Published online October 31, 2008
PEDIATRICS Vol. 122 No. 5 November 2008, pp. e1022-e1029 (doi:10.1542/peds.2008-1183)

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ARTICLE

Parental Alcohol Screening in Pediatric Practices

Celeste R. Wilson, MD^a,b, Sion Kim Harris, PhD^a,b, Lon Sherritt, MPH^a, Nohelani Lawrence, BS^a, Deborah Glotzer, MD^b,c, Judith S. Shaw, EdD, MPH, RN^d and John R. Knight, MD^a,b

^a Department of Medicine, Children's Hospital Boston, Boston, Massachusetts
^b Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
^c Cambridge Health Alliance, Cambridge, Massachusetts
^d Department of Pediatrics, University of Vermont College of Medicine, Burlington, Vermont

OBJECTIVES. Pediatricians are in an ideal position to screen parents of their patients for alcohol use. The objective of this study was to assess parents’ preferences regarding screening and intervention for parental alcohol use during pediatric office visits for their children.

METHODS. A descriptive multicenter study that used 3 pediatric primary care clinic sites (rural, urban, suburban) was conducted between June 2004 and December 2006. Participants were a convenience sample of consecutively recruited parents who brought children for medical care. Parents completed an anonymous questionnaire that contained demographics; 2 alcohol-screening tests (TWEAK and Alcohol Use Disorders Identification Test); and items that assessed preferences for who should perform alcohol-screening, acceptance of screening, and preferred interventions if the screening result was positive.

RESULTS. A total of 929 of 1028 eligible parents agreed to participate, and 879 of 929 completed surveys that yielded sufficient data for analysis. Most participants were mothers. A total of 101 of 879 parents screened positive on either the TWEAK or the Alcohol Use Disorders Identification Test. Parents with a negative alcohol screen (alcohol-negative) were more likely than parents with a positive alcohol screen (alcohol-positive) to report that they would agree to being asked about their alcohol use. There were no significant differences in preferences within alcohol-positive and alcohol-negative groups for screening by the pediatrician or computer-based questionnaire. Most preferred interventions for the alcohol-positive group were for the pediatrician to initiate additional discussion about drinking and its effect on their child, give educational materials about alcoholism, and refer for evaluation and treatment. Alcohol-positive men were more accepting than alcohol-positive women of having no intervention.

CONCLUSIONS. A majority of parents would agree to being screened for alcohol problems in the pediatric office. Regardless of their alcohol screen status, parents are accepting of being screened by the pediatrician, a computer-based questionnaire, or a paper-and-pencil survey. Parents who screen positive prefer that the pediatrician discuss the problem further with them and present options for referral.

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Key Words: alcohol-related disorders • substance abuse detection • parent-child relationship • primary care • physician-patient/parent communication

Abbreviations: AAP—American Academy of Pediatrics • AUDIT—Alcohol Use Disorders Identification Test

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Accepted Jul 10, 2008.

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