Associations between alcohol outlet densities and adolescent alcohol consumption: A study in Australian students

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.

Download Full-text

Development and evaluation of the OHCITIES instrument: assessing alcohol urban environments in the Heart Healthy Hoods project

BMJ Open ◽

10.1136/bmjopen-2017-017362 ◽

2017 ◽

Vol 7 (10) ◽

pp. e017362 ◽

Cited By ~ 2

Author(s):

Xisca Sureda ◽

Albert Espelt ◽

Joan R Villalbí ◽

Alba Cebrecos ◽

Lucía Baranda ◽

...

Keyword(s):

Alcohol Consumption ◽

Urban Environment ◽

Intraclass Correlation ◽

Urban Environments ◽

Secondary Outcome ◽

Research Experience ◽

Alcohol Outlet ◽

Alcohol Outlets ◽

Retest Reliability ◽

Test Retest Reliability

ObjectivesTo describe the development and test–retest reliability of OHCITIES, an instrument characterising alcohol urban environment in terms of availability, promotion and signs of consumption.DesignThis study involved: (1) developing the conceptual framework for alcohol urban environment by means of literature reviewing and previous alcohol environment research experience; (2) pilot testing and redesigning the instrument; (3) instrument digitalisation; (4) instrument evaluation using test–retest reliability.SettingData for testing the reliability of the instrument were collected in seven census sections in Madrid in 2016 by two observers.Primary and secondary outcome measuresWe computed per cent agreement and Cohen’s kappa coefficients to estimate inter-rater and test–retest reliability for alcohol outlet environment measures. We calculated interclass coefficients and their 95% CIs to provide a measure of inter-rater reliability for signs of alcohol consumption measures.ResultsWe collected information on 92 on-premise and 24 off-premise alcohol outlets identified in the studied areas about availability, accessibility and promotion of alcohol. Most per cent-agreement values for alcohol measures in on-premise and off-premise alcohol outlets were greater than 80%, and inter-rater and test–retest reliability values were generally above 0.80. Observers identified 26 streets and 3 public squares with signs of alcohol consumption. Intraclass correlation coefficient between observers for any type of signs of alcohol consumption was 0.50 (95% CI −0.09 to 0.77). Few items promoting alcohol unrelated to alcohol outlets were found on public spaces.ConclusionsThe OHCITIES instrument is a reliable instrument to characterise alcohol urban environment. This instrument might be used to understand how alcohol environment associates with alcohol behaviours and its related health outcomes, and can help in the design and evaluation of policies to reduce the harm caused by alcohol.

Download Full-text