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Conigrave JH, Lee KSK, Zheng C, Wilson S, Perry J, Chikritzhs T, Slade T, Morley K, Room R, Callinan S, Hayman N, Conigrave KM. Drinking risk varies within and between Australian Aboriginal and Torres Strait Islander samples: a meta-analysis to identify sources of heterogeneity. Addiction 2020; 115:1817-1830. [PMID: 32057135 DOI: 10.1111/add.15015] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Revised: 12/01/2019] [Accepted: 02/05/2020] [Indexed: 01/01/2023]
Abstract
BACKGROUND AND AIMS To reduce health and social inequities, it is important to understand how drinking patterns vary within and between Indigenous peoples. We aimed to assess variability in estimates of Indigenous Australian drinking patterns and to identify demographic and methodological factors associated with this. DESIGN A three-level meta-analysis of Australian Aboriginal and Torres Strait Islander ('Indigenous') drinking patterns [International Prospective Register of Systematic Reviews (PROSPERO) no. CRD42018103209]. SETTING Australia. PARTICIPANTS Indigenous Australians. MEASUREMENTS The primary outcomes extracted were drinking status, single-occasion risk and life-time risk. Moderation analysis was performed to identify potential sources of heterogeneity. Moderators included gender, age, socio-economic status, local alcohol restrictions, sample population, remoteness, Australian state or territory, publication year, Indigenous involvement in survey design or delivery and cultural adaptations. FINDINGS A systematic review of the literature revealed 41 eligible studies. For all primary outcomes, considerable heterogeneity was identified within ( I22 = 51.39-68.80%) and between ( I32 = 29.27-47.36%) samples. The pooled proportions (P) of current drinkers [P = 0.59, 95% confidence interval (CI) = 0.53-0.65], single-occasion (P = 0.34, 95% CI = 0.24-0.44) and life-time (P = 0.21, 95% CI = 0.15-0.29) risk were all moderated by gender, age, remoteness and measurement tool. Reference period moderated proportions of participants at single-occasion risk. CONCLUSIONS Indigenous Australian drinking patterns vary within and between communities. Initiatives to reduce high-risk drinking should take account of this variability.
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Affiliation(s)
- James H Conigrave
- Discipline of Addiction Medicine, Central Clinical School, Faculty of Medicine and Health, University of Sydney, NSW, Australia.,NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, Camperdown, NSW, Australia
| | - K S Kylie Lee
- Discipline of Addiction Medicine, Central Clinical School, Faculty of Medicine and Health, University of Sydney, NSW, Australia.,NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, Camperdown, NSW, Australia.,Centre for Alcohol Policy Research, La Trobe University, Bundoora, VIC, Australia
| | - Catherine Zheng
- Discipline of Addiction Medicine, Central Clinical School, Faculty of Medicine and Health, University of Sydney, NSW, Australia.,NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, Camperdown, NSW, Australia
| | - Scott Wilson
- Discipline of Addiction Medicine, Central Clinical School, Faculty of Medicine and Health, University of Sydney, NSW, Australia.,NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, Camperdown, NSW, Australia.,Aboriginal Drug and Alcohol Council Inc South Australia, SA, Australia
| | - Jimmy Perry
- Aboriginal Drug and Alcohol Council Inc South Australia, SA, Australia
| | - Tanya Chikritzhs
- National Drug Research Institute, Curtin University, Health Sciences, WA, Australia
| | - Tim Slade
- The Matilda Centre for Research in Mental Health and Substance Use, Faculty of Medicine and Health, University of Sydney, NSW, Australia
| | - Kirsten Morley
- Discipline of Addiction Medicine, Central Clinical School, Faculty of Medicine and Health, University of Sydney, NSW, Australia
| | - Robin Room
- Centre for Alcohol Policy Research, La Trobe University, Bundoora, VIC, Australia
| | - Sarah Callinan
- Centre for Alcohol Policy Research, La Trobe University, Bundoora, VIC, Australia
| | - Noel Hayman
- Southern Queensland Centre of Excellence in Aboriginal and Torres Strait Islander Primary Health Care, Queensland Health, QLD, Australia.,School of Medicine, Griffith University, QLD, Australia.,School of Medicine, University of Queensland, QLD, Australia
| | - Katherine M Conigrave
- Discipline of Addiction Medicine, Central Clinical School, Faculty of Medicine and Health, University of Sydney, NSW, Australia.,NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, Camperdown, NSW, Australia.,Drug Health Services, Royal Prince Alfred Hospital, Sydney Local Health District, NSW, Australia
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