Adapting the Grog survey app for alcohol screening and feedback in aboriginal and Torres Strait Islander health services: a mixed methods study protocol

Monika Dzidowska^{1

2}, James H Conigrave³, Scott Wilson^{3

4}, Noel Hayman^{5

6

7}, Jim Cook⁸, Lydia Gu⁹, Darren Phung⁸, Angela Dawson¹⁰, Nikki Percival¹⁰, Annalee Stearne^{3

9}, Marguerite Tracy¹¹, Jimmy Perry^{3

4}, Tanya Chikritzhs⁹, Michelle Fitts¹², Teagan J Weatherall³, Lynette Bullen^{3

13}, Craig Holloway^{3

14}, Kirsten Morley^{15

16}, Mustafa Al Ansari³, K S Kylie Lee^{3

9

16

17}

Affiliations

¹ Faculty of Medicine and Health, Sydney Pharmacy School, The University of Sydney, Badham Building (A15), Sydney, NSW, Australia. monika.dzidowska@sydney.edu.au.
² School of Psychology and Public Health, La Trobe University, Centre for Alcohol Policy Research, NR1, Bundoora, Melbourne, 3086, Australia. monika.dzidowska@sydney.edu.au.
³ School of Psychology and Public Health, La Trobe University, Centre for Alcohol Policy Research, NR1, Bundoora, Melbourne, 3086, Australia.
⁴ Aboriginal Drug and Alcohol Council (SA) Aboriginal Corporation, 155 Holbrooks Road, Adelaide, Underdale, SA, 5032, Australia.
⁵ Southern Queensland Centre of Excellence in Aboriginal and Torres Strait Islander Primary Health Care (Inala Indigenous Health Service), 37 Wirraway Parade, Brisbane, Inala, Qld, 4077, Australia.
⁶ School of Medicine, Griffith Health Centre (G40), Griffith University, Gold Coast campus, Gold Coast, 4222, QLD, Australia.
⁷ School of Medicine, University of Queensland, Herston Road, Brisbane, Herston, Qld, 4006, Australia.
⁸ Information and Communications Technology, The University of Sydney, ICT TechLab, Services Building (G12), Sydney, NSW, Australia.
⁹ Faculty of Health Sciences, Curtin University, National Drug Research Institute (NDRI), Building 609, 7 Parker Place, Bentley, WA, 6102, Australia.
¹⁰ Faculty of Health, University of Technology Sydney, 235 Jones Street, Ultimo, NSW, 2007, Australia.
¹¹ Faculty of Medicine and Health, The University of Sydney, General Practice Clinical School, Edward Ford Building (A27), Sydney, 2006, NSW, Australia.
¹² Menzies School of Health Research, Charles Darwin University, Mparntwe Alice Springs, Building 15, Springs Campus 10 Grevillea Drive, Alice Springs, Darwin, NT, 0871, Australia.
¹³ NSW Health, Involuntary Drug and Alcohol Treatment Unit, Western NSW Local Health District, Bloomfield Campus, 1502 Forest Road, 2800, Orange, NSW, Australia.
¹⁴ Victorian Aboriginal Health Service, 186 Nicholson Street, Melbourne, Fitzroy, Vic, 3065, Australia.
¹⁵ Faculty of Medicine and Health, The University of Sydney, Central Clinical School, Lev 6, King George V Building (C39), Sydney, NSW, Australia.
¹⁶ The Edith Collins Centre (Translational Research in Alcohol Drugs and Toxicology), Drug Health Services, Sydney Local Health District, Royal Prince Alfred Hospital (KGV) 83-117 Missenden Road, Camperdown, NSW, 2050, Australia.
¹⁷ Burnet Institute, 85 Commercial Road, Melbourne, Vic, 3004, Australia.

PMID: 40898313
PMCID: PMC12403270
DOI: 10.1186/s13722-025-00602-w

Adapting the Grog survey app for alcohol screening and feedback in aboriginal and Torres Strait Islander health services: a mixed methods study protocol

Monika Dzidowska et al. Addict Sci Clin Pract. 2025.

. 2025 Sep 2;20(1):70.

doi: 10.1186/s13722-025-00602-w.

Authors

Affiliations

¹ Faculty of Medicine and Health, Sydney Pharmacy School, The University of Sydney, Badham Building (A15), Sydney, NSW, Australia. monika.dzidowska@sydney.edu.au.
² School of Psychology and Public Health, La Trobe University, Centre for Alcohol Policy Research, NR1, Bundoora, Melbourne, 3086, Australia. monika.dzidowska@sydney.edu.au.
³ School of Psychology and Public Health, La Trobe University, Centre for Alcohol Policy Research, NR1, Bundoora, Melbourne, 3086, Australia.
⁴ Aboriginal Drug and Alcohol Council (SA) Aboriginal Corporation, 155 Holbrooks Road, Adelaide, Underdale, SA, 5032, Australia.
⁵ Southern Queensland Centre of Excellence in Aboriginal and Torres Strait Islander Primary Health Care (Inala Indigenous Health Service), 37 Wirraway Parade, Brisbane, Inala, Qld, 4077, Australia.
⁶ School of Medicine, Griffith Health Centre (G40), Griffith University, Gold Coast campus, Gold Coast, 4222, QLD, Australia.
⁷ School of Medicine, University of Queensland, Herston Road, Brisbane, Herston, Qld, 4006, Australia.
⁸ Information and Communications Technology, The University of Sydney, ICT TechLab, Services Building (G12), Sydney, NSW, Australia.
⁹ Faculty of Health Sciences, Curtin University, National Drug Research Institute (NDRI), Building 609, 7 Parker Place, Bentley, WA, 6102, Australia.
¹⁰ Faculty of Health, University of Technology Sydney, 235 Jones Street, Ultimo, NSW, 2007, Australia.
¹¹ Faculty of Medicine and Health, The University of Sydney, General Practice Clinical School, Edward Ford Building (A27), Sydney, 2006, NSW, Australia.
¹² Menzies School of Health Research, Charles Darwin University, Mparntwe Alice Springs, Building 15, Springs Campus 10 Grevillea Drive, Alice Springs, Darwin, NT, 0871, Australia.
¹³ NSW Health, Involuntary Drug and Alcohol Treatment Unit, Western NSW Local Health District, Bloomfield Campus, 1502 Forest Road, 2800, Orange, NSW, Australia.
¹⁴ Victorian Aboriginal Health Service, 186 Nicholson Street, Melbourne, Fitzroy, Vic, 3065, Australia.
¹⁵ Faculty of Medicine and Health, The University of Sydney, Central Clinical School, Lev 6, King George V Building (C39), Sydney, NSW, Australia.
¹⁶ The Edith Collins Centre (Translational Research in Alcohol Drugs and Toxicology), Drug Health Services, Sydney Local Health District, Royal Prince Alfred Hospital (KGV) 83-117 Missenden Road, Camperdown, NSW, 2050, Australia.
¹⁷ Burnet Institute, 85 Commercial Road, Melbourne, Vic, 3004, Australia.

PMID: 40898313
PMCID: PMC12403270
DOI: 10.1186/s13722-025-00602-w

Abstract

Background: Routine use of brief, structured screening tools is essential to detect and provide support for Australians who drink above recommended levels. However, detecting drinking above recommended levels in Aboriginal and Torres Strait Islander Australian primary care settings is complex. Inaccuracies in completing a screening tool such as Alcohol Use Disorders Identification Test - Consumption, can lead to errors in estimating drinking in First Nations contexts where group sharing and episodic drinking make it difficult to accurately estimate alcohol consumption with tools that assume regular drinking patterns. This can lead to under-detection of drinking and a mismatch with the subsequent care that is offered. Hence, screening tools that consider these contextual factors are needed to make it easier for First Nations Australian primary care services to screen for alcohol consumption above recommended levels. Electronic screening tools offer the technical flexibility to consider the drinking contexts Furthermore, for sensitive topics such as alcohol and other drugs, computer-based screening in the general population has been shown to provide more accurate and comprehensive responses compared with face-to-face interviews.

Aim: To facilitate alcohol screening and brief intervention in First Nations Australian primary care settings by adapting the Grog App - a community survey tool validated in Aboriginal and Torres Strait Islander populations for use in primary care.

Methods: The project will use mixed-methods techniques across five study stages: 1 - Interest-holder consultation; 2 - technical development; 3 - re-validation and user interface acceptability; 4 - implementation in an Aboriginal and Torres Strait Islander primary care setting; 5 - acceptability study, six months after implementation.

Discussion: The project will produce a novel, culturally appropriate digital health tool and implementation resources to make it easier to conduct routine alcohol screening in primary care contexts for a priority population, which may lead to increased screening and alcohol care rates. It will also provide first-ever contextual data about implementation of new health service improvement strategy focused on an electronic alcohol consumption screening tool, which is lacking in peer-reviewed literature. This study will also provide an important evidence base for using continuous quality improvement as an implementation approach in primary care settings.

Keywords: Aboriginal and torres strait islander; Alcohol; Brief interventions; Continuous quality improvement; Electronic screening; First nations; Implementation; Primary care.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: This study received ethics approval from the Aboriginal Health and Medical Research Council of New South Wales (NSW; approval no. 2076/23), and Metro South Health, Queensland Human Research Ethics Committee (Qld, approval No. REC/2023/QMS/100707, REC/2023/QMS/100707). Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

**Fig. 1**
The relationship between study stages and their outcomes Blue boxes designate project stages; green boxes designate stage outcomes

See this image and copyright information in PMC

References

1. Kaner EFS, Beyer FR, Muirhead C, Campbell F, Pienaar ED, Bertholet N et al. Effectiveness of brief alcohol interventions in primary care populations. Cochrane Database Syst Rev. 2018;(2). - PMC - PubMed
1. O’Connor EA, Perdue LA, Senger CA, Rushkin M, Patnode CD, Bean SI, et al. Screening and behavioral counseling interventions to reduce unhealthy alcohol use in adolescents and adults: updated evidence report and systematic review for the US preventive services task force. JAMA. 2018;320(18):1910–28. - PubMed
1. Islam MM, Oni HT, Lee KSK, Hayman N, Wilson S, Harrison K, et al. Standardised alcohol screening in primary health care services targeting aboriginal and Torres Strait Islander peoples in Australia. Addict Sci Clin Pract. 2018;13(1):5. - PMC - PubMed
1. Lee KK, Wilson S, Perry J, Room R, Callinan S, Assan R, et al. Developing a tablet computer-based application (‘App’) to measure self-reported alcohol consumption in Indigenous Australians. BMC Med Inf Decis Mak. 2018;18(1):8. - PMC - PubMed
1. Brady M, Sibthorpe B, Bailie R, Ball S, Sumnerdodd P. The feasibility and acceptability of introducing brief intervention for alcohol misuse in an urban aboriginal medical service. Drug Alcohol Rev. 2002;21(4):375–80. - PubMed

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Adapting the Grog survey app for alcohol screening and feedback in aboriginal and Torres Strait Islander health services: a mixed methods study protocol

Affiliations

Adapting the Grog survey app for alcohol screening and feedback in aboriginal and Torres Strait Islander health services: a mixed methods study protocol

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

Medical