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Citation
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Walton MAL, Chermack ST, Blow FC, Ehrlich PF, Barry KL, Booth BM, Cunningham RM. Subst. Abuse 2014; 36(3): 339-349. |
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Affiliation
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a University of Michigan , Department of Psychiatry, Addiction Research Center , Ann Arbor , MI , USA. |
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Abstract
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BACKGROUND: Alcohol brief interventions (BIs) delivered by therapists are promising among underage drinkers in the emergency department (ED); however, integration into routine ED care is lacking. Harnessing technology for identification of at-risk drinkers and delivery of interventions could have tremendous public health impact by addressing practical barriers to implementation. The paper presents baseline, within BI session, and post-test data from an ongoing randomized controlled trial (RCT) of youth in the ED.
METHODS: Patients (ages 14-20) who screened positive for risky drinking were randomized to: computer BI (CBI), therapist BI (TBI), or control. Measures included: demographics, alcohol consumption (AUDIT-C), process questions, BI components (e.g., strengths, tools) and psychological constructs (i.e., importance of cutting down, likelihood of cutting down, readiness to stop, and wanting help).
RESULTS: Among 4389 youth surveyed (13.7% refused), 24.0% (n = 1053) screened positive for risky drinking and 80.3% (n = 836) were enrolled in the RCT; 93.7% (n = 783) completed the post-test. Although similar in content, the TBI included a tailored, computerized workbook to structure the session whereas the CBI was a stand-alone, offline "Facebook" styled program. As compared to controls, significant increases were found at post-test for the TBI in 'importance to cut down' and 'readiness to stop' and for the CBI in 'importance and likelihood to cut-down'. BI components positively associated with outcomes at post-test included greater identification of personal strengths, protective behavioral strategies; benefits of change, and alternative activities involving sports. In contrast, providing information during the TBI was negatively related to outcomes at post-test.
CONCLUSIONS: Initial data suggest that therapist and computer BI's are promising, increasing perceived importance of reducing drinking. In addition, findings provide clues to potentially beneficial components of BIs. Future studies are needed to identify BI components that have the greatest influence on reducing risky drinking behaviors among adolescents and emerging adults.
Language: en |