Alcohol consumption among urban, suburban, and rural Veterans Affairs outpatients.

United States rural residents tend toward poorer health than urban residents. Although alcohol use is associated with multiple medical conditions and can be reduced via brief primary care-based interventions, it is unknown whether alcohol consumption differs by rurality among primary care patients. We sought to describe alcohol consumption among urban, suburban, and rural Veterans Affairs (VA) outpatients. Outpatients from 7 VA facilities responded to mailed surveys that included the validated Alcohol Use Disorders Identification Test Consumption (AUDIT-C) screening questionnaire. The ZIP code approximation of the US Department of Agriculture's rural-urban commuting area (RUCA) codes classified participants into urban, suburban, and rural areas. For each area, adjusted logistic regression models estimated the prevalence of past-year abstinence among all participants and unhealthy alcohol use (AUDIT-C ≥ 3 for women and ≥ 4 for men) among drinkers. Among 33,883 outpatients, 14,967 (44%) reported abstinence. Among 18,916 drinkers, 8,524 (45%) screened positive for unhealthy alcohol use. The adjusted prevalence of abstinence was lowest in urban residents (43%, 95% CI 42%-43%) with significantly higher rates in both suburban and rural residents [45% (44%-46%) and 46% (45%-47%), respectively]. No significant differences were observed in the adjusted prevalence of unhealthy alcohol use among drinkers. Abstinence is slightly more common among rural and suburban than urban VA outpatients, but unhealthy alcohol use does not vary by rurality. As the VA and other health systems implement evidence-based care for unhealthy alcohol use, more research is needed to identify whether preventive strategies targeted to high-risk areas are needed.

Williams EC ，McFarland LV ，Nelson KM 《-》

Rural, suburban, and urban variations in alcohol consumption in the United States: findings from the National Epidemiologic Survey on Alcohol and Related Conditions.

Borders TF ，Booth BM 《JOURNAL OF RURAL HEALTH》

Association between alcohol screening results and hospitalizations for trauma in Veterans Affairs outpatients.

Williams EC ，Bryson CL ，Sun H ，Chew RB ，Chew LD ，Blough DK ，Au DH ，Bradley KA ... -  《-》

Antiretroviral adherence among rural compared to urban veterans with HIV infection in the United States.

Ohl ME ，Perencevich E ，McInnes DK ，Kim N ，Rimland D ，Akgun K ，Fiellin DA ，Skanderson M ，Wang K ，Justice A ... -  《-》

Recognition and management of alcohol misuse in OEF/OIF and other veterans in the VA: a cross-sectional study.

Mental health problems have been identified among soldiers serving in Operations Enduring Freedom and Iraqi Freedom (OEF/OIF), but little is known about the prevalence and management of alcohol misuse in OEF/OIF veterans seen in the Veterans Administration health care system (VA). We identified 12,092 veterans (n=2009 women) 55 and younger and screened for alcohol misuse in FY2007 from a cross-sectional national sample of VA outpatients randomly selected for standardized medical record review for quality monitoring. Alcohol misuse was assessed with the Alcohol Use Disorders Identification Test Consumption questions (AUDIT-C > or =5). Based on medical record reviews, brief alcohol interventions (BI) were defined as documented (1) advice to abstain or drink within recommended limits or (2) feedback about health risks associated with drinking. Adjusted prevalence of alcohol misuse was higher in OEF/OIF men than non-OEF/OIF men [21.8% vs. 10.5%, adjusted odds ratio (AOR)=2.37 (95% CI: 1.88-2.99)], but did not differ reliably between OEF/OIF and non-OEF/OIF women [4.7% vs. 2.9%, AOR=1.68 (0.74-3.79)]. Adjusted rates of documented advice or feedback [31.6% vs. 34.6%, AOR=0.87 (0.58-1.21)] and referral [24.1% vs. 28.9%, AOR=0.78 (0.47-1.30)] were not significantly different between OEF/OIF and non-OEF/OIF men who screened positive for alcohol misuse. OEF/OIF men were more likely to screen positive for alcohol misuse than non-OEF/OIF men. Overall, approximately half of those with alcohol misuse had documented BI and/or referral to alcohol treatment suggesting a need for improvement in addressing alcohol misuse in OEF/OIF and other veterans.

Hawkins EJ ，Lapham GT ，Kivlahan DR ，Bradley KA ... -  《-》