Supporting Aboriginal Community Controlled Health Services in their alcohol care
Aboriginal and Torres Strait Islander (‘Aboriginal’) community controlled health services (ACCHSs) offer accessible and culturally secure care to their communities. There are many pressures on staff time. We worked with services to support their capacity to proactively detect unhealthy alcohol use and provide help.
We tested out a model of support, to see if it could help Aboriginal community controlled health services (ACCHSs) to increase screening for unhealthy alcohol use, and to offer help for alcohol from their primary care (general clinic) sections. Study methods were suggested by the Aboriginal Health Council, South Australia. Twenty-two ACCHSs around Australia took part in this trial; 11 received support at the start of the study (early support). The other 11 services received support two years later (late support). Support consisted of eight elements, including training -provided by Aboriginal and non-Aboriginal project staff; sharing of knowledge between services; and regular feedback of routinely collected data. We analysed the odds of screening and recording of help, before and after support started (using multilevel logistic modelling).
Both early and late support services increased their alcohol screening over the 2-year period. But early support services increased screening at more than seven times the rate of late support (OR=7.5, 95% CI=4.4-12.6, p<0.001). The odds of staff recording help or treatment on alcohol using selected practice software items increased in early support services at twice the rate as in late support (OR=2.0, 95% CI=1.3-3.1, p<0.001).
This flexible model of support was built on sharing of strengths and knowledge between services, and continuing quality improvement within services. Support allowed services to increase alcohol screening and to offer help for unhealthy alcohol use as part of general care.