# Enhancing Screening and Counseling for Alcohol Use Disorder in a Predominantly Hispanic Border Town Population With the Alcohol Use Disorders Identification Test-Concise (AUDIT-C)

## TL;DR

A clinic in a predominantly Hispanic border town implemented a brief alcohol screening tool and counseling, finding high patient willingness to discuss alcohol use and positive responses to counseling.

## Contribution

The study demonstrates successful integration of the AUDIT-C screening tool and behavioral counseling in a clinic with a primarily Hispanic population.

## Key findings

- 34 out of 39 patients screened positive for alcohol use disorder using the AUDIT-C.
- 75% of patients who received counseling found it helpful and 67% were willing to consider changing their drinking behaviors.

## Abstract

The United States Preventive Services Task Force (USPSTF) recommends routine screening for alcohol use disorders in adults 18 years or older using one to three validated tools. One favored tool is the Alcohol Use Disorders Identification Test-Concise (AUDIT-C), a brief three-item questionnaire noted for its ease of implementation, sensitivity, and specificity. A positive screen on the AUDIT-C should prompt brief behavioral health counseling to help reduce harmful drinking patterns.

Before this quality improvement project, the Texas Tech University Health Sciences Center (TTUHSC) El Paso Internal Medicine Residency Clinic did not routinely use the AUDIT-C and its residents had not received training in alcohol-related behavioral health counseling. In response, the AUDIT-C was integrated into the clinic’s electronic medical record (EMR), and residents received instruction on alcohol use disorder counseling from a certified physician in Addiction Medicine. This intervention enhanced compliance with USPSTF recommendations and provided an opportunity to evaluate alcohol use in a primarily Hispanic border population.

A total of 39 patients reporting alcohol use were screened with the AUDIT-C; 34 screened positive and five screened negative. Among the patients who received behavioral health counseling, 12 completed a post-counseling survey to assess their drinking habits. The survey revealed that 10 (83%) of these patients had never previously received counseling. Furthermore, nine (75%) found the counseling helpful, eight (67%) were surprised by the unhealthiness of their drinking habits, and nine (75%) felt comfortable during the session. Additionally, eight (67%) expressed a willingness to consider changing their drinking behaviors. Among those unwilling to change, five patients did not perceive a problem with their drinking, while one patient did not wish to reduce alcohol consumption.

These findings demonstrate a strong willingness among El Paso residents to discuss problematic alcohol use within the clinical setting. The positive patient responses support the broader implementation of the AUDIT-C in practice and underscore the importance of training clinicians in effective intervention techniques.