Talking about alcohol to patients (TAP) study: Assessing patient-provider communication of alcohol's breast cancer risks

Background Primary care providers are well-positioned to educate patients about alcohol-related health risks, such as breast cancer, but little is known about their awareness of the alcohol-breast cancer (ABC) link or their counseling practices. This study aimed to assess the level of awareness of alcohol as a breast cancer risk factor among providers; to assess the prevalence of provider counseling discussions with their patients about the alcohol-breast cancer link; and identify predictors of level of awareness and counseling discussion about the alcohol-breast cancer link. Methods We conducted a cross-sectional survey of primary care providers in Alabama between September and December 2023. A 3-min online questionnaire assessed provider knowledge of the ABC link, counseling practices, and perceived barriers to patient education. Descriptive statistics, bivariate analyses, and logistic regression were used to identify predictors of awareness and counseling behavior. Results Among 123 respondents, only 19.5% reported counseling patients about the ABC link. Awareness was significantly higher among counseling providers (95.8%) compared to non-counseling providers (41.7%, p < 0.001). Older age and female gender were associated with greater awareness (OR = 1.08 per year, p = 0.001; OR = 5.26 for females, p = 0.003). Counseling was more likely among providers who were female (OR = 5.26, p = 0.041), did not engage in binge drinking (OR = 12.5, p = 0.045), and had higher patient loads (OR = 1.02 per patient, p = 0.019). The most cited barrier to counseling was lack of awareness (49.4%), while increased provider education was the most frequently proposed solution (45.3%). Conclusions Despite the critical role of providers in preventive health, most providers do not counsel patients about the ABC link. Awareness is a key driver of counseling but not sufficient on its own. Targeted educational interventions are needed to enhance provider engagement in alcohol-related cancer prevention.