title: Missed opportunity for alcohol problem prevention among army active duty service members postdeployment.
abstract: OBJECTIVE
  We identified to what extent the Department of Defense postdeployment health surveillance program identifies at-risk drinking, alone or in conjunction with psychological comorbidities, and refers service members who screen positive for additional assessment or care.
  
  
  METHODS
  We completed a cross-sectional analysis of 333 803 US Army active duty members returning from Iraq or Afghanistan deployments in fiscal years 2008 to 2011 with a postdeployment health assessment. Alcohol measures included 2 based on self-report quantity-frequency items-at-risk drinking (positive Alcohol Use Disorders Identification Test alcohol consumption questions [AUDIT-C] screen) and severe alcohol problems (AUDIT-C score of 8 or higher)-and another based on the interviewing provider's assessment.
  
  
  RESULTS
  Nearly 29% of US Army active duty members screened positive for at-risk drinking, and 5.6% had an AUDIT-C score of 8 or higher. Interviewing providers identified potential alcohol problems among only 61.8% of those screening positive for at-risk drinking and only 74.9% of those with AUDIT-C scores of 8 or higher. They referred for a follow-up visit to primary care or another setting only 29.2% of at-risk drinkers and only 35.9% of those with AUDIT-C scores of 8 or higher.
  
  
  CONCLUSIONS
  This study identified missed opportunities for early intervention for at-risk drinking. Future research should evaluate the effect of early intervention on long-term outcomes.
authors.affiliation: Mary Jo Larson and Rachel Sayko Adams are with The Heller School for Social Policy & Management, Institute for Behavioral Health, Brandeis University, Waltham, MA. Beth A. Mohr is with The Heller School for Social Policy & Management, Schneider Institutes for Health Policy, Brandeis University. Nikki R. Wooten is with Military Social Work Research and Practice, University of South Carolina College of Social Work, Columbia. Thomas V. Williams is with Methods, Measures, Analyses, Defense Health Cost Assessment and Program Evaluation, Defense Health Agency, Department of Defense, Falls Church, VA.
authors.forename: Mary Jo
authors.initials: MJ
authors.lastname: Larson
authors.forename: Beth A
authors.initials: BA
authors.lastname: Mohr
authors.forename: Rachel Sayko
authors.initials: RS
authors.lastname: Adams
authors.forename: Nikki R
authors.initials: NR
authors.lastname: Wooten
authors.forename: Thomas V
authors.initials: TV
authors.lastname: Williams
mesh_terms: D000293:Adolescent; D055826:Afghan Campaign 2001-; D000437:Alcoholism / Q000453:epidemiology / Q000517:prevention & control*; D003430:Cross-Sectional Studies; D005260:Female; D006304:Health Status; D006801:Humans; D054542:Iraq War, 2003-2011; D008297:Male; D008603:Mental Health / Q000706:statistics & numerical data; D008889:Military Personnel / Q000706:statistics & numerical data; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012307:Risk Factors; D011795:Surveys and Questionnaires; D055815:Young Adult