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• INTRODUCTION This paper provides a comprehensive view of the implementation of alcohol, screening, brief intervention, and referral to treatment (SBIRT) in the primary health care system of the region of Ribeirão Preto, in the State of São Paulo, Brazil, mostly concerning the evaluation of SBIRT training. • METHODS The data were obtained from a community-based study of 776, public primary health care professionals enrolled in an SBIRT training and implementation program in the region of Ribeirão Preto, SP, Brazil from 2003 to 2008. The majority of health professionals who attended the trainings were community health agents (59%) working in the Family Health Program. Physicians, psychologists and nurses also contributed. Data collection was performed using self-report questionnaires, direct interviews, observational, methods and focus groups. • RESULTS There was a statistically significant decrease in health professionals' positive beliefs about alcohol consumption in the post-training period and a significant increase in SBIRT knowledge. Among professional groups, physicians and nurses showed most improvement in their perceived feeling of being "prepared to counsel" patients about risky alcohol use. Qualitative analysis showed an improvement in the level, of awareness of alcohol problems, adoption of a disease model, and an increase in referrals for alcohol treatment. The program was disseminated to a large enough proportion of the health professionals in small, cities to have a significant reach into the general, population of heavy drinkers. • CONCLUSION The training model combined with concurrent supervision and support seem to be effective in the implementation of SBIRT in the routine of health professionals in primary hearth care. This model shows promise as a way to implement alcohol screening and brief intervention as a standard practice in primary health care in large population areas of Brazil. It has been extended to other parts of Brazil and could serve as a model for other Latin-American countries. [ABSTRACT FROM AUTHOR]

Objective: The Alcohol Use Disorders Identification Test (AUDIT) has been developed to screen for hazardous and harmful alcohol consumption. It has been used among a variety of primary care, general population and general hospital populations. However, with the exception of one study undertaken by the author and colleagues, the use of the AUDIT in general hospital psychiatric patients has not been reported. This paper reports on a substudy of this larger study whose aim was to determine the frequency of hazardous alcohol use and dependence among patients admitted to the psychiatric units of general hospitals in Perth, Western Australia, and discusses major reasons for non-AUDIT screening among this group. Method: In a 12-month period 990 patients aged 18–64 years and residing in the Perth metropolitan area were admitted to the psychiatric unit of the two hospitals. Using the AUDIT alcohol use in patients with four major types of psychiatric disorder, namely mood, adjustment, anxiety and psychotic disorders, was assessed. Results: Of the 834 admissions targeted for AUDIT screening 263 were not screened. This non-screening represented 27–42% of patients in each of the major diagnostic categories. There was no significant difference in the proportion of patients screened versus not screened for mood, adjustment or schizophrenia/psychosis. There were however, significantly fewer patients with anxiety disorder screened compared with mood disorder. Those non-screened patients in major psychiatric groups had significantly shorter hospital stays than their diagnostic counterparts who were screened. The major reason for non-screening in all groups was due to patients leaving the psychiatric facility before they could be accessed. This included discharge before screening, transfer to another psychiatric facility and short admission. To a lesser extent cognitive dysfunction accounted for non-screening among major diagnostic groups. Conclusions: Failure to... [ABSTRACT FROM AUTHOR]

Background: Foetal alcohol spectrum disorders (FASDs) are one of the most common preventable forms of developmental disability and congenital abnormalities globally, particularly in countries where alcohol is considered socially acceptable. Screening for alcohol use early in pregnancy can facilitate the detection of alcohol-exposed pregnancies and identify women who require further assessment. However, only a small percentage of children with FASD are identified in the United Kingdom. This may be partly attributed to a lack of awareness of the condition by National Health Service (NHS) health professionals. Methods: We developed an online survey to determine health care professionals' (midwives, health visitors, obstetricians, paediatricians, and general practitioners) perceived knowledge, attitudes, and clinical practices relating to alcohol in pregnancy and FASD. Results: There were a total of 250 responses to the surveys (78 midwives, 60 health visitors, 55 obstetricians, 31 paediatricians, and 26 general practitioners). About 58.1% of paediatricians had diagnosed a patient with foetal alcohol syndrome (FAS) or FASD and 36.7% worried about stigmatisation with diagnosis. Paediatricians reported the highest levels of FASD training (54.8%), with much lower levels in midwives (21.3%). This was reflected in perceived knowledge levels; overall, only 19.8% of respondents knew the estimated UK prevalence of FASD for example. Conclusions: We identified a need for training in alcohol screening in pregnancy and FASD to improve awareness and recognition by UK professionals. This could improve patient care from the antenatal period and throughout childhood. [ABSTRACT FROM AUTHOR]

Background: An estimated 15.1 million adults ages 18 years and older are classified with an alcohol use disorder, which includes 9.8 million men and 5.3 million women. A brief intervention is indicated for those identified to be at risk because of alcohol use. Objective: To determine the feasibility and acceptability of informational videos about alcohol use. Design: This feasibility study provided participants with the opportunity to choose one of two videos, Alcohol and the Brain or Rethinking Drinking. An online survey was administered to all study participants to identify alcohol-related risk, readiness to decrease use, and knowledge pertaining to alcohol use. Results: The two videos provided in this study were feasibly delivered in an on-line format to 129 adults, including 115 males and 5 females identified to be at risk. Knowledge scores increased only slightly. There were mixed results for the readiness scores. Conclusions: Future research should examine the efficacy of these two alcohol brief interventions on alcohol-related outcomes. [ABSTRACT FROM AUTHOR]

Providing antenatal and postnatal support for women who drink alcohol in pregnancy is only possible if those at risk can be identified. However, screening will only be helpful if women feel comfortable with the method used. We conducted a survey of pregnant women and their partners to investigate self-reported beliefs and practice regarding drinking during pregnancy and the acceptability of screening. Pregnant women and their partners attending antenatal clinics in North-East England were asked to complete a short survey regarding their alcohol consumption in pregnancy, their beliefs about safe levels of alcohol in pregnancy and whether they would be happy to have their blood or their baby's meconium analysed for alcohol biomarkers. The data were summarised using descriptive statistics and thematic analysis. A total of 171 pregnant women and 41 partners participated. Of the pregnant women, 153 (89.5%) felt women should abstain from alcohol consumption, although only 70 (40.9%) reported not drinking in pregnancy. Of 96 women who reported drinking in pregnancy and reported when they stopped, all but six (6.3%) stopped drinking when they found out they were pregnant. Of women and partners who recorded an answer, 177 (87.2%) said they would consent to blood biomarker analysis. Confusion over what level of alcohol is safe and using screening as an opportunity for education and support emerged as key themes from free-text responses. Most women viewed screening for alcohol in pregnancy positively, although its acceptability in the small number of women who continue to drink is unclear. [ABSTRACT FROM AUTHOR]

The CAGE is a commonly used alcohol screening instrument. Although considerable work has been done on the validity of CAGE scores, relatively little information is available on their reliability. Reliability induction and generalization studies were performed for the CAGE. Of the 259 studies available for analysis, only 19(7.3%) contained reliability information for the sample scores. Thirteen (5.0%) and 227 (87.6%) articles made what are designated as reliability induction by report and reliability induction by omission. The median internal consistency reliability across 22 samples was .74, with a range of .52 to .90. Sample age was the only identified sample characteristic that demonstrated a statistically significant relationship with CAGE score reliability. [ABSTRACT FROM AUTHOR]