Costa, Marie and Barré, Tangui and Coste, Marion and Yaya, Issifou and Berenger, Cyril and Tanti, Marc and Cutarella, Christophe and Mora, Marion and Poloméni, Pierre and Maynard, Marianne and Teuma, Danielle and Bazin, Michaël and Maradan, Gwenaelle and Roux, Perrine and Carrieri, Patrizia Maria (2020) Screening and care for alcohol use disorder in France: expectations, barriers and levers using a mixed-methods approach. BMC Public Health, 20, (358), p. 358. 10.1186/s12889-020-08495-x.
External website: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC70815...
BACKGROUND: The widespread under-screening and under-treatment of alcohol use disorder (AUD) contributes to its health and socioeconomic burden. We conducted a mixed-methods (qualitative and qualitative) study in people with alcohol use disorder (PWAUD) to explore their expectations, as well as barriers and levers to AUD care.
METHODS: Individuals with AUDIT > 15 (N = 179) were interviewed using computer-assisted interviews in several medical and non-medical sites (e.g., bars) (quantitative substudy). We also conducted semi-structured face-to-face interviews with 36 PWAUD (qualitative substudy). Using logistic regression, we explored factors associated with having previously received/sought care for AUD. Three major themes were identified in the qualitative textual analysis using a descending hierarchical classification.
RESULTS: Not socializing with heavy drinkers (AOR [95%CI]:3.84[1.66-8.85]), regular smoking (9.72[3.91-24.15]) and feeling discriminated against (2.35[1.10-5.05]) were independent levers to having sought/received care for AUD, while being aged < 50 and employment were independent barriers. The five predominant themes in PWAUD discourses emerging from the textual analysis were: drinking context, medical care, alcohol treatment, tobacco/addiction and family. When triangulating results from the logistic regression and the textual analysis, two barriers (social drinking and difficulties with the medical care system), and two levers (family influence and tobacco addiction), emerged.
CONCLUSION: These results underline the need for interventions targeting families and the social network to increase awareness about AUD and related care. Simplified and novel comprehensive care trajectories are urgently needed to reduce the clinical and public health burden of AUD.
B Substances > Tobacco (cigarette smoking)
G Health and disease > Substance use disorder (addiction) > Alcohol use disorder
G Health and disease > Substance use disorder (addiction) > Alcohol use disorder > Alcohol dependence
J Health care, prevention, harm reduction and treatment > Risk and protective factors
J Health care, prevention, harm reduction and treatment > Risk and needs assessment > Risk assessment
J Health care, prevention, harm reduction and treatment > Identification and screening > Identification and screening for substance use
L Social psychology and related concepts > Interpersonal interaction and group dynamics > Peer relations / social networks
L Social psychology and related concepts > Family > Family and kinship > Family support
L Social psychology and related concepts > Family > Family and kinship > Family relations > Family role
T Demographic characteristics > Adolescent / youth (teenager / young person)
VA Geographic area > Europe > France
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