OBJECTIVE: Prior research supports the effectiveness of brief interventions for reducing alcohol misuse among patients in the emergency department (ED). However, limited information is available regarding the mechanisms of change, which could assist clinicians in streamlining or amplifying these interventions. This article examines moderators of outcomes among ED patients, ages 19 and older, who participated in a randomized controlled trial of a brief intervention for alcohol misuse. METHOD: Injured patients (N= 4,476) completed a computerized survey; 575 at-risk drinkers were randomly assigned to one of four brief intervention conditions, and 85% were interviewed again at 3-month and 12-month follow-ups. RESULTS: Regression models using the generalized estimating equations approach examined interaction effects between intervention condition (advice/no advice) and hypothesized moderator variables (stage of change, self-efficacy, acute alcohol use, attribution of injury to alcohol) on alcohol outcomes over time. Overall, participants who reported higher levels of self-efficacy had lower weekly consumption and consequences, whereas those with higher readiness to change had greater weekly consumption and consequences. Furthermore, individuals who attributed their injury to alcohol and received advice had significantly lower levels of average weekly alcohol consumption and less frequent heavy drinking from baseline to 12-month follow-up compared with those who attributed their injury to alcohol but did not receive advice. CONCLUSIONS: This study provides novel data regarding attribution for alcohol-related injury as an important moderator of change and suggests that highlighting the alcohol/injury connection in brief, ED-based alcohol interventions can augment their effectiveness.
RCT Entities:
OBJECTIVE: Prior research supports the effectiveness of brief interventions for reducing alcohol misuse among patients in the emergency department (ED). However, limited information is available regarding the mechanisms of change, which could assist clinicians in streamlining or amplifying these interventions. This article examines moderators of outcomes among ED patients, ages 19 and older, who participated in a randomized controlled trial of a brief intervention for alcohol misuse. METHOD: Injured patients (N= 4,476) completed a computerized survey; 575 at-risk drinkers were randomly assigned to one of four brief intervention conditions, and 85% were interviewed again at 3-month and 12-month follow-ups. RESULTS: Regression models using the generalized estimating equations approach examined interaction effects between intervention condition (advice/no advice) and hypothesized moderator variables (stage of change, self-efficacy, acute alcohol use, attribution of injury to alcohol) on alcohol outcomes over time. Overall, participants who reported higher levels of self-efficacy had lower weekly consumption and consequences, whereas those with higher readiness to change had greater weekly consumption and consequences. Furthermore, individuals who attributed their injury to alcohol and received advice had significantly lower levels of average weekly alcohol consumption and less frequent heavy drinking from baseline to 12-month follow-up compared with those who attributed their injury to alcohol but did not receive advice. CONCLUSIONS: This study provides novel data regarding attribution for alcohol-related injury as an important moderator of change and suggests that highlighting the alcohol/injury connection in brief, ED-based alcohol interventions can augment their effectiveness.
Authors: Cheryl J Cherpitel; Yu Ye; Jason Bond; Jürgen Rehm; Vladimir Poznyak; Scott Macdonald; Martin Stafström; Wei Hao Journal: Addiction Date: 2005-12 Impact factor: 6.526
Authors: Michael F Fleming; Marlon P Mundt; Michael T French; Linda Baier Manwell; Ellyn A Stauffacher; Kristen Lawton Barry Journal: Alcohol Clin Exp Res Date: 2002-01 Impact factor: 3.455
Authors: P M Monti; D J Rohsenow; R M Swift; S B Gulliver; S M Colby; T I Mueller; R A Brown; A Gordon; D B Abrams; R S Niaura; M K Asher Journal: Alcohol Clin Exp Res Date: 2001-11 Impact factor: 3.455
Authors: Brendan J Clark; Alexandra Smart; Robert House; Ivor Douglas; Ellen L Burnham; Marc Moss Journal: Alcohol Clin Exp Res Date: 2011-09-26 Impact factor: 3.455
Authors: Patrick M Carter; Maureen A Walton; Manya F Newton; Michael Clery; Lauren K Whiteside; Marc A Zimmerman; Rebecca M Cunningham Journal: Pediatrics Date: 2013-07-08 Impact factor: 7.124
Authors: Emily C Williams; Tibor Palfai; Debbie M Cheng; Jeffrey H Samet; Katharine A Bradley; Thomas D Koepsell; Thomas M Wickizer; Patrick J Heagerty; Richard Saitz Journal: Alcohol Clin Exp Res Date: 2010-05-04 Impact factor: 3.455
Authors: Joanne E Brady; Charles J DiMaggio; Katherine M Keyes; John J Doyle; Lynne D Richardson; Guohua Li Journal: Ann Epidemiol Date: 2015-04-02 Impact factor: 3.797
Authors: Frederic C Blow; Mark A Ilgen; Maureen A Walton; Ewa K Czyz; Ryan McCammon; Stephen T Chermack; Rebecca M Cunningham; Kristen L Barry Journal: Alcohol Alcohol Date: 2009-08-19 Impact factor: 2.826
Authors: Adeline Nyamathi; Steven Shoptaw; Allan Cohen; Barbara Greengold; Kamala Nyamathi; Mary Marfisee; Viviane de Castro; Farinaz Khalilifard; Daniel George; Barbara Leake Journal: Drug Alcohol Depend Date: 2010-02-01 Impact factor: 4.492