The ATTAIN Solution Tested: Initial Pilot Results of an Automated, Web-based Screening Tool for Unhealthy Drinking Behaviors.

Abstract

Automated Alcohol Misuse Interventions (ATTAIN) is an automated, computer-based tool that screens people for unhealthy alcohol use and offers web-based counseling with minimal involvement of health-care personnel. We describe the outcomes of the initial quality improvement pilot tests done to examine the screening component of ATTAIN. This is a data-only study that reports the results from the ATTAIN-quality improvement database. A detailed description of the quality improvement methods is presented in a related article. The primary outcome was the ATTAIN questionnaire response rate. Secondary outcomes included the percentage of individuals who screened positive for unhealthy drinking behaviors and for alcohol use disorders, respondents' comfort level with ATTAIN, and the cost of ATTAIN. A total of 301 members were included in the pilot tests. The ATTAIN response rate was 46%. The prevalence of unhealthy drinking behaviors and alcohol use disorders was 16% and 5%, respectively. These rates were noninferior to the Healthcare Effectiveness Data and Information Set 2019 rates submitted from the same organization for the Unhealthy Alcohol Use Screening and Follow-up measure. In the post-ATTAIN paper surveys, 100% agreed to the statement: "I felt comfortable answering [ATTAIN] questions . . . ." The cost of ATTAIN screening was estimated to be one-tenth the cost of office-based screening. ATTAIN was well accepted by eligible adults, appeared noninferior to office-based screening, and added several potential advantages in terms of screening for alcohol use disorders and readiness to change.