Abstract
Screening for harmful alcohol use (HAU) is standard in clinical settings; however, self-reports of the quantity/frequency of use are often inconsistent with population survey data and objective assessment. Inaccuracies of self-reported alcohol use prompt exploration of patients' reluctance to share this information with their health care providers. The purpose of this article is to identify the assumptions and biases that affect screening and brief interventions for HAU. A total of 22 research articles were selected for a systematic review of the literature. The studies included prospective and retrospective studies, randomized controlled trials, case studies, and quantitative and qualitative research from 2015 to 2021. This systematic review identified alcohol health literacy, the inherent bias of surveys and screening tools, stigma, avoidance bias, and the normalization/villainization of alcohol use as contributors to the assumptions and biases that affect screening and brief interventions for HAU. Exploring these assumptions and biases presents opportunities to develop strategies that promote positive change.
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