Stability of At-risk Alcohol Use Screening Results in a General Population Sample

In combination with systematic routine screening, brief alcohol interventions have the potential to promote population health. Little is known on the optimal screening interval. Therefore, this study pursued 2 research questions: (i) How stable are screening results for at-risk drinking over 12 months? (ii) Can the transition from low-risk to at-risk drinking be predicted by gender, age, school education, employment, or past week alcohol use?

A sample of 831 adults (55% female; mean age = 30.8 years) from the general population was assessed 4 times over 12 months. The Alcohol Use Disorders Identification Test-Consumption was used to screen for at-risk drinking each time. Participants were categorized either as low-risk or at-risk drinkers at baseline, 3, 6, and 12 months later. Stable and instable risk status trajectories were analyzed descriptively and graphically. Transitioning from low-risk drinking at baseline to at-risk drinking at any follow-up was predicted using a logistic regression model.

Consistent screening results over time were observed in 509 participants (61%). Of all baseline low-risk drinkers, 113 (21%) received a positive screening result in 1 or more follow-up assessments. Females (vs. males; OR = 1.66; 95% confidence intervals [95% CI] = 1.04; 2.64), 18- to 29-year-olds (vs. 30- to 45-year-olds; OR = 2.30; 95% CI = 1.26; 4.20), and those reporting 2 or more drinking days (vs. less than 2; OR = 3.11; 95% CI = 1.93; 5.01) and heavy episodic drinking (vs. none; OR = 2.35; 95% CI = 1.06; 5.20) in the week prior to the baseline assessment had increased odds for a transition to at-risk drinking.

Our findings suggest that the widely used time frame of 1 year may be ambiguous regarding the screening for at-risk alcohol use although generalizability may be limited due to higher-educated people being overrepresented in our sample.