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Evidence into action: implementing alcohol screening and brief interventions in the UK Armed Forces
  1. Mark Andrew Dermont1,
  2. P Field2,
  3. J Shepherd3 and
  4. R Rushton4
  1. 1 Defence Public Health Unit, Defence Medical Services, Lichfield, UK
  2. 2 DPHC Dental Centre Colchester, Defence Medical Services, Colchester, UK
  3. 3 School of Dentistry, Cardiff University, Cardiff, UK
  4. 4 Defence Clinical Psychology Service, Ministry of Defence, Portsmouth, UK
  1. Correspondence to Mark Andrew Dermont, Defence Public Health Unit, Defence Medical Services, Lichfield WS14 9PY, UK; mark.dermont240{at}mod.gov.uk

Abstract

Introduction Alcohol-related harm continues to represent a major public health problem and previous evidence suggests that alcohol misuse within the UK Armed Forces is higher than in the general population. The aim was to introduce a population-level primary care intervention with an existing evidence base to identify and support Service Personnel whose drinking places them at greater risk of harm.

Implementation Following successful piloting, the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) brief screening tool was introduced as part of routine dental inspections by Defence Primary Healthcare (DPHC) dentists. Alcohol brief intervention (ABI) advice and signposting to support services was offered to personnel identified as being at increased risk and recorded in the patient’s electronic health record.

Achievements to date Patients attending DPHC Dental Centres are now routinely offered AUDIT-C with 74% (109 459) personnel screened in the first 12 months rising to over 276 000 at 24 months, representing the single largest use of AUDIT-C and ABIs in a military population to date.

Discussion Introduction of AUDIT-C has seen Defence successfully deliver a whole population alcohol initiative, overcoming implementation barriers to demonstrate the flexibility of a dental workforce to deliver a public health intervention at scale and contributing towards promoting positive attitudes towards alcohol use. The initiative represents a first step towards the goal of a standardised alcohol screening and treatment pathway across DPHC while recognising that the Defence Medical Services are only one aspect of the broader public health approach required to tackle alcohol-related harm in Service Personnel.

  • dental
  • alcohol
  • public health
  • primary care
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Footnotes

  • Contributors MAD as lead author (corresponding author) was responsible for the idea of the article and drafted the majority of the content. MAD was supported by PF, on whose original MPH dissertation, the work draws heavily and who supplied his dissertation for reference. PF, with support from JS and others, was instrumental in implementing the original alcohol initiative and JS provided input on the training section of the manuscript. RR provided input on sections covering the impact of alcohol on Service Personnel and some of the advantages and disadvantages of AUDIT-C as a screening tool.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval The dissertation work reported in the manuscript was conducted as service audit (audit registration number RCDM/Res/Audit/1036/14/0402). The remainder of the work is a service improvement project carried out by DPHC as part of routine business.

  • Provenance and peer review Commissioned; externally peer reviewed.

  • Data availability statement There are no data in this work.

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