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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: Contrary to stereotypes, Aboriginal and Torres Strait Islander Australians are more likely to abstain from drinking than other Australians. We explored characteristics and experiences of Aboriginal and Torres Strait Islander Australians who do not drink alcohol. Method: We conducted a cross‐sectional, representative survey of 775 Aboriginal and Torres Strait Islander Australians (16+ years) in remote and urban South Australia. We explore correlates of not drinking alcohol using multi‐level logistic regression. We describe reasons for non‐drinking and harms participants experienced in past 12 months from others' drinking. Results: Non‐drinking participants were more likely to be older (OR 1.35 [95% CI 1.21, 1.50] per decade) and unemployed (OR 2.72 [95% CI 1.77, 4.20]). Participants who spoke Aboriginal Australian languages at home were three times more likely to be lifetime abstainers from drinking (OR 3.07 [95% CI 1.52, 6.21]). Common reasons for not drinking alcohol were health and family. Most did not report harms from others' alcohol consumption (79.6%, 76.9%, urban and remote respectively). Stress from others' alcohol consumption was the most reported harm by non‐drinkers (14.5% and 23.1%, urban and remote, respectively). Discussion and Conclusions: Culture such as speaking Aboriginal Australian languages might have protective effects that promote abstaining but was rarely explicitly cited as a reason for not drinking. A greater understanding of local values held by people who do not drink alcohol could help inform health messaging and other interventions to reduce alcohol‐related harms. Understanding local reasons for abstaining can help tailor health messaging to suit local contexts. [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]

Introduction Methods Results Discussion and Conclusions Regular screening for risky drinking is important to improve the health of Aboriginal and Torres Strait Islander Australians. We explored whether the rate of screening for risky drinking using the Alcohol Use Disorders Identification Test—Consumption (AUDIT‐C) questions was disrupted at Aboriginal Community Controlled Health Services (ACCHS) during state‐wide and territory‐wide COVID‐19 lockdowns in 2020.Retrospective analysis of screening data from 22 ACCHSs located in New South Wales, the Northern Territory, Queensland, South Australia, Victoria and Western Australia. These services provide holistic and culturally appropriate primary care. A multi‐level Poisson regression, including AR(1) autocorrelation, was used to predict counts of AUDIT‐C screening at ACCHSs.AUDIT‐C screening was suppressed during state‐wide and territory‐wide lockdowns in 2020 (incident rate ratio [IRR] 0.42 [0.29, 0.61]). The effect of lockdowns differed by service remoteness. While there was a substantial reduction in AUDIT‐C screening for urban and inner regional services (IRR 0.25 [95% confidence interval (CI) 0.15, 0.42]), there was not a statistically significant change in screening at outer regional and remote (IRR 0.60 [95% CI 0.33, 1.09]) or very remote services (IRR 0.67 [95% CI 0.40, 1.11]).The COVID‐19 lockdowns in Australia likely suppressed rates of screening for risky drinking in urban and inner regional regions. As harm from alcohol consumption may have increased during lockdowns, policymakers should consider implementing measures to enable screening for risky drinking to continue during future lockdowns. [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]

Introduction: Aboriginal and Torres Strait Islander (Indigenous) Australians have identified alcohol consumption as an area of concern. Accurate screening tools are required to help detect and assist at‐risk drinkers, and to provide accurate data to policy makers. The Finnish method (determining drinking patterns based on the last two to four drinking occasions), has been proposed as a culturally appropriate and effective screening tool for detecting Indigenous Australians at risk from alcohol consumption. While it has been found to be valid and acceptable for use with Indigenous Australians, the Finnish method has not been compared to the three‐item Alcohol Use Disorders Identification Test—Consumption (AUDIT‐C) which is currently recommended by the Australian government for use in Aboriginal community‐controlled health services. Methods: We compared the performance of the AUDIT‐C and Finnish method as screening tools for detecting harms experienced from alcohol in a representative, cross‐sectional, sample of Indigenous Australians. Results: AUDIT‐C was substantially faster for participants to complete than the Finnish method. Metrics derived from both the AUDIT‐C and Finnish method were similarly linked to the frequency of self‐reported International Classification of Diseases, 11th revision dependence symptoms and harms. Discussion and Conclusions: The AUDIT‐C is likely most appropriate for use in clinical settings due to its speed and ease of use. The Finnish method provides relatively detailed information about drinking and is better suited to population surveys. [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: Aboriginal clients accessing Aboriginal community‐controlled residential alcohol and other drug rehabilitation services in New South Wales, Australia believe they have better outcomes due to culturally appropriate care. However, there is a paucity of published treatment outcome data. This study aims to identify predictors of treatment outcomes based on client characteristics at intake. Methods: A cross‐sectional, retrospective, observational study of 2326 admissions to six services between January 2011 and December 2016. The outcomes were: (i) leaving treatment early; (ii) self‐discharge or house discharge (by staff); and (iii) re‐admission within two years. The predictors examined were Aboriginal status, age, justice system referral and primary substance of concern. Competing risk and Poisson regression analyses were used to identify trends in the data. Results: The mean age of clients was 33 years, and the majority (56%) stayed at least 6 weeks. Aboriginal clients whose primary substance of concern was stimulants were almost eight times more likely to re‐admitted within 2 years than other clients (risk ratio 7.91; P < 0.001). Aboriginal clients who were also referred from justice were more likely to self‐discharge (risk ratio 1.87; P < 0.001). Furthermore, Aboriginal clients who were aged older than 30 were less likely to have a re‐admission (risk ratio 0.32; P ≤ 0.001). Discussion and Conclusions: This study showed client characteristics that are predictive of harmful outcomes include age under 30, justice client, primary substance of use and their interactions. Future research could build on these results to aid ongoing development of residential rehabilitation programs for Aboriginal peoples. [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]

Self-determination theory's (SDT) dual process model claims that parental autonomy support relates positively to child well-being, while psychologically controlling parenting is linked positively to child ill-being. We tested these claims using a combination of one-stage and univariate meta-analytic structural equation modeling with moderation ( k = 238; n = 1,040, N = 126,423). In the univariate models, parental autonomy support was linked positively with child well-being, r = 0.30, 95% CI [0.26, 0.33], whereas parental psychological control was positively linked with child ill-being, r = 0.26, 95% CI [0.23, 0.28]. Consistent with SDT's dual process model, the one-stage model that controlled for the intercorrelations between predictors showed that parental autonomy support and psychological control had distinct links to child wellness outcomes. Parental autonomy support was linked positively with child well-being, even when accounting for psychological control, r = 0.26, 95% CI [0.20, 0.31], and parental psychological control was positively linked to child ill-being, controlling for autonomy support, r = 0.20, 95% CI [0.17, 0.23]. Crucially, the beneficial effects of parental autonomy support and the costs of psychological control applied across regions, degrees of national individualism and cultural hierarchy, as well as child developmental periods and sexes. These results help move the field beyond debates about whether autonomy is beneficial toward questions about manifestations of autonomy across groups and variations in its optimal support. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Introduction: Little is known about the prevalence of current alcohol dependence in Indigenous Australian communities. Here we identify the frequency of reported symptoms, estimate the prevalence and describe the correlates of current alcohol dependence., Methods: A representative sample of Indigenous Australians (16+ years) was recruited from an urban and remote community in South Australia. Data were collected between July and October 2019 via a tablet computer-based application. Participants were likely dependent if they reported two or more dependence symptoms (ICD-11; in the last 12 -months), weekly or more frequently. Chi-square tests described the relationship between demographics, remoteness and alcohol dependence. Spearman correlations estimated the relationship between symptoms of dependence, consumption characteristics and demographics., Results: A total of 775 Indigenous Australians participated. The most frequently reported symptoms were prioritising alcohol over other things and loss of control. Overall, 2.2% were likely dependent on alcohol (n = 17/775). Prevalence did not vary by remoteness. Participants who drank more and more frequently tended to report more frequent symptoms of dependence. In the urban site, men tended to report more frequent symptoms of dependence than women. Age, income and schooling were not linked to dependence., Discussion and Conclusions: The prevalence of current alcohol dependence in this representative sample was similar to that of the general Australian and international estimates. Understanding risk factors for current alcohol dependence will be useful to inform the allocation of funding and support. Accurate estimates of the prevalence of current alcohol dependence are important to better identify specialist treatment needs., (© 2021 Australasian Professional Society on Alcohol and other Drugs.)