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Introduction Methods Results Discussion and Conclusion The Grog Survey App is a validated, visual and interactive self‐administered application for tablet computers that is designed to help Aboriginal Australians describe their alcohol consumption. Each person who completes the App also receives a brief intervention with feedback tailored to their survey responses. We aimed to qualitatively assess the acceptability and perceived quality of the Grog App's brief intervention, among higher risk consumers and health providers at an Aboriginal residential rehabilitation centre.This descriptive qualitative study analysed feedback from clients (n = 20) and staff (n = 10) of a drug and alcohol residential rehabilitation service on the brief intervention element of the Grog App. Data were collected face‐to‐face via semi‐structured interviews over four consecutive weeks between May and June 2021. A content analysis was conducted, which was informed by the Mobile App Rating Scale (MARS).Client and staff feedback is summarised using four themes from the MARS framework: (i) aesthetics; (ii) engagement; (iii) functionality; and (iv) information. Most clients and staff felt like health messages on the brief intervention were written by ‘someone who understands’. Overall, clients and staff described the brief intervention as visually appealing, engaging and likely able to elicit ‘lightbulb moments’.The brief intervention on the Grog App is unique in its provision of tailored advice based on survey responses to all individuals (i.e., those who do not drink through to those with likely dependence). Further research is needed to assess effectiveness of this brief intervention. [ABSTRACT FROM AUTHOR]

Introduction: Alcohol screening among Indigenous Australians is important to identify individuals needing support to reduce their drinking. Understanding clinical contexts in which clients are screened, and which clients are more or less likely to be screened, could help identify areas of services and communities that might benefit from increased screening. Methods: We analysed routinely collected data from 22 Aboriginal Community Controlled Health Organisations Australia‐wide. Data collected between February 2016 and February 2021 were analysed using R, and aggregated to describe screening activity per client, within 2‐monthly extraction periods. Descriptive analyses were performed to identify contexts in which clients received an Alcohol Use Disorders Identification Test consumption (AUDIT‐C) screen. Multi‐level logistic regression determined demographic factors associated with receiving an AUDIT‐C screen. Three models are presented to examine if screening was predicted by: (i) age; (ii) age and gender; (iii) age, gender and service remoteness. Results: We observed 83,931 occasions where AUDIT‐C was performed at least once during a 2‐monthly extraction period. Most common contexts were adult health check (55.0%), followed by pre‐consult examination (18.4%) and standalone item (9.9%). For every 10 years' increase in client age, odds of being screened with AUDIT‐C slightly decreased (odds ratio 0.98; 95% confidence interval [CI] 0.98, 0.99). Women were less likely to be screened with AUDIT‐C (odds ratio 0.95; 95% CI 0.93, 0.96) than men. Discussion and Conclusions: This study identified areas where alcohol screening can be increased (e.g., among women). Increasing AUDIT‐C screening across entire communities could help reduce or prevent alcohol‐related harms. Future Indigenous‐led research could help identify strategies to increase screening rates. [ABSTRACT FROM AUTHOR]

Several initiatives have sought to increase the number of First Nations individuals with a higher degree in research (i.e., PhD or research masters)—in Australia and in similarly colonised countries. However, little has been written on day‐to‐day support structures and mechanisms that might help First Nations Australian candidates thrive in postgraduate research degrees and beyond. For sensitive research fields such as alcohol, emerging Aboriginal and Torres Strait Islander researchers must grapple with topics which are stigmatising and in some instances associated with traumatic associations. There is also a lack of studies internationally that describe optimal support for First Nations students undertaking a higher degree by research with a primary focus on alcohol. Here we discuss what we have learned from the support offered through the Centre of Research Excellence in Indigenous Health and Alcohol—from the perspective of academic staff, students, trainees and early career researchers. We consider what may be generalisable lessons from this experience. [ABSTRACT FROM AUTHOR]

Background and aims: There is a higher prevalence of unhealthy alcohol use among Indigenous populations, but there have been few studies of the effectiveness of screening and treatment in primary health care. Over 24 months, we tested whether a model of service-wide support could increase screening and any alcohol treatment. Design: Cluster-randomized trial with 24-month implementation (12 months active, 12 months maintenance). Setting: Australian Aboriginal Community Controlled primary care services. Participants: Twenty-two services (83 032 clients) that use Communicare practice software and see at least 1000 clients annually, randomized to the treatment arm or control arm. Intervention and comparator: Multi-faceted early support model versus a comparator of waiting-list control (11 services). Measurements: A record (presence = 1, absence = 0) of: (i) Alcohol Use Disorders Identification Test--Consumption (AUDIT-C) screening (primary outcome), (ii) any-treatment and (iii) brief intervention. We received routinely collected practice data bimonthly over 3 years (1-year baseline, 1-year implementation, 1-year maintenance). Multi-level logistic modelling was used to compare the odds of each outcome before and after implementation. Findings: The odds of being screened within any 2-month reference period increased in both arms post-implementation, but the increase was nearly eight times greater in earlysupport services [odds ratio (OR) = 7.95, 95% confidence interval (CI) = 4.04-15.63, P < 0.001]. The change in odds of any treatment in early support was nearly double that of waiting-list controls (OR = 1.89, 95% CI = 1.19-2.98, P = 0.01) but was largely driven by decrease in controls. There was no clear evidence of difference between groups in the change in the odds of provision of brief intervention (OR = 1.95, 95% CI = 0.53-7.17, P = 0.32). Conclusions: An early support model designed to aid routine implementation of alcohol screening and treatment in Aboriginal health services resulted in improvement of Alcohol Use Disorders Identification Test--Consumption screening rates over 24 months of implementation, but the effect on treatment was less clear. [ABSTRACT FROM AUTHOR]

Introduction: Measuring self‐reported alcohol use is challenging in any population, including when episodic drinking may be common. Drinking among Indigenous Australians has been shown to vary greatly within and between communities. However, most survey methods assume 'regular' patterns of drinking. National estimates have also been shown to underestimate alcohol use among this group. This paper describes drinking patterns in two representative community samples (urban and remote). Methods: Indigenous Australians (aged 16+ years) in two South Australian sites were recruited to complete the Grog Survey App. The App is a validated, interactive tablet‐based survey tool, designed to help Indigenous Australians describe their drinking. Drinking patterns were described using medians and interquartile ranges; gender and remoteness were compared using Wilcoxon rank‐sum tests. Spearman correlations explored the relationship between drinking patterns and age. Logistic regressions tested if beverage or container preference differed by remoteness or gender. Results: Three‐quarters of participants (77.0%, n = 597/775) were current drinkers. Median standard drinks per occasion was 7.8 (78 g), 1.3 drinking occasions per month (median). Three‐quarters of current drinkers (73.7%) reported a period without drinking (median: 60 days). Remote drinkers were more likely to drink beer. Improvised containers were used by 40.5% of drinkers. Discussion and Conclusions: Episodic drinking with extended 'dry' periods and from non‐standard drinking containers was common in this representative sample of Indigenous Australians. The diversity of container use and beverage preference, by gender and remoteness, illustrates nuances in drinking patterns between communities. It shows the importance of community‐level data to inform local strategies addressing alcohol misuse. [ABSTRACT FROM AUTHOR]

We examined acceptability and feasibility of a tablet application ("App") to record self-reported alcohol consumption among Aboriginal and Torres Strait Islander Australians. Four communities (1 urban; 3 regional/remote) tested the App, with 246 adult participants (132 males, 114 females). The App collected (a) completion time; (b) participant feedback; (c) staff observations. Three research assistants were interviewed. Only six (1.4%) participants reported that the App was "hard" to use. Participants appeared to be engaged and to require minimal assistance; nearly half verbally reflected on their drinking or drinking of others. The App has potential for surveys, screening, or health promotion. [ABSTRACT FROM AUTHOR]

Background and Aims: To reduce health and social inequities, it is important to understand how drinking patterns vary within and between Indigenous peoples. We aimed to assess variability in estimates of Indigenous Australian drinking patterns and to identify demographic and methodological factors associated with this. Design A three‐level meta‐analysis of Australian Aboriginal and Torres Strait Islander ('Indigenous') drinking patterns [International Prospective Register of Systematic Reviews (PROSPERO) no. CRD42018103209]. Setting: Australia. Participants: Indigenous Australians. Measurements The primary outcomes extracted were drinking status, single‐occasion risk and life‐time risk. Moderation analysis was performed to identify potential sources of heterogeneity. Moderators included gender, age, socio‐economic status, local alcohol restrictions, sample population, remoteness, Australian state or territory, publication year, Indigenous involvement in survey design or delivery and cultural adaptations. Findings A systematic review of the literature revealed 41 eligible studies. For all primary outcomes, considerable heterogeneity was identified within (I22 = 51.39–68.80%) and between (I32 = 29.27–47.36%) samples. The pooled proportions (P) of current drinkers [P = 0.59, 95% confidence interval (CI) = 0.53–0.65], single‐occasion (P = 0.34, 95% CI = 0.24–0.44) and life‐time (P = 0.21, 95% CI = 0.15–0.29) risk were all moderated by gender, age, remoteness and measurement tool. Reference period moderated proportions of participants at single‐occasion risk. Conclusions: Indigenous Australian drinking patterns vary within and between communities. Initiatives to reduce high‐risk drinking should take account of this variability. [ABSTRACT FROM AUTHOR]