title: Use of the 5 As for Teen Alcohol Use.
abstract: Clinical guidelines recommend addressing adolescent alcohol use in primary care; the 5 As (Ask, Advise, Assess, Assist, Arrange) may be a useful model for intervention. We audio-recorded 540 visits with 49 physicians and adolescents, compared alcohol disclosure rates in the encounter with those in a survey, and analyzed conversations for use of the 5 As and their relation to adolescent reports of drinking 3 months after the encounter. When physicians asked clear, nonleading questions, drinkers were more likely to disclose alcohol use ( P = .004). In 64% of visits in which alcohol was discussed, physicians used one or more of the 5 As, most frequently "Ask." No physician used all 5 As. Among drinkers, there was no association between physicians' partial use of the 5 As and adolescent alcohol consumption at 3 months. Physicians can learn more effective ways to "Ask" about alcohol use to increase disclosure of drinking and to be more comprehensive in their counseling.
authors.affiliation: 1 Duke University School of Medicine, Durham, NC, USA.|2 University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
authors.forename: Jessica L
authors.initials: JL
authors.lastname: Friedman
authors.affiliation: 3 Duke Cancer Institute, Durham, NC, USA.
authors.forename: Pauline
authors.initials: P
authors.lastname: Lyna
authors.affiliation: 1 Duke University School of Medicine, Durham, NC, USA.
authors.forename: Mya D
authors.initials: MD
authors.lastname: Sendak
authors.affiliation: 2 University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Viera
authors.affiliation: 1 Duke University School of Medicine, Durham, NC, USA.
authors.forename: Mina
authors.initials: M
authors.lastname: Silberberg
authors.affiliation: 1 Duke University School of Medicine, Durham, NC, USA.|3 Duke Cancer Institute, Durham, NC, USA.
authors.forename: Kathryn I
authors.initials: KI
authors.lastname: Pollak
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D000428:Alcohol Drinking / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D010817:Physician-Patient Relations
keywords: adolescent; alcohol drinking; counseling; physicians; primary health care