Alcohol Use in a Tribal Rural Population of India: Prevalence, Social Determinants, and Impact of a Community-Based...

Alcohol consumption is an overlooked public health concern in tribal populations of India. Culturally and systemically rooted factors contribute to neglect in engagement and treatment, even with prohibition policies in place. Therefore, this study analyzed the prevalence and sociodemographic factors associated with alcohol consumption in a tribal rural district of India and evaluated the effects of a health system-integrated, community-based intervention on knowledge, attitudes, and practices (KAP) concerning abstinence.

A total of 269 community members and 81 healthcare workers participated in this quasi-experimental study. The KAP survey and Alcohol Use Disorders Identification Test (AUDIT) were used, and sociodemographic details were noted. Tailored to local cultural settings, a 3-month community mobilization and provider training intervention was carried out. Statistical analyses, including logistic regression, Cox regression, and structural equation modeling, were performed.

The prevalence of alcohol use was 111 (41.3%). The significant predictors were identified as male sex, education level, and family history (adjusted odds ratios=2.73, 1.96, and 2.83, respectively). Following the intervention, community participant KAP scores (4.60 to 8.53, P<0.001) and healthcare worker KAP scores (15.0 to 22.3, P<0.001) improved significantly. Of the 111 alcohol users, 81(73%) started treatment. Abstinence rates were 63(77.8%) at 1 month and 39 (48.1%) at 3 months. Those aged over 40 years who had low income and those with unstable employment faced the highest relapse risk.

Using community-specific approaches within broad systemic frameworks improves intervention outcomes for alcohol use among tribal populations. To maintain long-term effectiveness, concurrent support from socioeconomic systems is essential.