Association between Alcohol Screening and Brief Intervention during Routine Check-Ups and Alcohol Consumption among Adults Living in California

Objective: Alcohol consumption accounts for 1 in 10 deaths among U.S. adults, and has cost upwards of $200 billion in a single year due to lost productivity. Alcohol Screening and Brief Intervention (ASBI) was developed as a treatment approach for use in primary care to identify and reduce hazardous and harmful substance use behaviors among the general population. Although ASBI has proven to be successful, implementation rates remain low. Few studies have been conducted in Nevada to encourage or improve ASBI implementation in primary care. In order to better support Nevada policy decisions, this study investigates the proportion of ASBI in primary care settings in California. With a population demographic similar to that of Nevada, and ASBI implementation initiatives supported by government policy and funded through Medicaid, California represents an ideal location for evaluating the usefulness of ASBI implementation. Methods: Using population level representative data from the 2014 Behavioral Risk Factor Surveillance System, this study utilizes logistic regression to analyze the association between self-reported drinking levels and screening and brief intervention practices during routine check-ups. Results: The results demonstrated that the more a person drank, the lower their odds of receiving ASBI during a routine check-up. Hispanics had reduced odds of receiving ASBI when compared to Whites. Women had increased odds of receiving intervention compared to men, but the odds of screening were the same for both genders. Among those who were at risk for alcohol abuse, there was roughly 80% screening coverage and only those who made more than $50,000 per year had reduced odds of receiving screening. However, the proportion of intervention was much lower and men had reduced odds of receiving screening compared to women. Conclusion: California’s policy initiatives are effective in improving ASBI coverage among its general population but only in terms of screening. However, more attention should be given to increasing the number of follow-up interventions. It is recommended that private insurers follow the lead of Medi-Cal and require ASBI from all general practitioners. To improve the overall coverage of screening and intervention, more attention should be directed toward providing ASBI to Hispanics and males. Nevada would benefit from implementing policies similar to California, requiring ASBI from general practitioners accepting Medicaid patients