Citation

Ehrlich PF, Roche JS, Cunningham RM, Chermack ST, Carter PM, Booth BM, Blow F, Barry K, Walton MAL. J. Trauma Acute Care Surg. 2016; 81(1): 149-155.

Affiliation

1University of Michigan Injury Center University of Michigan Medical School 2800 Plymouth Road, NCRC 10-G080 Ann Arbor, Michigan, 48109 2Department of Emergency Medicine University of Michigan School of Medicine 1500 East Medical Center Drive Ann Arbor, Michigan, 48105 3Department of Health Behavior and Health Education University of Michigan School of Public Health 1415 Washington Heights 3790A SPH I Ann Arbor, Michigan, 48109 4Michigan Youth Violence Prevention Center University of Michigan School of Public Health 1415 Washington Heights Ann Arbor, Michigan, 48109 5University of Michigan Addiction Center Department of Psychiatry University of Michigan School of Medicine 4250 Plymouth Rd. Ann Arbor, Michigan, 48109 6Center for Clinical Management Research Ann Arbor VA Healthcare System Department of Veterans Affairs Ann Arbor, Michigan, 48105 7Department of Psychiatry College of Medicine, University of Arkansas for Medical Sciences UAMS-PRI 4301 W. Markham St, #755 Little Rock, Arkansas, 72205 8Department of Surgery, Section of Pediatric Surgery CS Mott Children's Hospital University of Michigan School of Medicine, Ann Arbor Michigan 48109 9Institute for Healthcare Policy and Innovation, University of Michigan 2800 Plymouth Road, NCRC 16 Ann Arbor, Michigan, 48109.

Copyright

(Copyright © 2016, Lippincott Williams and Wilkins)

DOI

10.1097/TA.0000000000001093

PMID

27120317

Abstract

BACKGROUND: While the relationship between underage drinking and injury has been well established, few studies have examined whether presenting for an acute injury moderates the efficacy of a brief intervention (BI) on alcohol misuse.

METHOD: Patients (aged 14-20) in the emergency department screening positive for risky drinking (AUDIT-C score) completed a baseline assessment, were randomized to conditions [a stand-alone computer-delivered BI (n=277), a therapist-delivered BI (n=278), or a control condition (n=281)], and completed a 3-month follow-up. This secondary analysis of Project U connect examined regression models (controlling for baseline values) to examine the main effects of injury, and the interaction effects of injury by BI condition, on alcohol consumption and consequences.

RESULTS: Among 836 youth enrolled in the randomized controlled trial (mean age = 18.6, 51.6% male, 79.4% Caucasian), 303 (36.2%) had a primary complaint of intentional or unintentional injury. At baseline, injured patients were more likely to be male (p <0.001) and have higher alcohol consumption (p <0.01), but were less likely to misuse prescription drugs (p=0.02) than those presenting for medical reasons. Regression models (controlling for baseline values) demonstrated that injury presentation predicted greater alcohol consumption prior to a BI. The computer BI was more effective at reducing alcohol consequences among those presenting with injury than those presenting for other reasons. Injury did not affect the efficacy of the computer BI on alcohol consumption, and injury did not affect the efficacy of the therapist BI on alcohol outcomes.

CONCLUSION: A therapist or computer BI reduced alcohol consumption and consequences among risky drinkers regardless of reason for ED presentation highlighting the opportunity to reach a broad array of youth. Although the therapist BI was not moderated by injury presentation, the computer BI was particularly effective at reducing alcohol consequences among those presenting with injury at three month follow-up. LEVEL OF EVIDENCE: Level 1 TYPE OF STUDY: Criteria.

Language: en