title: Effect of using different modes to administer the AUDIT-C on identification of hazardous drinking and acquiescence to trial participation among injured patients.
abstract: OBJECTIVE
  We compared the effect of three different modes of questionnaire administration on screening for hazardous drinking and acquiescence to trial participation.
  
  
  METHODS
  A quasi-randomized controlled trial among injured patients seen in acute care clinics compared self-administered paper-and-pencil, self-administered electronic, and orally-administered interview questionnaires. Outcomes included positive AUDIT-C screens for hazardous drinking, willingness to participate in a (hypothetical) lifestyle intervention trial, and recruitment success. Differences were analyzed with nonlinear mixed models, controlling for age, sex, and facility. Structured interviews with staff explored levers and barriers to screening.
  
  
  RESULTS
  Of the 370 participants, 22.7% scored > or =4 and 7.8% > or =6 on the AUDIT-C. Electronic questionnaires were more likely than paper questionnaires to identify an AUDIT-C > or =6 (OR = 1.96; 95% CI 1.10-3.48), but not > or =4 (OR = 0.83; 95% CI 0.43-1.62). Oral questionnaires were as likely as paper questionnaires to identify an AUDIT-C > or =4 (OR = 1.00; 95% CI 0.40-2.51) or > or =6 (OR = 1.94; 95% CI 0.83-4.50). Electronic and oral questionnaires were more likely to elicit acquiescence to trial participation (OR = 1.59; 95% CI 1.23-2.07, and OR = 1.66; 95% CI 1.22-2.26, respectively). Oral questionnaires created problems with confidentiality, privacy, and disruption of patient flow, and reduced recruitment success (OR = 0.51; 95% CI 0.42-0.62).
  
  
  CONCLUSIONS
  Among acutely injured patients in clinics who consented to screening, nearly one-fourth reported hazardous drinking. Compared to paper questionnaires, electronic screening produced less social desirability bias and greater acquiescence to trial participation. Oral questionnaires produced greater acquiescence, but barriers to use adversely affected recruitment. Electronic questionnaires may be preferable for screening for hazardous drinking and recruitment into intervention trials in acute care clinics.
authors.affiliation: Kaiser Permanente Health Plan of Colorado, Denver, CO 80262, USA.
authors.forename: Allan
authors.initials: A
authors.lastname: Graham
authors.forename: Cynthia
authors.initials: C
authors.lastname: Goss
authors.forename: Stanley
authors.initials: S
authors.lastname: Xu
authors.forename: David J
authors.initials: DJ
authors.lastname: Magid
authors.forename: Carolyn
authors.initials: C
authors.lastname: DiGuiseppi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000437:Alcoholism / Q000175:diagnosis* / Q000523:psychology* / Q000534:rehabilitation; D003627:Data Interpretation, Statistical; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D008875:Middle Aged; D011581:Psychological Tests; D013383:Suburban Population; D011795:Surveys and Questionnaires; D014505:Urban Population; D014947:Wounds and Injuries / Q000523:psychology*