Alcohol Misuse

Appendix Figure 1. Analytic Framework and Key Questions (Text Description)

Appendix Figure 1 is a diagram illustrating the analytic framework and 7 key questions (KQ) that were addressed in the evidence summary. The diagram reads from left to right and begins on the left with a list of the four sectors of the clinical population that the researchers studied: adolescent males and females, adult females and males, senior females and males (older than 65 years), and pregnant women.

On the far right is KQ 1, the ultimate question—"Is there direct evidence that behavioral counseling interventions to reduce risky or harmful alcohol use reduce morbidity and/or mortality?" The outcome is listed as "reduction in all-cause mortality, alcohol-related deaths, morbidity, accidents, and injuries."

From the clinical population list, the arrow labeled KQ 2—"What methods were used to identify target populations for behavioral counseling interventions in primary care?"—points to KQ 3—"What are adverse effects associated with alcohol use screening and screening-related assessment?"—and stops there. Another arrow proceeds from KQ 2 through "harmful/at-risk alcohol users" to KQ 4—"Does behavioral counseling intervention in primary care reduce risky or harmful alcohol use in the targeted subgroup? What are the essential elements of efficacious interventions?" Dotted lines proceed from KQ 2 and KQ 4 to KQ 7, "What are adverse effects associated with behavioral counseling interventions for risky/harmful alcohol use?"

From KQ 4, an arrow points to KQ 5—"Are there other positive outcomes from behavioral counseling interventions to reduce risky/harmful alcohol use?" Another arrow from KQ 4 goes to KQ 6—"What are adverse effects associated with behavioral counseling interventions for risky/harmful alcohol use?"—and stops there. Still another arrow from KQ 4 goes to "measures of lower risk alcohol use" and becomes a dotted line that proceeds to KQ1.

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