Practices and Perceptions on Screening Adolescent Alcohol Use Among Pediatric Diabetes Providers

Abstract

Objective: Adolescent alcohol consumption is especially dangerous for youth with type 1 diabetes (T1D) due to additional health risks (e.g., alcohol-induced hypoglycemia). To examine diabetes healthcare providers’ practices and attitudes about screening for adolescent alcohol use in outpatient diabetes clinics, we surveyed diabetes providers via email throughout the United States who were known from professional associations. Methods: The survey assessed current practices for alcohol use screening and attitudes about screening and implementing an evidenced-based Screening, Brief Intervention, and Referral to Treatment (SBIRT) model in diabetes clinics. We also surveyed current barriers to addressing alcohol use and perceived barriers for implementing an SBIRT model. Results: 73 participants completed the anonymous survey. Most of the respondents believed that youth with T1D required diabetes-specific education about the effects of alcohol; however, most acknowledged not having a standardized way to screen for adolescent alcohol use (AAU). Most providers stated that an SBIRT model would be helpful and would meet the needs of youth with T1D; but identified several barriers to implementing the model into diabetes outpatient clinics. Conclusions: Additional work is needed to adapt a T1D-specific SBIRT model, assess the effectiveness of an AAU SBIRT model on alcohol-related behaviors and T1D health outcomes, and evaluate implementation strategies within pediatric diabetes clinics to increase access to evidence-based programs that may reduce alcohol-related behaviors.

Impact Statement

Most of the pediatric diabetes healthcare providers surveyed in this study believe that adolescents with T1D require diabetes-specific education about alcohol use (e.g., information on how alcohol affects blood sugars), and that the diabetes team is responsible for providing such education. However, there was much variability between providers and settings in the way in which alcohol education is provided, and whether adolescents are screened and counseled for alcohol use. While providers believed an evidence-based model for alcohol use screening, that is, SBIRT, would be appropriate for youth with diabetes, they also endorsed several potential barriers to implementing SBIRT into pediatric diabetes specialty care clinics.

Keywords

adolescents alcohol screening specialty clinics type 1 diabetes

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