title: Evidence-based alcohol screening and brief intervention in Aboriginal Community Controlled Health Services: experiences of health-care providers.
abstract: OBJECTIVE
  Alcohol screening and brief intervention (SBI) is a cost-effective treatment for reducing alcohol misuse in non-Indigenous populations. To increase the likelihood of alcohol SBI proving cost-effective for Indigenous Australians in practice, strategies to increase its uptake in Aboriginal Community Controlled Health Services (ACCHSs) should be implemented. The aim of this study is to describe the experiences of health-care providers supported to implement evidence-based alcohol SBI in two ACCHSs.
  
  
  METHODS
  Pre- and post-surveys were administered to health staff (n = 32) participating in training workshops, followed by group interviews with health-care providers delivering alcohol SBI. Patient group interviews were also conducted. Survey results were summarised using descriptive statistics and interviews were analysed using a phenomenological approach.
  
  
  RESULTS
  Thirty-two per cent (n = 10) of workshop participants were confident or very confident at baseline to deliver alcohol SBI, increasing significantly to 81% (n = 25) post-training (McNemar Test, P < 0.05). Fifty-seven per cent (n = 16) of health-care providers attending workshops reported delivering alcohol SBI in the following 6 months. Group interviews with health-care providers elicited five themes relating to their experiences of alcohol SBI delivery. Patients in group interviews expressed a preference to be screened for alcohol as part of health assessments.
  
  
  CONCLUSIONS
  Training workshops appear to be an acceptable initial strategy for disseminating alcohol SBI to ACCHSs. Outreach support is required to assist health-care providers to tailor guidelines and resources, and optimally integrate their clinical skills with evidence-based practice. Patients' needs should inform the tailoring process. Tailored collaborative and supportive strategies are probably required to optimally disseminate alcohol SBI in ACCHSs.
authors.affiliation: National Drug and Alcohol Research Centre, Faculty of Medicine, University of New South Wales, Sydney, Australia. a.shakeshaft@unsw.edu.au
authors.forename: Anton
authors.initials: A
authors.lastname: Clifford
authors.forename: Anthony
authors.initials: A
authors.lastname: Shakeshaft
mesh_terms: D000428:Alcohol Drinking / Q000517:prevention & control; D001294:Attitude to Health; D001315:Australia; D003153:Community Health Services; D003159:Community-Institutional Relations; D003362:Cost-Benefit Analysis; D003376:Counseling; D019317:Evidence-Based Medicine; D017144:Focus Groups; D006282:Health Personnel / Q000193:education; D006801:Humans; D008297:Male; D011320:Primary Health Care; D015813:Substance Abuse Detection / Q000523:psychology*; D011795:Surveys and Questionnaires