Short screening tools for risky drinking in Aboriginal and Torres Strait Islander Australians: modified AUDIT-C and a new approach

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 (r 2 = 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. Electronic supplementary material The online version of this article (10.1186/s13722-019-0152-6) contains supplementary material, which is available to authorized users.

Support can increase use of the AUDIT‐C in Australian Aboriginal Community Controlled Health Services: a cluster randomized trial

“…Drinking that leads to harms (especially to others) can be a source of shame [17], and is probably under-reported [18,19]. Short structured screening tools, such as the Alcohol Use Disorders Identification Test consumption questions (AUDIT-C) [20][21][22], can help to guide conversations about unhealthy drinking [23][24][25].…”

Prevalence and correlates of alcohol dependence in an Australian Aboriginal and Torres Strait Islander representative sample: Using the Grog Survey App

“…The App collects information on demographics (including age, gender, language spoken, highest educational attainment, individual income per week: <200; 200–399; 400–599; 600–799; 800+ $AUD), alcohol consumption (modified Finnish method [25,26] and Timeline Followback [27]), money spent on alcohol (0–25; 26–50; 51–75; 76–99; 100+ $AUD), frequency of symptoms of alcohol dependence (ICD‐11), harms to self or others, treatment access, and participants' feedback on using the App [22]. All survey data were collected offline and synchronised daily to a secure server hosted by the University of Sydney.…”

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

“…The Finnish method [ 40 , 55 ] was used to estimate drinking intensity (based on the last two drinking occasions) and frequency (based on the last four drinking occasions). The Finnish method has been found to be a valid and acceptable tool for measuring the alcohol consumption of Indigenous Australians [ 40 , 41 ].…”