medicine and Health, Discipline of Addiction Medicine, NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, Sydney, Australia.,Sydney Local Health District, Royal Prince Alfred Hospital, Drug Health Services, Sydney, Australia
| | - Scott Wilson
- The University of Sydney, Faculty of Medicine and Health, Discipline of Addiction Medicine, NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, Sydney, Australia.,Aboriginal Drug and Alcohol Council, Adelaide, Australia
| | - Jimmy Perry
- Aboriginal Drug and Alcohol Council, Adelaide, Australia
| | - Tanya N Chikritzhs
- Health Sciences, National Drug Research Institute, Curtin University, Perth, Australia
| | - Michelle S Fitts
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia.,Menzies School of Health Research, Alice Springs, Australia
| | - K S Kylie Lee
- The University of Sydney, Faculty of Medicine and Health, Discipline of Addiction Medicine, NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, Sydney, Australia.,Health Sciences, National Drug Research Institute, Curtin University, Perth, Australia.,Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia.,Burnet Institute, Melbourne, Australia
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12
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Staiger PK, Liknaitzky P. An alternative goal-setting technique for addictive behaviour interventions: The Chronos Approach. CLIN PSYCHOL-UK 2021. [DOI: 10.1080/13284207.2021.1923129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Petra K. Staiger
- School of Psychology, Deakin University, Geelong, Australia
- Deakin University Centre for Drug use, Addictive and Anti‐Social Behaviour Research (CEDAAR), Geelong, Australia
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13
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Weatherall TJ, Conigrave JH, Conigrave KM, Perry J, Wilson S, Room R, Fitts MS, Hayman N, Lee KSK. Prevalence and correlates of alcohol dependence in an Australian Aboriginal and Torres Strait Islander representative sample: Using the Grog Survey App. Drug Alcohol Rev 2021; 41:125-134. [PMID: 33896067 DOI: 10.1111/dar.13292] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 03/11/2021] [Accepted: 03/16/2021] [Indexed: 01/21/2023]
Abstract
INTRODUCTION Little is known about the prevalence of current alcohol dependence in Indigenous Australian communities. Here we identify the frequency of reported symptoms, estimate the prevalence and describe the correlates of current alcohol dependence. METHODS A representative sample of Indigenous Australians (16+ years) was recruited from an urban and remote community in South Australia. Data were collected between July and October 2019 via a tablet computer-based application. Participants were likely dependent if they reported two or more dependence symptoms (ICD-11; in the last 12 -months), weekly or more frequently. Chi-square tests described the relationship between demographics, remoteness and alcohol dependence. Spearman correlations estimated the relationship between symptoms of dependence, consumption characteristics and demographics. RESULTS A total of 775 Indigenous Australians participated. The most frequently reported symptoms were prioritising alcohol over other things and loss of control. Overall, 2.2% were likely dependent on alcohol (n = 17/775). Prevalence did not vary by remoteness. Participants who drank more and more frequently tended to report more frequent symptoms of dependence. In the urban site, men tended to report more frequent symptoms of dependence than women. Age, income and schooling were not linked to dependence. DISCUSSION AND CONCLUSIONS The prevalence of current alcohol dependence in this representative sample was similar to that of the general Australian and international estimates. Understanding risk factors for current alcohol dependence will be useful to inform the allocation of funding and support. Accurate estimates of the prevalence of current alcohol dependence are important to better identify specialist treatment needs.
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Affiliation(s)
- Teagan J Weatherall
- 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.,The Edith Collins Centre (Translational Research in Alcohol Drugs and Toxicology), Drug Health Services, Sydney Local Health District, Sydney, Australia
| | - James H Conigrave
- 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.,The Edith Collins Centre (Translational Research in Alcohol Drugs and Toxicology), Drug Health Services, Sydney Local Health District, Sydney, Australia
| | - Katherine M Conigrave
- 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.,The Edith Collins Centre (Translational Research in Alcohol Drugs and Toxicology), Drug Health Services, Sydney Local Health District, Sydney, Australia.,Drug Health Services, Royal Prince Alfred Hospital, Sydney, Australia
| | - Jimmy Perry
- Aboriginal Drug and Alcohol Council South Australia, Adelaide, Australia
| | - Scott Wilson
- 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.,The Edith Collins Centre (Translational Research in Alcohol Drugs and Toxicology), Drug Health Services, Sydney Local Health District, Sydney, Australia.,Aboriginal Drug and Alcohol Council South Australia, Adelaide, Australia
| | - Robin Room
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia.,Centre for Social Research on Alcohol and Drugs, Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
| | - Michelle S Fitts
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia.,Menzies School of Health Research, Alice Springs, Australia
| | - Noel Hayman
- Southern Queensland Centre of Excellence in Aboriginal and Torres Strait Islander Primary Health Care, Brisbane, Australia.,School of Medicine, University of Queensland, Brisbane, Australia.,School of Medicine, Griffith University, Gold Coast, Australia
| | - K S Kylie Lee
- 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.,The Edith Collins Centre (Translational Research in Alcohol Drugs and Toxicology), Drug Health Services, Sydney Local Health District, Sydney, Australia.,Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia.,National Drug Research Institute, Faculty of Health Sciences, Curtin University, Perth, Australia
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14
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Conigrave JH, Bradshaw EL, Conigrave KM, Ryan RM, Wilson S, Perry J, Doyle MF, Lee KSK. Alcohol consumption and dependence is linked to the extent that people experience need satisfaction while drinking alcohol in two Aboriginal and Torres Strait Islander communities. Addict Sci Clin Pract 2021; 16:23. [PMID: 33849650 PMCID: PMC8042904 DOI: 10.1186/s13722-021-00231-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 03/29/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Unhealthy alcohol use is a key concern for Aboriginal and Torres Strait Islander ('Indigenous Australian') communities. Due to systematic disadvantage and inter-generational trauma, Indigenous Australians may be less likely to have satisfied basic psychological needs (autonomy, competence, and relatedness). When people are need-thwarted, they may engage in compensatory behaviours to feel better in the short-term. We explore the relationship between perceived basic psychological needs satisfaction and alcohol consumption use among Indigenous Australians. Better understanding the functions that alcohol may play for some Indigenous Australian drinkers may aid communities, clinicians, and policy makers in improving programs for reducing drinking-related harms. METHODS We performed a cross-sectional survey of Indigenous Australians (aged 16 years or older) living in two South Australian communities. Participants were eligible if they had consumed any alcohol in the past 12 months. Spearman correlations and linear regressions were used to determine if feeling more autonomous, competent, and related to others (need satisfied) while drinking, was linked to alcohol consumption and dependence. RESULTS Controlling for participant demographics, reporting feeling need satisfied while drinking was linked to drinking more alcohol per day, reporting more frequent symptoms of alcohol dependence, spending more money on alcohol, and scoring higher on the AUDIT-C. CONCLUSIONS Unhealthy drinking may partly stem from attempts to satisfy basic psychological needs. Programs which support Indigenous Australians to meet basic psychological needs could reduce attempts to meet psychological needs through alcohol consumption.
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Affiliation(s)
- James H Conigrave
- Faculty of Medicine and Health, Central Clinical School, NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, The University of Sydney, Drug Health Services, Level 6 King George V Building, 83-117 Missenden Road, Camperdown, 2050, NSW, Australia. .,The Edith Collins Centre (Translational Research in Alcohol, Drugs and Toxicology), Drug Health Services, Sydney Local Health District, Sydney, NSW, Australia.
| | - Emma L Bradshaw
- Institute for Positive Psychology and Education, Australian Catholic University, Sydney, Australia
| | - Katherine M Conigrave
- Faculty of Medicine and Health, Central Clinical School, NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, The University of Sydney, Drug Health Services, Level 6 King George V Building, 83-117 Missenden Road, Camperdown, 2050, NSW, Australia.,The Edith Collins Centre (Translational Research in Alcohol, Drugs and Toxicology), Drug Health Services, Sydney Local Health District, Sydney, NSW, Australia.,Drug Health Services, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
| | - Richard M Ryan
- Institute for Positive Psychology and Education, Australian Catholic University, Sydney, Australia
| | - Scott Wilson
- Faculty of Medicine and Health, Central Clinical School, NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, The University of Sydney, Drug Health Services, Level 6 King George V Building, 83-117 Missenden Road, Camperdown, 2050, NSW, Australia.,Aboriginal Drug & Alcohol Council SA, Aboriginal Corporation, Underdale, SA, Australia
| | - Jimmy Perry
- Aboriginal Drug & Alcohol Council SA, Aboriginal Corporation, Underdale, SA, Australia
| | - Michael F Doyle
- Faculty of Medicine and Health, Central Clinical School, NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, The University of Sydney, Drug Health Services, Level 6 King George V Building, 83-117 Missenden Road, Camperdown, 2050, NSW, Australia.,The Edith Collins Centre (Translational Research in Alcohol, Drugs and Toxicology), Drug Health Services, Sydney Local Health District, Sydney, NSW, Australia
| | - K S Kylie Lee
- Faculty of Medicine and Health, Central Clinical School, NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, The University of Sydney, Drug Health Services, Level 6 King George V Building, 83-117 Missenden Road, Camperdown, 2050, NSW, Australia.,The Edith Collins Centre (Translational Research in Alcohol, Drugs and Toxicology), Drug Health Services, Sydney Local Health District, Sydney, NSW, Australia.,National Drug Research Institute, Faculty of Health Sciences,, Curtin University, Perth, Australia.,Centre for Alcohol Policy Research, La Trobe University, Melbourne, VIC, Australia
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15
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Doyle MF. Alcohol and drug research with Indigenous peoples: where do we go from here? Addiction 2021; 116:435-437. [PMID: 32621552 DOI: 10.1111/add.15176] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 06/14/2020] [Accepted: 06/15/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Michael F Doyle
- NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
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16
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Snijder M, Stapinski L, Lees B, Ward J, Conrod P, Mushquash C, Belone L, Champion K, Chapman C, Teesson M, Newton N. Preventing Substance Use Among Indigenous Adolescents in the USA, Canada, Australia and New Zealand: a Systematic Review of the Literature. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2020; 21:65-85. [PMID: 31641922 PMCID: PMC6957574 DOI: 10.1007/s11121-019-01038-w] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
This systematic review assessed the current evidence base of substance use prevention programs for Indigenous adolescents in the USA, Canada, Australia and New Zealand. The authors investigated (a) the outcomes, type, setting and context of prevention programs; (b) the common components of beneficial prevention programs; and (c) the methodological quality of evaluations of included prevention programs. The authors searched eight peer-reviewed and 20 grey literature databases for studies published between 1 January 1990 and 31 August 2017. Data extracted included type of program (culturally adapted, culture-based or unadapted), the setting (school, community, family or multi-setting), delivery (computerised or traditional), context (Indigenous-specific or multi-cultural environment) and common components of the programs. Program evaluation methodologies were critically appraised against standardised criteria. This review identified 26 eligible studies. Substance use prevention programs for Indigenous youth led to reductions in substance use frequency and intention to use; improvements in substance-related knowledge, attitudes and resistance strategies; and delay in substance use initiation. Key elements of beneficial programs included substance use education, skills development, cultural knowledge enhancement and community involvement in program development. Five programs were rated as methodologically strong, seven were moderate and fourteen were weak. Prevention programs have the potential to reduce substance use among Indigenous adolescents, especially when they are developed in partnership with Indigenous people. However, more rigorously conducted evaluation trials are required to strengthen the evidence base.
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Affiliation(s)
- Mieke Snijder
- The Matilda Centre, Faculty of Health and Medicine, The University of Sydney, Darlington, Sydney, NSW, 2006, Australia.
| | - Lexine Stapinski
- The Matilda Centre, Faculty of Health and Medicine, The University of Sydney, Darlington, Sydney, NSW, 2006, Australia
| | - Briana Lees
- The Matilda Centre, Faculty of Health and Medicine, The University of Sydney, Darlington, Sydney, NSW, 2006, Australia
| | - James Ward
- South Australian Health and Medical Research Institute, Flinders University, Adelaide, Australia
| | - Patricia Conrod
- Department of Psychiatry, Université de Montréal, Montreal, Canada
| | - Christopher Mushquash
- Centre for Rural and Northern Health Research, Northern Ontario School of Medicine, Lakehead University, Thunder Bay, Canada
| | - Lorenda Belone
- Department of Health, Exercise & Sports Sciences, College of Education, University of New Mexico, Albuquerque, NM, USA
| | - Katrina Champion
- The Matilda Centre, Faculty of Health and Medicine, The University of Sydney, Darlington, Sydney, NSW, 2006, Australia
| | - Cath Chapman
- The Matilda Centre, Faculty of Health and Medicine, The University of Sydney, Darlington, Sydney, NSW, 2006, Australia
| | - Maree Teesson
- The Matilda Centre, Faculty of Health and Medicine, The University of Sydney, Darlington, Sydney, NSW, 2006, Australia
| | - Nicola Newton
- The Matilda Centre, Faculty of Health and Medicine, The University of Sydney, Darlington, Sydney, NSW, 2006, Australia
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17
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Chikritzhs T. The elusiveness of representativeness in general population surveys for alcohol: Commentary on Rehm
et al
. Drug Alcohol Rev 2020; 40:166-168. [DOI: 10.1111/dar.13175] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 08/24/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Tanya Chikritzhs
- National Drug Research Institute, Health Sciences Curtin University Perth Australia
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18
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Lee KSK, Fitts MS, Conigrave JH, Zheng C, Perry J, Wilson S, Ah Chee D, Bond S, Weetra K, Chikritzhs TN, Slade T, Conigrave KM. Recruiting a representative sample of urban South Australian Aboriginal adults for a survey on alcohol consumption. BMC Med Res Methodol 2020; 20:183. [PMID: 32631364 PMCID: PMC7339418 DOI: 10.1186/s12874-020-01067-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 06/26/2020] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Population estimates of alcohol consumption vary widely among samples of Aboriginal and Torres Strait Islander (Indigenous) Australians. Some of this difference may relate to non-representative sampling. In some communities, household surveys are not appropriate and phone surveys not feasible. Here we describe activities undertaken to implement a representative sampling strategy in an urban Aboriginal setting. We also assess our likely success. METHODS We used a quota-based convenience sample, stratified by age, gender and socioeconomic status to recruit Indigenous Australian adults (aged 16+) in an urban location in South Australia. Between July and October 2019, trained research staff (n = 7/10, Aboriginal) recruited community members to complete a tablet computer-based survey on drinking. Recruitment occurred from local services, community events and public spaces. The sampling frame and recruitment approach were documented, including contacts between research staff and services, and then analysed. To assess representativeness of the sample, demographic features were compared to the 2016 Australian Bureau of Statistics Census of Population and Housing. RESULTS Thirty-two services assisted with data collection. Many contacts (1217) were made by the research team to recruit organisations to the study (emails: n = 610; phone calls: n = 539; texts n = 33; meetings: n = 34, and one Facebook message). Surveys were completed by 706 individuals - equating to more than one third of the local population (37.9%). Of these, half were women (52.5%), and the average age was 37.8 years. Sample characteristics were comparable with the 2016 Census in relation to gender, age, weekly individual income, Indigenous language spoken at home and educational attainment. CONCLUSION Elements key to recruitment included: 1) stratified sampling with multi-site, service-based recruitment, as well as data collection events in public spaces; 2) local services' involvement in developing and refining the sampling strategy; and 3) expertise and local relationships of local Aboriginal research assistants, including health professionals from the local Aboriginal health and drug and alcohol services. This strategy was able to reach a range of individuals, including those usually excluded from alcohol surveys (i.e. with no fixed address). Carefully pre-planned stratified convenience sampling organised in collaboration with local Aboriginal health staff was central to the approach taken.
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Affiliation(s)
- K S Kylie Lee
- Faculty of Medicine and Health, Discipline of Addiction Medicine, NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, The University of Sydney, King George V Building, 83-117 Missenden Road, Camperdown, NSW, 2050, Australia.
- Centre for Alcohol Policy Research, La Trobe University, Bundoora, Victoria, 3084, Australia.
| | - Michelle S Fitts
- Centre for Alcohol Policy Research, La Trobe University, Bundoora, Victoria, 3084, Australia
- Menzies School of Health Research, Alice Springs, Northern Territory, 0870, Australia
| | - James H Conigrave
- Faculty of Medicine and Health, Discipline of Addiction Medicine, NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, The University of Sydney, King George V Building, 83-117 Missenden Road, Camperdown, NSW, 2050, Australia
| | - Catherine Zheng
- Faculty of Medicine and Health, Discipline of Addiction Medicine, NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, The University of Sydney, King George V Building, 83-117 Missenden Road, Camperdown, NSW, 2050, Australia
| | - Jimmy Perry
- Aboriginal Drug and Alcohol Council SA, Underdale, South Australia, 5032, Australia
| | - Scott Wilson
- Faculty of Medicine and Health, Discipline of Addiction Medicine, NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, The University of Sydney, King George V Building, 83-117 Missenden Road, Camperdown, NSW, 2050, Australia
- Aboriginal Drug and Alcohol Council SA, Underdale, South Australia, 5032, Australia
| | - Dudley Ah Chee
- Watto Purunna Aboriginal Primary Health Care Service, Adelaide, South Australia, Australia
| | - Shane Bond
- Watto Purunna Aboriginal Primary Health Care Service, Adelaide, South Australia, Australia
| | - Keith Weetra
- Watto Purunna Aboriginal Primary Health Care Service, Adelaide, South Australia, Australia
| | - Tanya N Chikritzhs
- National Drug Research Institute, Curtin University, Shenton Park, Western Australia, 6102, Australia
| | - Tim Slade
- Faculty of Medicine and Health, Matilda Centre for Research in Mental health and Substance Use, The University of Sydney, Camperdown, New South Wales, 2050, Australia
| | - Katherine M Conigrave
- Faculty of Medicine and Health, Discipline of Addiction Medicine, NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, The University of Sydney, King George V Building, 83-117 Missenden Road, Camperdown, NSW, 2050, Australia
- Sydney Local Health District, Royal Prince Alfred Hospital, Drug Health Services, Camperdown, New South Wales, 2050, Australia
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19
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Staiger PK, Liknaitzky P. An alternative goal‐setting technique for addictive behaviour interventions: The Chronos Approach. CLIN PSYCHOL-UK 2020. [DOI: 10.1111/cp.12226] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Petra K. Staiger
- School of PsychologyDeakin University Geelong Australia
- Deakin University Centre for Drug use, Addictive and Anti‐Social Behaviour Research (CEDAAR) Geelong Australia
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20
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Lee KSK, Conigrave JH, Wilson S, Perry J, Hayman N, Zheng C, Al Ansari M, Doyle M, Room R, Callinan S, Chikritzhs T, Slade T, Conigrave KM. Patterns of drinking in Aboriginal and Torres Strait Islander peoples as self-reported on the Grog Survey App: a stratified sample. BMC Med Inform Decis Mak 2019; 19:180. [PMID: 31488135 PMCID: PMC6729068 DOI: 10.1186/s12911-019-0879-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2019] [Accepted: 07/29/2019] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND The Grog Survey App is a visual and interactive tablet computer-based survey application. It has been shown to be an accurate and acceptable tool to help Indigenous Australians describe what they drink. METHODS The Grog Survey App was used to enquire into patterns of drinking in a stratified sample of Indigenous Australians in urban and remote/regional sites during testing of the App. The App asked about the last four drinking occasions in the past 12 months, including preferred alcohol types and containers; and symptoms of alcohol dependence, based on ICD-11 descriptions. Drinking patterns are presented here using medians and interquartile ranges, and the thresholds set out by the Australian National and Health and Medical Research Council guidelines. Patterns of consumption are compared by gender and remoteness, using Wilcoxon rank-sum test to compare medians. Logistic regressions tested whether alcohol types and drinking containers varied by remoteness. RESULTS In this stratified sample most people either consumed nothing (21.7%), or consumed quantities which placed them at short- (95.6%) or long-term risk (47.8%) of harms. Drinkers in remote areas were more likely to drink beer, but less likely to drink pre-mixed spirits. 'Stubbies' and other beer glasses were popular in urban areas, compared with 'slabs' (cases of beer) in remote/regional areas. The use of improvised containers (i.e. empty juice bottles) did not vary by remoteness. Nearly one in six (15%) current drinkers reported experiencing at least two symptoms of alcohol dependence at least monthly. Average drinks per day was the consumption measure most highly correlated with each dependence symptom (r = 0.34-0.38). CONCLUSIONS The App was able to capture a wide range of preferred alcohol types and containers, and demonstrate a diversity in how alcohol is consumed. This detail was captured in a relative brief survey delivered using an interactive and appealing tablet computer-based application.
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Affiliation(s)
- KS Kylie Lee
- Discipline of Addiction Medicine, Indigenous Health and Substance Use, The University of Sydney, Faculty of Medicine and Health, NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, King George V Building 83-117 Missenden Road, Camperdown, New South Wales 2050 Australia
- Centre for Alcohol Policy Research, La Trobe University, Bundoora, Victoria 3084 Australia
| | - James H. Conigrave
- Discipline of Addiction Medicine, Indigenous Health and Substance Use, The University of Sydney, Faculty of Medicine and Health, NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, King George V Building 83-117 Missenden Road, Camperdown, New South Wales 2050 Australia
| | - Scott Wilson
- Discipline of Addiction Medicine, Indigenous Health and Substance Use, The University of Sydney, Faculty of Medicine and Health, NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, King George V Building 83-117 Missenden Road, Camperdown, New South Wales 2050 Australia
- Aboriginal Drug and Alcohol Council South Australia, 155 Holbrooks Road, Underdale, South Australia 5032 Australia
| | - Jimmy Perry
- Aboriginal Drug and Alcohol Council South Australia, 155 Holbrooks Road, Underdale, South Australia 5032 Australia
| | - Noel Hayman
- Southern Queensland Centre of Excellence in Aboriginal and Torres Strait Islander Primary Health Care (Inala Indigenous Health Service), 37 Wirraway Parade, Inala, Queensland 4077 Australia
- School of Medicine, Griffith University, Gold Coast Campus, Brisbane, Queensland 4222 Australia
- University of Queensland, School of Medicine, Herston Road, Herston, Queensland 4006 Australia
| | - Catherine Zheng
- Discipline of Addiction Medicine, Indigenous Health and Substance Use, The University of Sydney, Faculty of Medicine and Health, NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, King George V Building 83-117 Missenden Road, Camperdown, New South Wales 2050 Australia
| | - Mustafa Al Ansari
- Discipline of Addiction Medicine, Indigenous Health and Substance Use, The University of Sydney, Faculty of Medicine and Health, NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, King George V Building 83-117 Missenden Road, Camperdown, New South Wales 2050 Australia
| | - Michael Doyle
- Discipline of Addiction Medicine, Indigenous Health and Substance Use, The University of Sydney, Faculty of Medicine and Health, NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, King George V Building 83-117 Missenden Road, Camperdown, New South Wales 2050 Australia
| | - Robin Room
- Centre for Alcohol Policy Research, La Trobe University, Bundoora, Victoria 3084 Australia
| | - Sarah Callinan
- Centre for Alcohol Policy Research, La Trobe University, Bundoora, Victoria 3084 Australia
| | - Tanya Chikritzhs
- Curtin University, Health Sciences, National Drug Research Institute, 10 Selby St, Shenton Park, Western Australia 6008 Australia
| | - Tim Slade
- Faculty of Medicine and Health, Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Camperdown campus, New South Wales 2050 Australia
| | - Katherine M. Conigrave
- Discipline of Addiction Medicine, Indigenous Health and Substance Use, The University of Sydney, Faculty of Medicine and Health, NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, King George V Building 83-117 Missenden Road, Camperdown, New South Wales 2050 Australia
- Sydney Local Health District, Royal Prince Alfred Hospital, Drug Health Services, King George V Building, 83-117 Missenden Road, Camperdown, New South Wales 2050 Australia
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Dowsett M, Islam MM, Ganora C, Day C, Lee KSK, Dawson A, Joseph T, White A, Freeburn B, Conigrave KM. Asking young Aboriginal people who use illicit drugs about their healthcare preferences using audio‐computer‐assisted self‐interviewing. Drug Alcohol Rev 2019; 38:482-493. [DOI: 10.1111/dar.12957] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Revised: 05/13/2019] [Accepted: 05/14/2019] [Indexed: 11/30/2022]
Affiliation(s)
| | - M. Mofizul Islam
- Department of Public HealthLa Trobe University Bundoora Australia
| | - Christopher Ganora
- Department of General PracticeThe University of Sydney, Faculty of Medicine and Health (Westmead) Sydney Australia
| | - Carolyn Day
- Addiction MedicineThe University of Sydney, Faculty of Medicine and Health Sydney Australia
| | - K. S. Kylie Lee
- NHMRC Centre of Research Excellence in Indigenous Health and AlcoholThe University of Sydney, Faculty of Medicine and Health, Addiction Medicine Sydney Australia
- Centre for Alcohol Policy ResearchLa Trobe University Bundoora Australia
| | - Angela Dawson
- Australian Centre for Public and Population Health ResearchThe University of Technology Sydney Australia
| | - Telphia Joseph
- School of Public Health and Community MedicineThe University of New South Wales Sydney Australia
| | - Ann White
- Drug Health ServiceSydney Local Health District, Royal Prince Alfred Hospital Sydney Australia
| | | | - Katherine M. Conigrave
- NHMRC Centre of Research Excellence in Indigenous Health and AlcoholThe University of Sydney, Faculty of Medicine and Health, Addiction Medicine Sydney Australia
- Drug Health ServiceSydney Local Health District, Royal Prince Alfred Hospital Sydney Australia
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22
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Lee KSK, Conigrave JH, Wilson S, Perry J, Callinan S, Room R, Chikritzhs TN, Slade T, Hayman N, Leggat G, Conigrave KM. Short screening tools for risky drinking in Aboriginal and Torres Strait Islander Australians: modified AUDIT-C and a new approach. Addict Sci Clin Pract 2019; 14:22. [PMID: 31256762 PMCID: PMC6600888 DOI: 10.1186/s13722-019-0152-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Accepted: 05/30/2019] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Alcohol consumption among Indigenous Australians can involve a stop-start pattern of drinking, with consumption well above recommended guidelines on each occasion. Such intermittent drinking patterns can make screening for risky drinking difficult. This study evaluates the ability of several short alcohol screening tools, contained in the Grog Survey Application, to detect short- or long-term risky drinking as defined by Australian guidelines. Tested tools include a modification of Alcohol Use Disorders Identification Test-Consumption (AUDIT-Cm). METHODS Alcohol consumption was assessed in current drinkers in the past year (n = 184) using AUDIT-Cm and using the last four drinking occasions (Finnish method). Sensitivity and specificity were assessed relative to the Finnish method, for how AUDIT-Cm score (3 + for women, 4 + for men), and how subsets of AUDIT-Cm questions (AUDIT-1m and AUDIT-2m; and AUDIT-3mV alone) were able to determine short- or long-term risk from drinking. Responses to AUDIT-Cm were used to calculate the average standard drinks consumed per day, and the frequency at which more than four standard drinks were consumed on single occasions. Finally, shorter versions of the Finnish method (1, 2, or 3 occasions of drinking) were compared to the full Finnish method, by examining the percentage of variance retained by shorter versions. RESULTS AUDIT-Cm has a high sensitivity in detecting at-risk drinking compared with the Finnish method (sensitivity = 99%, specificity = 67%). The combination of AUDIT-1m and AUDIT-2m was able to classify the drinking risk status for all but four individuals in the same way as the Finnish method did. For the Finnish method, two drinking sessions to calculate drinks per drinking occasion, and four to calculate frequency resulted in nearly identical estimates to data on all four of the most recent drinking occasions (r2 = 0.997). CONCLUSIONS The combination of AUDIT-1m and AUDIT-2m may offer advantages as a short screening tool, over AUDIT-3mV, in groups where intermittent and high per occasion drinking is common. As an alternative to the full Finnish method, the quantity consumed on the last two occasions and timing of the last four occasions may provide a practical short screening tool.
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Affiliation(s)
- K S Kylie Lee
- NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, Discipline of Addiction Medicine, Indigenous Health and Substance Use, Faculty of Medicine and Health, The University of Sydney, King George V Building, Level 6, 83-117 Missenden Road, Camperdown, NSW, 2050, Australia. .,Centre for Alcohol Policy Research, La Trobe University, Bundoora, VIC, Australia.
| | - James H Conigrave
- NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, Discipline of Addiction Medicine, Indigenous Health and Substance Use, Faculty of Medicine and Health, The University of Sydney, King George V Building, Level 6, 83-117 Missenden Road, Camperdown, NSW, 2050, Australia
| | - Scott Wilson
- NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, Discipline of Addiction Medicine, Indigenous Health and Substance Use, Faculty of Medicine and Health, The University of Sydney, King George V Building, Level 6, 83-117 Missenden Road, Camperdown, NSW, 2050, Australia.,Aboriginal Drug and Alcohol Council (ADAC), Underdale, SA, Australia
| | - Jimmy Perry
- Aboriginal Drug and Alcohol Council (ADAC), Underdale, SA, Australia
| | - Sarah Callinan
- Centre for Alcohol Policy Research, La Trobe University, Bundoora, VIC, Australia
| | - Robin Room
- Centre for Alcohol Policy Research, La Trobe University, Bundoora, VIC, Australia
| | - Tanya N Chikritzhs
- Health Sciences, National Drug Research Institute, Curtin University, Perth, WA, Australia
| | - Tim Slade
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia
| | - Noel Hayman
- Southern Queensland Centre of Excellence in Aboriginal and Torres Strait Islander Primary Health Care (Inala Indigenous Health Service), Inala, QLD, Australia.,School of Medicine, Griffith University, Brisbane, QLD, Australia.,School of Medicine, University of Queensland, Saint Lucia, QLD, Australia
| | - Geoffrey Leggat
- Centre for Alcohol Policy Research, La Trobe University, Bundoora, VIC, Australia
| | - Katherine M Conigrave
- NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, Discipline of Addiction Medicine, Indigenous Health and Substance Use, Faculty of Medicine and Health, The University of Sydney, King George V Building, Level 6, 83-117 Missenden Road, Camperdown, NSW, 2050, Australia.,Sydney Local Health District, Royal Prince Alfred Hospital, Drug Health Services, Camperdown, NSW, Australia
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23
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Lee KSK, Conigrave JH, Callinan S, Wilson S, Room R, Perry J, Slade T, Chikritzhs TN, Hayman N, Weatherall T, Leggat G, Gray D, Conigrave KM. Asking about the last four drinking occasions on a tablet computer as a way to record alcohol consumption in Aboriginal and Torres Strait Islander Australians: a validation. Addict Sci Clin Pract 2019; 14:15. [PMID: 31039824 PMCID: PMC6492339 DOI: 10.1186/s13722-019-0148-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Accepted: 03/26/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Alcohol consumption among Indigenous Australians can be irregular, depending on social and geographic context. The Finnish method uses the last four drinking occasions to estimate drinking quantity and pattern. The Grog Survey App is an interactive and visual tablet computer application which uses touch-screen technology to deliver questions on drinking. METHODS Alcohol consumption recorded on the Grog Survey App using the last four occasions (Finnish) method was compared with a clinical interview conducted by an Indigenous Australian health professional. To assess convergent validity, Spearman's ranked correlations between consumption estimates from the App and from interview were calculated. Sensitivity and specificity analyses were used to compare how well the App and clinical interview agreed when classifying drinkers' risk. To assess criterion validity, average grams alcohol per day as estimated by the App (and by interview) were compared against presence of self-reported withdrawal tremors (from App or interview). Test-retest reliability was assessed by correlations between measures of alcohol consumption recorded on two occasions. RESULTS The App recorded higher numbers of standard drinks consumed per drinking occasion than the interview. There was reasonable agreement between the App and interview across common reference periods (sensitivity 92.7%, specificity 69.8%, short-term risk; sensitivity 70.7%, specificity 68.8%, long-term risk). Average consumption recorded by the App was as good or better predictor of withdrawal tremors than consumption as estimated by interview. CONCLUSIONS The Finnish method, as delivered by the App, offers an innovative way to collect survey data on alcohol in a population with an intermittent drinking pattern.
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Affiliation(s)
- K. S. Kylie Lee
- NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, Discipline of Addiction Medicine, Faculty of Medicine and Health, The University of Sydney, King George V Building, 83-117 Missenden Road, Camperdown, NSW 2050 Australia
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, VIC Australia
| | - James H. Conigrave
- NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, Discipline of Addiction Medicine, Faculty of Medicine and Health, The University of Sydney, King George V Building, 83-117 Missenden Road, Camperdown, NSW 2050 Australia
| | - Sarah Callinan
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, VIC Australia
| | - Scott Wilson
- NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, Discipline of Addiction Medicine, Faculty of Medicine and Health, The University of Sydney, King George V Building, 83-117 Missenden Road, Camperdown, NSW 2050 Australia
- Aboriginal Drug and Alcohol Council (ADAC) South Australia, Adelaide, Australia
| | - Robin Room
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, VIC Australia
| | - Jimmy Perry
- Aboriginal Drug and Alcohol Council (ADAC) South Australia, Adelaide, Australia
| | - Tim Slade
- The Matilda Centre for Research in Mental Health and Substance Use, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW Australia
| | - Tanya N. Chikritzhs
- Health Sciences, National Drug Research Institute, Curtin University, Perth, WA Australia
| | - Noel Hayman
- Southern Queensland Centre of Excellence in Aboriginal and Torres Strait Islander Primary Health Care, Inala, QLD Australia
- School of Medicine, Griffith University, Brisbane, QLD Australia
- School of Medicine, University of Queensland, Brisbane, QLD Australia
| | - Teagan Weatherall
- NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, Discipline of Addiction Medicine, Faculty of Medicine and Health, The University of Sydney, King George V Building, 83-117 Missenden Road, Camperdown, NSW 2050 Australia
| | - Geoffrey Leggat
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, VIC Australia
| | - Dennis Gray
- School of Medicine, University of Queensland, Brisbane, QLD Australia
| | - Katherine M. Conigrave
- NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, Discipline of Addiction Medicine, Faculty of Medicine and Health, The University of Sydney, King George V Building, 83-117 Missenden Road, Camperdown, NSW 2050 Australia
- Drug Health Services, Sydney Local Health District, Royal Prince Alfred Hospital, Sydney, NSW Australia
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24
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Freeman J, Condon C, Hamilton S, Mutch RC, Bower C, Watkins RE. Challenges in Accurately Assessing Prenatal Alcohol Exposure in a Study of Fetal Alcohol Spectrum Disorder in a Youth Detention Center. Alcohol Clin Exp Res 2019; 43:309-316. [PMID: 30427546 PMCID: PMC6590127 DOI: 10.1111/acer.13926] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Accepted: 11/03/2018] [Indexed: 01/28/2023]
Abstract
BACKGROUND Prenatal alcohol exposure (PAE) can result in permanent disability, including physical, neurodevelopmental, and cognitive impairments, known as fetal alcohol spectrum disorder (FASD). Individuals with FASD are more likely to engage with the law, including being placed in detention, than individuals without FASD. Young people who were sentenced to detention participated in a FASD prevalence study in Western Australia. The diagnosis of FASD requires a multidisciplinary assessment and confirmation of maternal alcohol consumption during pregnancy. Obtaining accurate assessment of PAE for young people participating in the study was challenging. METHODS An interview with the birth mother or other responsible adult for young people sentenced to detention in Western Australia was conducted as part of the FASD assessment. The Alcohol Use Disorders Identification Test consumption subset (AUDIT-C), other relevant questions, and documentary evidence were used to assess PAE. PAE was categorized according to the Australian Guide to the Diagnosis of FASD: no PAE reported, confirmed or confirmed high-risk, or unknown. RESULTS Among the 101 participants, information on PAE was unable to be obtained for 13 (13%) young people. Of the remaining 88 participants with information of PAE, 41 reported no PAE and 47 had confirmed PAE. CONCLUSIONS Accurately assessing prenatal alcohol consumption is challenging in any setting, but it is exceptionally challenging when assessed 13 to 17 years retrospectively as part of a FASD assessment for a young person sentenced to detention. Recording and recoding detailed qualitative responses was required to provide an accurate assessment of PAE using the AUDIT-C. Standardized recording of PAE in antenatal and birth records would facilitate later assessments for FASD and provide opportunities for advice and support for women who continue to drink during pregnancy.
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Affiliation(s)
- Jacinta Freeman
- Telethon Kids InstituteUniversity of Western AustraliaPerthWestern AustraliaAustralia
| | - Carmen Condon
- Telethon Kids InstituteUniversity of Western AustraliaPerthWestern AustraliaAustralia
| | - Sharynne Hamilton
- Telethon Kids InstituteUniversity of Western AustraliaPerthWestern AustraliaAustralia
- School of Paediatrics and Child HealthUniversity of Western AustraliaPerthWestern AustraliaAustralia
| | - Raewyn C. Mutch
- Telethon Kids InstituteUniversity of Western AustraliaPerthWestern AustraliaAustralia
- School of Paediatrics and Child HealthUniversity of Western AustraliaPerthWestern AustraliaAustralia
- School of MedicineDentistry and Health SciencesUniversity of Western AustraliaPerthWestern AustraliaAustralia
- Child and Adolescent Health ServiceDepartment of Health Western AustraliaPerthWestern AustraliaAustralia
| | - Carol Bower
- Telethon Kids InstituteUniversity of Western AustraliaPerthWestern AustraliaAustralia
| | - Rochelle E. Watkins
- Telethon Kids InstituteUniversity of Western AustraliaPerthWestern AustraliaAustralia
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25
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Symons M, Pedruzzi RA, Bruce K, Milne E. A systematic review of prevention interventions to reduce prenatal alcohol exposure and fetal alcohol spectrum disorder in indigenous communities. BMC Public Health 2018; 18:1227. [PMID: 30390661 PMCID: PMC6215602 DOI: 10.1186/s12889-018-6139-5] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Accepted: 10/22/2018] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Fetal alcohol spectrum disorder (FASD) is a preventable, lifelong neurodevelopmental disorder caused by prenatal alcohol exposure. FASD negatively impacts individual Indigenous communities around the world. Although many prevention interventions have been developed and implemented, they have not been adequately evaluated. This systematic review updates the evidence for the effectiveness of FASD prevention interventions in Indigenous/Aboriginal populations internationally, and in specific populations in North America and New Zealand, and offers recommendations for future work. METHOD The MEDLINE, Embase, CINAHL Plus, Web of Science, PsycINFO, SocINDEX, and Informit databases were searched from inception to 22/08/2017 for all prevention and intervention papers published in peer-reviewed scientific journals, with results, targeting prenatal alcohol exposure and FASD in Indigenous populations. This review was limited to studies published in English and excluded interventions focusing on the workforce. All steps were completed independently by two reviewers with discrepancies resolved via consensus with the senior author. RESULTS There was significant heterogeneity in the ten included studies. Populations targeted included non-pregnant women of child-bearing age, pregnant women, school children and the general public. Study designs included one randomised controlled trial, five cohort studies with pre-post design, one cross-sectional study with different pre- and post-intervention groups, and four studies collected post-intervention data. Studies assessed changes in knowledge, and/or changes in risk for prenatal alcohol exposure including self-reported alcohol consumption, use of birth control or a combination of both. One study was conducted in Australia and nine in the US. The methodological quality of all studies was rated as 'Poor' using the systematic review assessment tools developed by The National Heart, Lung and Blood Institute. Studies were subject to substantial bias due to issues such as high loss to follow-up, lack of control groups and the reliance on self-report measures to assess the main outcome. CONCLUSION Overall, there is little evidence that previous interventions aiming to reduce the risk of prenatal alcohol exposure or FASD in Indigenous populations have been effective. Future intervention studies should address the cultural factors and historical context that are fundamental to successful work with Indigenous populations, and be designed, implemented and evaluated using rigorous methods. This systematic review was registered with PROSPERO, CRD42018086212.
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Affiliation(s)
- Martyn Symons
- Telethon Kids Institute, The University of Western Australia, PO Box 855, West Perth, Perth, WA 6872 Australia
- National Health and Medical Research Council FASD Research Australia Centre of Research Excellence, Perth, Australia
| | - Rebecca Anne Pedruzzi
- Telethon Kids Institute, The University of Western Australia, PO Box 855, West Perth, Perth, WA 6872 Australia
| | - Kaashifah Bruce
- Telethon Kids Institute, The University of Western Australia, PO Box 855, West Perth, Perth, WA 6872 Australia
| | - Elizabeth Milne
- Telethon Kids Institute, The University of Western Australia, PO Box 855, West Perth, Perth, WA 6872 Australia
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Lee KSK, Wilson S, Perry J, Room R, Callinan S, Assan R, Hayman N, Chikritzhs T, Gray D, Wilkes E, Jack P, Conigrave KM. Correction to: Developing a tablet computer-based application ('App') to measure self-reported alcohol consumption in Indigenous Australians. BMC Med Inform Decis Mak 2018; 18:26. [PMID: 29720186 PMCID: PMC5932830 DOI: 10.1186/s12911-018-0604-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- K S Kylie Lee
- University of Sydney, Discipline of Addiction Medicine, Indigenous Health and Substance Use, NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, King George V Building, 83-117 Missenden Road, Camperdown, NSW, 2050, Australia. .,Centre for Alcohol Policy Research, LaTrobe University, 215 Franklin Street, Melbourne, VIC, 3000, Australia.
| | - Scott Wilson
- University of Sydney, Discipline of Addiction Medicine, Indigenous Health and Substance Use, NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, King George V Building, 83-117 Missenden Road, Camperdown, NSW, 2050, Australia.,Aboriginal Drug and Alcohol Council (ADAC) South Australia, 155 Holbrooks Road Underdale, Adelaide, South Australia, 5032, Australia
| | - Jimmy Perry
- Aboriginal Drug and Alcohol Council (ADAC) South Australia, 155 Holbrooks Road Underdale, Adelaide, South Australia, 5032, Australia
| | - Robin Room
- Centre for Alcohol Policy Research, LaTrobe University, 215 Franklin Street, Melbourne, VIC, 3000, Australia
| | - Sarah Callinan
- Centre for Alcohol Policy Research, LaTrobe University, 215 Franklin Street, Melbourne, VIC, 3000, Australia
| | - Robert Assan
- Alcohol, Tobacco and other Drugs Service, Queensland Health, 190 Palmerston Vincent, Townsville, QLD, 4814, Australia
| | - Noel Hayman
- Southern Queensland Centre of Excellence in Aboriginal and Torres Strait Islander Primary Health Care, 37 Wirraway Parade, Inala, QLD, 4077, Australia.,School of Medicine, University of Queensland, Herston Road, Brisbane, QLD, 4006, Australia.,School of Medicine, Griffith University, Gold Coast Campus, Gold Coast, Brisbane, QLD, 4222, Australia
| | - Tanya Chikritzhs
- National Drug Research Institute, Curtin University, 10 Selby St, Shenton Park, WA, 6008, Australia
| | - Dennis Gray
- National Drug Research Institute, Curtin University, 10 Selby St, Shenton Park, WA, 6008, Australia
| | - Edward Wilkes
- National Drug Research Institute, Curtin University, 10 Selby St, Shenton Park, WA, 6008, Australia
| | - Peter Jack
- Drug Health Services, Royal Prince Alfred Hospital, Sydney Local Health District, KGV Building, Missenden Road, Camperdown, NSW, 2050, Australia
| | - Katherine M Conigrave
- University of Sydney, Discipline of Addiction Medicine, Indigenous Health and Substance Use, NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, King George V Building, 83-117 Missenden Road, Camperdown, NSW, 2050, Australia.,Drug Health Services, Royal Prince Alfred Hospital, Sydney Local Health District, KGV Building, Missenden Road, Camperdown, NSW, 2050, Australia
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27
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Islam MM, Oni HT, Lee KSK, Hayman N, Wilson S, Harrison K, Hummerston B, Ivers R, Conigrave KM. Standardised alcohol screening in primary health care services targeting Aboriginal and Torres Strait Islander peoples in Australia. Addict Sci Clin Pract 2018; 13:5. [PMID: 29592801 PMCID: PMC5875000 DOI: 10.1186/s13722-018-0108-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Accepted: 01/17/2018] [Indexed: 11/10/2022] Open
Abstract
Introduction and aims Aboriginal and Torres Strait Islander Community Controlled Health Services (ACCHSs) around Australia have been asked to standardise screening for unhealthy drinking. Accordingly, screening with the 3-item AUDIT-C (Alcohol Use Disorders Identification Test—Consumption) tool has become a national key performance indicator. Here we provide an overview of suitability of AUDIT-C and other brief alcohol screening tools for use in ACCHSs. Methods All peer-reviewed literature providing original data on validity, acceptability or feasibility of alcohol screening tools among Indigenous Australians was reviewed. Narrative synthesis was used to identify themes and integrate results. Results Three screening tools—full AUDIT, AUDIT-3 (third question of AUDIT) and CAGE (Cut-down, Annoyed, Guilty and Eye-opener) have been validated against other consumption measures, and found to correspond well. Short forms of AUDIT have also been found to compare well with full AUDIT, and were preferred by primary care staff. Help was often required with converting consumption into standard drinks. Researchers commented that AUDIT and its short forms prompted reflection on drinking. Another tool, the Indigenous Risk Impact Screen (IRIS), jointly screens for alcohol, drug and mental health risk, but is relatively long (13 items). IRIS has been validated against dependence scales. AUDIT, IRIS and CAGE have a greater focus on dependence than on hazardous or harmful consumption. Discussion and conclusions Detection of unhealthy drinking before harms occur is a goal of screening, so AUDIT-C offers advantages over tools like IRIS or CAGE which focus on dependence. AUDIT-C’s brevity suits integration with general health screening. Further research is needed on facilitating implementation of systematic alcohol screening into Indigenous primary healthcare.
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Affiliation(s)
- M Mofizul Islam
- Department of Public Health, La Trobe University, Melbourne, Australia.
| | - Helen T Oni
- Department of Public Health, La Trobe University, Melbourne, Australia
| | - K S Kylie Lee
- NHMRC Centre of Research Excellence: Indigenous Health and Alcohol, Sydney, Australia.,Indigenous Health and Substance Use, Discipline of Addiction Medicine, Sydney Medical School, The University of Sydney, Sydney, Australia
| | - Noel Hayman
- Southern Queensland Centre of Excellence in Aboriginal and Torres Strait Islander Primary Health Care, Inala, Australia.,Faculty of Medicine, University of Queensland, Brisbane, Australia.,School of Medicine, Griffith University, Brisbane, Australia
| | - Scott Wilson
- Aboriginal Drug and Alcohol Council SA, Underdale, South Australia, Australia.,Discipline of Addiction Medicine, Sydney Medical School, The University of Sydney, Sydney, Australia
| | - Kristie Harrison
- Sydney School of Public Health, The University of Sydney, Sydney, Australia
| | - Beth Hummerston
- Alcohol Treatment Project, Aboriginal Health Council of South Australia Ltd, Adelaide, Australia
| | - Rowena Ivers
- Illawarra Aboriginal Medical Service, Wollongong, Australia.,Graduate School of Medicine, University of Wollongong, Wollongong, Australia
| | - Katherine M Conigrave
- NHMRC Centre of Research Excellence: Indigenous Health and Alcohol, Sydney, Australia.,Discipline of Addiction Medicine, Sydney Medical School, The University of Sydney, Sydney, Australia.,Royal Prince Alfred Hospital, Sydney Local Health District, Camperdown, Australia
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