Patient Attitudes Toward Substance Use Screening and Discussion in Primary Care: Comparison Across Demographic Characteristics

Introduction: Screening for unhealthy alcohol and drug use is recommended in primary care, and effective implementation requires understanding patients’ perspectives. Failure to identify and address potential differences in attitudes toward screening across demographic groups may result in care gaps...

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Main Authors: Madeline C. Frost, Jennifer McNeely, Noa Appleton, Sarah Farkas, Sarah E. Wakeman, Timothy E. Wilens, Joseph Kannry, Bethany McLeman, Noah Nesin, Richard N. Rosenthal, Carmen Rosa, Aimee Wahle, Seth Pitts, Emily C. Williams, Leah Hamilton
Format: Article
Language:English
Published: SAGE Publishing 2025-08-01
Series:Journal of Primary Care & Community Health
Online Access:https://doi.org/10.1177/21501319251364034
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author Madeline C. Frost
Jennifer McNeely
Noa Appleton
Sarah Farkas
Sarah E. Wakeman
Timothy E. Wilens
Joseph Kannry
Bethany McLeman
Noah Nesin
Richard N. Rosenthal
Carmen Rosa
Aimee Wahle
Seth Pitts
Emily C. Williams
Leah Hamilton
author_facet Madeline C. Frost
Jennifer McNeely
Noa Appleton
Sarah Farkas
Sarah E. Wakeman
Timothy E. Wilens
Joseph Kannry
Bethany McLeman
Noah Nesin
Richard N. Rosenthal
Carmen Rosa
Aimee Wahle
Seth Pitts
Emily C. Williams
Leah Hamilton
author_sort Madeline C. Frost
collection DOAJ
description Introduction: Screening for unhealthy alcohol and drug use is recommended in primary care, and effective implementation requires understanding patients’ perspectives. Failure to identify and address potential differences in attitudes toward screening across demographic groups may result in care gaps, but research examining this is limited. Methods: We surveyed 977 adult patients in 9 primary care clinics that participated in a screening implementation study. The survey collected demographics and attitudes toward screening/discussion of alcohol/drug use in primary care. We described responses overall and compared across age, gender, race, and ethnicity using Chi-square/Fisher’s exact tests. Results: Mean age was 51.1 years, and the sample was 39% male, 61% female, 72% White non-Hispanic, 11% Hispanic, 10% Black non-Hispanic, and 6% other/unknown race non-Hispanic. Most participants across all demographic groups reported supportive attitudes. Comfort reporting drug use was lower among young, male, Black non-Hispanic, and Hispanic patients, and comfort with screening overall was lower among middle-aged, Black non-Hispanic, and Hispanic patients. Conclusions: Results suggest that screening/discussion of alcohol/drug use in primary care is generally highly acceptable to patients across demographic groups. Strategies are needed to increase comfort and alleviate concerns about how medical information will be used, particularly among middle-aged, Black, and Hispanic patients.
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spelling doaj-art-d01966e2c8294f868821318d7d6c7ddd2025-08-20T03:44:17ZengSAGE PublishingJournal of Primary Care & Community Health2150-13272025-08-011610.1177/21501319251364034Patient Attitudes Toward Substance Use Screening and Discussion in Primary Care: Comparison Across Demographic CharacteristicsMadeline C. Frost0Jennifer McNeely1Noa Appleton2Sarah Farkas3Sarah E. Wakeman4Timothy E. Wilens5Joseph Kannry6Bethany McLeman7Noah Nesin8Richard N. Rosenthal9Carmen Rosa10Aimee Wahle11Seth Pitts12Emily C. Williams13Leah Hamilton14Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle, WA, USADepartment of Medicine, Division of General Internal Medicine, New York University Grossman School of Medicine, New York, NY, USADepartment of Population Health, New York University Grossman School of Medicine, New York, NY, USADepartment of Psychiatry, New York University Grossman School of Medicine, New York, NY, USADepartment of Medicine, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USADepartment of Psychiatry, Massachusetts General Hospital, Boston, MA, USADivision of General Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USACenter for Technology and Behavioral Health, Geisel School of Medicine at Dartmouth College, Hanover, NH, USAPenobscot Community Health Care, Bangor, ME, USARenaissance School of Medicine, Stony Brook University, Stony Brook, NY, USANational Institute on Drug Abuse, Bethesda, MD, USAThe Emmes Company, Rockville, MD, USAThe Emmes Company, Rockville, MD, USADepartment of Health Systems and Population Health, University of Washington School of Public Health, Seattle, WA, USAKaiser Permanente Washington Health Research Institute, Seattle, WA, USAIntroduction: Screening for unhealthy alcohol and drug use is recommended in primary care, and effective implementation requires understanding patients’ perspectives. Failure to identify and address potential differences in attitudes toward screening across demographic groups may result in care gaps, but research examining this is limited. Methods: We surveyed 977 adult patients in 9 primary care clinics that participated in a screening implementation study. The survey collected demographics and attitudes toward screening/discussion of alcohol/drug use in primary care. We described responses overall and compared across age, gender, race, and ethnicity using Chi-square/Fisher’s exact tests. Results: Mean age was 51.1 years, and the sample was 39% male, 61% female, 72% White non-Hispanic, 11% Hispanic, 10% Black non-Hispanic, and 6% other/unknown race non-Hispanic. Most participants across all demographic groups reported supportive attitudes. Comfort reporting drug use was lower among young, male, Black non-Hispanic, and Hispanic patients, and comfort with screening overall was lower among middle-aged, Black non-Hispanic, and Hispanic patients. Conclusions: Results suggest that screening/discussion of alcohol/drug use in primary care is generally highly acceptable to patients across demographic groups. Strategies are needed to increase comfort and alleviate concerns about how medical information will be used, particularly among middle-aged, Black, and Hispanic patients.https://doi.org/10.1177/21501319251364034
spellingShingle Madeline C. Frost
Jennifer McNeely
Noa Appleton
Sarah Farkas
Sarah E. Wakeman
Timothy E. Wilens
Joseph Kannry
Bethany McLeman
Noah Nesin
Richard N. Rosenthal
Carmen Rosa
Aimee Wahle
Seth Pitts
Emily C. Williams
Leah Hamilton
Patient Attitudes Toward Substance Use Screening and Discussion in Primary Care: Comparison Across Demographic Characteristics
Journal of Primary Care & Community Health
title Patient Attitudes Toward Substance Use Screening and Discussion in Primary Care: Comparison Across Demographic Characteristics
title_full Patient Attitudes Toward Substance Use Screening and Discussion in Primary Care: Comparison Across Demographic Characteristics
title_fullStr Patient Attitudes Toward Substance Use Screening and Discussion in Primary Care: Comparison Across Demographic Characteristics
title_full_unstemmed Patient Attitudes Toward Substance Use Screening and Discussion in Primary Care: Comparison Across Demographic Characteristics
title_short Patient Attitudes Toward Substance Use Screening and Discussion in Primary Care: Comparison Across Demographic Characteristics
title_sort patient attitudes toward substance use screening and discussion in primary care comparison across demographic characteristics
url https://doi.org/10.1177/21501319251364034
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