e-alcohol screening and brief intervention (e-SBI)

Background

The Hong Kong SAR government‘s strategic framework document “Promoting Health in Hong Kong: A Strategic Framework for Prevention and Control of Non-communicable Diseases” identified harms associated with alcohol as one of the public health priority areas. The Working Group on Alcohol and Health (WGAH), set up by the Hong Kong SAR Government, published the ‘Action Plan to Reduce Alcohol-related Harms in Hong Kong’ (‘Action Plan’) in October 2011. It outlines 17 specific actions on preventing and controlling alcohol-related harm. Under Actions 14 and 15 of the ‘Action Plan, the WGAH recognized the importance of primary care professionals routinely carrying out alcohol screening and brief intervention to identify and manage at-risk drinkers as an integral part of practice. It is believed that the universal access to primary care in Hong Kong provides an opportunity to reach drinkers in the community effectively. In accordance with these two Actions, the Department of Health has developed health education materials, guidelines for proper screening and brief interventions to facilitate primary care professionals’ work to identify and manage at-risk drinkers by reducing alcohol-related harm, within the context of Hong Kong under the "Alcohol Fails" campaign.

Alcohol Use Disorders Identification Test

Developed by the World Health Organization, the Alcohol Use Disorders Identification Test (AUDIT) is a validated screening tool to identify people whose drinking may pose a risk to their health. AUDIT allows alcohol users to understand their recent drinking, and facilitates the practitioners to provide relevant advice. According to the scoring system of AUDIT, four different risk levels of drinking with corresponding interventions are specified ranging from (i) providing health education materials, (ii) brief advice, (iii) counseling to (iv) referrals to specific services as appropriate.

Brief Intervention

It is found that brief advice is the most effective evidence-based treatment method for those who are at risk of or are suffering from inappropriate alcohol consumption. It includes feedback advice by using motivational interviewing style to support behavioural change. This approach has been shown to be effective in lowering alcohol consumption, mortality, morbidity, alcohol-related injuries, alcohol-related social consequences and health-care resource use.

In fact, extensive overseas evidence from systematic reviews and meta-analyses has showed that early identification and brief intervention in a range of primary care settings are effective in minimizing harm among people at risk of drinking while they are not severely dependent.