Brief Intervention to Reduce Injury in Minorities

The purpose of this study is to evaluate the effectiveness and ethnic differences of a brief alcohol intervention for injured patients.

Injuries are not isolated events or one time occurrences and injury has been identified as an important public health problem. Among the risk factors associated with injury and injury recidivism, the most widely recognized is alcohol use with approximately 50% of all injuries associated with alcohol. In general, alcohol use and drinking patterns vary by ethnicity, with frequent heavy drinking and associated problems more common among Blacks and Hispanics. Blacks, in general, suffer a disproportionate level of alcohol problems, despite having higher rates of abstention than Whites and Hispanics. Hispanics also generally suffer more alcohol-related problems than whites. Overall, injury recidivism is higher among poorer, minority populations and among individuals who abuse alcohol. The efficacy of brief alcohol interventions in the emergency care setting such as hospital emergency departments and trauma care centers is a relatively new area of research. Brief alcohol interventions appear to reduce alcohol intake and rates of injury following hospitalization; however, there is a need to evaluate the efficacy of these brief interventions in various ethnic groups. The proposed research involves a randomized controlled trial of a brief alcohol intervention based upon motivational interviewing and harm reduction to reduce alcohol consumption and injury following admission to an emergency room or trauma department for treatment of an injury. The primary aim of the proposed project is to determine the efficacy of this intervention as applied in the trauma care and emergency room setting among Whites, Blacks and Hispanics. The three outcomes of interest include: alcohol consumption as measured by number of standard drinks consumed per week and frequency of drinking five or more drinks per occasion engagement in injury related risk behaviors and injury recidivism rates It is hypothesized that the brief alcohol intervention will have a greater impact on alcohol consumption, injury related risk behaviors and injury recidivism among Whites than Blacks and Mexican Americans. In addition, it is hypothesized that the brief alcohol intervention will have less of an impact on alcohol consumption, injury related risk behaviors and injury recidivism among Mexican Americans born in the United States than among those born in Mexico after controlling for acculturation, acculturation stress and sociodemographic characteristics.

Patients randomized to this arm received an intervention based in the motivational interviewing style

The intervention was an approximately 30 minute discussion about alcohol-related risk behaviors and motivation to change

Standard hospital care provided the patient with information and referral for treatment as necessary.

Inclusion Criteria: Admission for treatment of an injury Self identification of Black, White or Hispanic Ethnicity Age > 17 Screen positive for potential alcohol related injury based upon clinical indication of alcohol use prior to injury including positive blood alcohol concentration, self report of alcohol use prior to injury, heavy drinking or drinking beyond normal limits as defined by NIAAA Exclusion Criteria: Glasgow Coma Score or GCS < 14 Admission for self inflicted injury

Cochran G, Field C, Caetano R. Injury-related consequences of alcohol misuse among injured patients who received screening and brief intervention for alcohol: a latent class analysis. Subst Abus. 2014;35(2):153-62. doi: 10.1080/08897077.2013.820679.

Cochran G, Field C, Caetano R. Changes in Classes of Injury-Related Risks and Consequences of Risk-Level Drinking: a Latent Transition Analysis. J Behav Health Serv Res. 2015 Jul;42(3):355-66. doi: 10.1007/s11414-013-9378-3.

Field CA, Caetano R, Harris TR, Frankowski R, Roudsari B. Ethnic differences in drinking outcomes following a brief alcohol intervention in the trauma care setting. Addiction. 2010 Jan;105(1):62-73. doi: 10.1111/j.1360-0443.2009.02737.x. Epub 2009 Nov 17.