Citation

Friedman JL, Lyna P, Sendak MD, Viera AJ, Silberberg M, Pollak KI. Clin. Pediatr. 2016; 56(5): 419-426.

Affiliation

Duke University School of Medicine, Durham, NC, USA Duke Cancer Institute, Durham, NC, USA.

Copyright

(Copyright © 2016, SAGE Publishing)

DOI

10.1177/0009922816655884

PMID

27330014

Abstract

Clinical guidelines recommend addressing adolescent alcohol use in primary care; the 5 As (Ask, Advise, Assess, Assist, Arrange) may be a useful model for intervention. We audio-recorded 540 visits with 49 physicians and adolescents, compared alcohol disclosure rates in the encounter with those in a survey, and analyzed conversations for use of the 5 As and their relation to adolescent reports of drinking 3 months after the encounter. When physicians asked clear, nonleading questions, drinkers were more likely to disclose alcohol use (P =.004). In 64% of visits in which alcohol was discussed, physicians used one or more of the 5 As, most frequently "Ask." No physician used all 5 As. Among drinkers, there was no association between physicians' partial use of the 5 As and adolescent alcohol consumption at 3 months. Physicians can learn more effective ways to "Ask" about alcohol use to increase disclosure of drinking and to be more comprehensive in their counseling.

© The Author(s) 2016.

Language: en