Training and tailored outreach support to improve alcohol screening and brief intervention in Aboriginal Community Controlled Health Services ANTON CLIFFORD 1,2 , ANTHONY SHAKESHAFT 1 & CATHERINE DEANS 1,3 1 School of Population Health, Faculty of Health Science, University of Queensland, Brisbane, Australia, 2 National Drug and Alcohol Research Centre, Faculty of Medicine, University of New SouthWales, Sydney, Australia, and 3 School of Women’s and Children’s Health, Faculty of Medicine, University of New SouthWales, Sydney, Australia Abstract Introduction and Aims. Aboriginal Community Controlled Health Services (ACCHSs) are often the primary point of contact for Indigenous Australians experiencing alcohol-related harms. Screening and brief intervention (SBI) is a cost-effective treatment for reducing these harms. Factors influencing evidence-based alcohol SBI delivery in ACCHSs have been identified. Evaluations of strategies targeting these factors are required.The aim of this paper is to quantify the effect of training and tailored outreach support on the delivery of alcohol SBI in four Aboriginal Community Controlled Health Services (ACCHSs). Design and Methods. A pre- post- assessment of alcohol information recorded in computerised patient information systems of four ACCHSs. Results. For ACCHSs combined there was a statistically significant increase in the proportion of eligible clients with an electronic record of any alcohol information (3.2% to 7.5%, P < 0.0001) and a valid alcohol screen (1.6% to 6.5%, P < 0.0001), and brief intervention (25.75% to 47.7%, P < 0.0001). All four ACCHSs achieved statistically significant increases in the proportion of clients with a complete alcohol screen (10.3%; 7.4%; 2%, P < 0.0001 and 1.3%, P < 0.05), and two in the proportion with a heavy drinking screen (7% and 3.1%, P < 0.0001). Discussion and Conclusions. Implementing evidence-based alcohol SBI in ACCHSs is likely to require multiple strategies tailored to the characteristics of specific services. Outreach support provided by local drug and alcohol practitioners and a one item heavy drinking screen offer considerable promise for increasing routine alcohol SBI delivery in ACCHSs.Training and outreach support appear to be effective for achieving modest improvements in alcohol SBI delivery in ACCHSs. [Clifford A, Shakeshaft A, Deans C. Training and tailored outreach support to improve alcohol screening and brief intervention in Aboriginal Community Controlled Health Services. Drug Alcohol Rev 2013;32:72–79] Key words: Indigenous health services, alcohol, screening, brief intervention. Introduction The deleterious impact of alcohol misuse on the health and well-being of Indigenous Australians, including the social functioning of their families and communities, is well documented [1–4]. Health-care practitioners in Aboriginal Community Controlled Health Services (ACCHS) are well placed to contribute to reducing the disproportionate burden of alcohol-related harm in Indigenous communities: they are typically the primary point of contact for Indigenous Australians experienc- ing alcohol-related harms, giving them insight into the social and environmental context in which these harms occur [5–7]. Screening patients to assess their level of alcohol consumption, followed by the provision of brief inter- vention (brief advice; motivational interviewing, coun- selling and/or referral to specialist support as required) to those identified as being at risk of alcohol-related harm [8], has been shown to reduce alcohol consump- tion [9] and be cost-effective [10]. Despite evidence that alcohol screening and brief intervention (SBI) is cost-effective, multiple factors have been shown to influence its routine uptake by health-care practitioners [11–13]. These factors can be broadly categorised into those associated with individual health-care practition- ers (e.g. perceived lack of time and expertise), the organisation (e.g. the availability and utilisation of Anton Clifford PhD, Research Fellow, Anthony Shakeshaft PhD, Associate Professor, Catherine Deans BPsych (Hons), Research Associate. Correspondence to Dr Anton Clifford, School of Population Health, Level 1, Public Health Building, The University of Queensland, Herston Road, Herston, Qld 4006, Australia. Tel: +61 (07) 3346 64687 0386; Fax: +61 (07) 3365 5509; Email: a.clifford@uq.edu.au Received 8 December 2011; accepted for publication 31 May 2012. REVIEW Drug and Alcohol Review (January 2013), 32, 72–79 DOI: 10.1111/j.1465-3362.2012.00488.x © 2012 Australasian Professional Society on Alcohol and other Drugs