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Influence of Community-Based Alcohol Screening on Hazardous Alcohol Use Detection among Adults in Nigeria

Abstract

Hazardous alcohol use is an important public health concern among adults in Nigeria and may contribute to injuries, chronic diseases, mental health problems, family difficulties, reduced productivity, and other adverse social and health outcomes. Hazardous alcohol use may remain undetected when individuals underestimate their level of alcohol consumption, have limited awareness of alcohol-related risks, experience stigma, or have inadequate access to preventive health services. Community-based alcohol screening provides an opportunity to identify adults whose drinking patterns may place them at increased risk of alcohol-related harm through primary healthcare centres, community outreach programmes, workplaces, community organizations, and other accessible platforms. Early detection can facilitate brief interventions, health education, counselling, risk-reduction strategies, treatment referral, and appropriate follow-up. Against this background, this study investigates the influence of community-based alcohol screening on hazardous alcohol use detection among adults in Nigeria. The study will be anchored on the Health Belief Model, Social Ecological Model, and Health Promotion Model. The Health Belief Model explains how adults' perceptions of their susceptibility to alcohol-related harm, perceived severity, perceived benefits of screening, perceived barriers, and cues to action may influence participation in community-based alcohol screening and subsequent help-seeking behaviour. The Social Ecological Model emphasizes the influence of individual, interpersonal, community, socioeconomic, cultural, and healthcare-system factors on alcohol consumption patterns and access to preventive services. The Health Promotion Model emphasizes individual knowledge, perceived benefits, behavioural influences, and actions that may encourage healthier alcohol-related behaviours and utilization of preventive health services. Collectively, these theoretical perspectives provide a suitable framework for explaining how community-based alcohol screening may influence hazardous alcohol use detection among adults in Nigeria. The study will adopt a quantitative cross-sectional analytical or quasi-experimental research design. The study population will comprise adults aged 18 years and above residing in selected communities across Nigeria. A multistage sampling technique will be used to select states, local government areas, communities, households, primary healthcare centres, workplaces, and eligible participants. Community-based alcohol screening will be measured using indicators such as availability of screening services, screening coverage, frequency of screening activities, use of validated alcohol-use screening instruments, assessment of drinking frequency, quantity of alcohol consumed, binge-drinking patterns, alcohol-related problems, availability of trained screening personnel, confidentiality arrangements, alcohol-related health education, brief intervention services, counselling, and referral pathways. Hazardous alcohol use detection will be assessed using indicators such as positive screening results, identification of hazardous drinking patterns, binge drinking, alcohol-related functional or social problems, adults requiring further assessment, newly identified hazardous alcohol use, referrals for counselling or treatment, brief interventions provided, and linkage to appropriate alcohol-related health services. Data will be collected using structured questionnaires, validated alcohol-use screening instruments such as the Alcohol Use Disorders Identification Test where appropriate, community health records, screening registers, counselling records, and referral documentation. Descriptive statistics will be used to summarize participants' demographic characteristics, alcohol-use patterns, screening coverage, and detection rates. Inferential statistical techniques, including chi-square tests, correlation analysis, and logistic or multiple regression analysis, will be used to determine the influence of community-based alcohol screening on hazardous alcohol use detection. Where appropriate, detection rates before and after implementation of community-based alcohol screening activities may be compared to determine changes associated with the intervention. Diagnostic tests will also be conducted to assess the reliability, validity, and robustness of the findings. The study is expected to find that community-based alcohol screening has a significant positive influence on hazardous alcohol use detection among adults in Nigeria. Adults who participate in systematic community-based alcohol screening are expected to have a higher likelihood of previously unrecognized hazardous drinking patterns being identified than adults without access to such screening. Routine screening may facilitate early recognition of excessive alcohol consumption, binge drinking, alcohol-related social or occupational problems, and other patterns associated with increased health risks. Early detection may provide opportunities for brief interventions, personalized health education, counselling, risk-reduction strategies, treatment referral, and follow-up. Conducting screening within community and primary healthcare settings may reduce geographical, financial, and time-related barriers and may reach adults who would not voluntarily seek specialized services for alcohol-related concerns. Confidential screening may also provide a less stigmatizing opportunity for individuals to discuss their drinking patterns and receive appropriate guidance. Conversely, stigma, denial or underreporting, cultural acceptance of alcohol consumption, lack of privacy, shortage of trained personnel, limited treatment services, financial constraints, and weak referral and follow-up systems may reduce the effectiveness of community-based alcohol screening. The study therefore expects accessible, confidential, and systematically implemented community-based alcohol screening to contribute significantly to improved detection and early management of hazardous alcohol use among adults in Nigeria. The study is expected to contribute to the literature on community-based alcohol screening, hazardous alcohol use detection, alcohol-related health risks, substance-use prevention, behavioural health, community health services, preventive healthcare, mental health, and public health in Nigeria. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, National Primary Health Care Development Agency, state ministries of health, primary healthcare centres, community health workers, mental health and substance-use practitioners, public health professionals, workplaces, community organizations, development partners, and policymakers regarding strategies for improving early identification of hazardous alcohol use. The study will also provide evidence-based recommendations for expanding community-based alcohol screening, strengthening the capacity of primary healthcare workers to identify hazardous drinking, increasing access to brief interventions and counselling, improving referral and treatment pathways, reducing stigma, strengthening community health education, and integrating appropriate alcohol-use screening into community-based primary healthcare and preventive health programmes across Nigeria.

Keywords: Community-based alcohol screening, hazardous alcohol use detection, adults, alcohol use, alcohol screening, substance-use prevention, brief intervention, behavioural health, community health services, preventive healthcare, Nigeria, public health.