Supporting Aboriginal Community Controlled Health Services to Reduce the Harms from Alcohol

Abstract

Introduction: Aboriginal and Torres Strait Islander communities have identified alcohol harms as a key concern. Aboriginal and Torres Strait Islander community controlled health services (ACCHS) are in a unique position to detect unhealthy drinking and to provide treatment. We aimed to determine whether training and off‐site support can increase the uptake of evidence‐based screening and brief‐interventions in ACCHSs.

Methods: We performed a cluster‐randomised‐trial in which 22 ACCHSs were randomly allocated to an early‐support, or to a wait list (control) group. Early support services received training, data feedback, and access to online resources, phone support, and a second‐monthly teleconference to facilitate sharing of experience and learning between service representatives. Rates of screening and brief interventions for unhealthy alcohol‐use were examined, using practice‐software data from 2016‐2018. Multi‐level logistic regression assessed the odds of receiving screening or brief intervention.

Results: Early results suggest the support provided was successful in increasing evidence‐based screening. In any two‐month period, clients who attended services which were actively receiving support were significantly more likely to be screened with Alcohol Use Disorders Identification Test‐Consumption. Support provided was also linked to significantly higher odds of receiving brief intervention, however, base rates were low so this model was unstable.

Discussions and Conclusions: ACCHS have a unique ability to engage their communities. Providing ACCHSs with training and support may be an effective way to increase evidence‐based screening for unhealthy alcohol use in Australia’s Indigenous peoples. Further analyses will examine whether these benefits are sustained in the longer‐term.

Disclosure of Interest Statement: This project is supported by the Australian National Health and Medical Research Council by a project grant (APP1105339), a Centre of Research Excellence (APP1117198) and a Practitioner Fellowship for KMC (APP1117582).