Supporting Aboriginal Community Controlled Health Services to deliver alcohol care: A cluster randomised controlled trial

Support is provided to staff of Aboriginal Community Controlled Health Services. This support focuses on building staff capacity and systems to improve AUDIT-C screening rates, and to respond with appropriate clinical care if unhealthy drinking (hazardous use or alcohol use disorders) is detected. Support is composed of the following : 1. Services asked to nominate two project champions 2. Project champions attend a two-day national workshop provided by the research team and selected invited speakers.. The workshop briefs participants on the nature of the study, and participants take part in small group discussions on the strengths and needs of their services in responding to alcohol issues. Brief interactive training sessions cover screening, brief intervention, home detox (withdrawal management), relapse prevention medicines, supporting families and supporting communities in responding to alcohol. 3. Onsite training is provided at one site for each health service, and all service staff are invited to attend. Training is provided by Prof Kate Conigrave (Addiction Medicine specialist) and by an Aboriginal staff member with clinical experience (Ms Kristie Harrison, a Wiradjuri woman with a background in alcohol and other drugs work, and youth work for the early support phase). The training includes core elements: screening, brief intervention, home detox, relapse prevention medicines, working with family and working with communities. Training is interactive. ITs duration and delivery is tailored to local needs and staff availability. Up to two days training is offered per service. 4. Support with refining practice software to facilitate screening, if needed 5. Provision of one-off funding ($9000 for 'early support' ['intervention'] services) for resources to support their work with alcohol. Services are provided with a list of potential resources (e.g. visual aids to brief intervention, breathalysers), but are also able to suggest their own resources. Resources must have prior approval from the Principal Investigator (KC) 6. Feedback of routinely collected clinical data every two months - AUDIT-C screening rates and results, rate of provision of brief intervention, counselling, and relapse prevention medicines for alcohol. The feedback is provided as a visual and easy-to-read pdf document, so that is accessible to community boards as well as to staff. This is emailed to service champions during their support phase 7. Phone conferences for champions every two months - to support sharing of expertise between services. The teleconferences last about 45 minutes and are chaired by the research staff (KC and Krisitie Harrison). These occur for two years during the support phase. The teleconferences focus on the service champions reporting back on what is working well in their service with regard to improving screening and response to alcohol, and what are the challenges. Services are split into two groups according to remoteness for the teleconferences, to increase the opportunity for interaction. 8. Password-protected website and online forum to share resources and ideas with other services in the 'support' phase. Resources are posted by the researchers; in addition service staff have the option for online 'chat' with each other or with the researchers on a discussion board. There is no required use of this discussion board. Support is provided over one year actively, and one year in maintenance mode Adherence to the protocol is monitored by a spreadsheet: on this, research staff record the date that each element of support is provided to each study site. In addition, attendance is recorded for second monthly teleconferences, and for all training sessions.