Alcohol screening and brief intervention in workplace settings and social services: a comparison of literature.

Bernd Schulte,Jens Reimer,Amy Jane O'Donnell,Ingo Schäfer,Sinja Kastner,Christiane Sybille Schmidt

doi:10.3389/fpsyt.2014.00131

Abstract

Background: The robust evidence base for the effectiveness of alcohol screening and brief interventions (ASBIs) in primary health care (PHC) suggests that a widespread expansion of ASBI in non-medical settings could be beneficial. Social service and criminal justice settings work frequently with persons with alcohol use disorders, and workplace settings can be an appropriate setting for the implementation of alcohol prevention programs, as a considerable part of their social interactions takes place in this context.Methods: Update of two systematic reviews on ASBI effectiveness in workplaces, social service, and criminal justice settings. Review to identify implementation barriers and facilitators and future research needs of ASBI in non-medical settings.Results: We found a limited number of randomized controlled trials in non-medical settings with an equivocal evidence of effectiveness of ASBI. In terms of barriers and facilitators to implementation, the heterogeneity of non-medical settings makes it challenging to draw overarching conclusions. In the workplace, employee concerns with regard to the consequences of self-disclosure appear to be key. For social services, the complexity of certain client needs suggest that a stepped and carefully tailored approach is likely to be required.Discussion: Compared to PHC, the reviewed settings are far more heterogeneous in terms of client groups, external conditions, and the focus on substance use disorders. Thus, future research should try to systematize these differences, and consider their implications for the deliverability, acceptance, and potential effectiveness of ASBI for different target groups, organizational frameworks, and professionals.

Highlights

The robust evidence base for the effectiveness of alcohol screening and brief interventions (ASBIs) in primary health care (PHC) suggests that a widespread expansion of ASBI in non-medical settings could be beneficial
This paper examines the existing evidence for the delivery of ASBI in social service and workplace settings, and considers the challenges that providers and recipients alike might experience in achieving their routine implementation
We report on the findings of two recent setting-specific systematic literature reviews focused around three key questions: 1. First, what evidence is there for the effectiveness of ASBI in social service and workplace settings?

Summary

Introduction

The robust evidence base for the effectiveness of alcohol screening and brief interventions (ASBIs) in primary health care (PHC) suggests that a widespread expansion of ASBI in non-medical settings could be beneficial. Alcohol screening and brief intervention (ASBI) has emerged as an effective, and cost-effective, preventative approach to reduce hazardous, and harmful drinking in non-treatment seeking individuals, and has been shown consistently to reduce the quantity, frequency, and intensity of drinking when delivered in primary health care (PHC) settings [4]. The robust evidence for ASBI effectiveness in PHC suggests that an extension of ASBI implementation into further settings with groups that may be at an increased risk of alcohol-related harm may be beneficial [5]. As in addition to the well documented health harms [2], alcohol impacts significantly upon individuals, families, and communities, with heavy drinkers potentially experiencing social harms such as family disruption, interpersonal violence [8,9,10], involvement in crime, problems within the workplace, and financial difficulties [11]

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