Emergency Department-Based Brief Intervention to Reduce Risky Driving and Hazardous/Harmful Drinking in Young Adults: A Randomized Controlled Trial

作者：Sommers Marilyn S^*; Lyons Michael S; Fargo Jamison D; Sommers Benjamin D; McDonald Catherine C; Shope Jean T; Fleming Michael F

来源：Alcoholism: Clinical and Experimental Research , 2013, 37(10): 1753-1762.

DOI：10.1111/acer.12142

• Brief Intervention
• Hazardous Drinking
• Risky Driving

BackgroundRisky driving and hazardous drinking are associated with significant human and economic costs. Brief interventions for more than one risky behavior have the potential to reduce health-compromising behaviors in populations with multiple risk-taking behaviors such as young adults. Emergency department (ED) visits provide a window of opportunity for interventions meant to reduce both risky driving and hazardous drinking. %26lt;br%26gt;MethodsWe determined the efficacy of a Screening, Brief Intervention, and Referral to Treatment (SBIRT) protocol addressing risky driving and hazardous drinking. We used a randomized controlled trial design with follow-ups through 12months. ED patients aged 18 to 44 who screened positive for both behaviors (n=476) were randomized to brief intervention (BIG), contact control (CCG), or no-contact control (NCG) groups. The BIG (n=150) received a 20-minute assessment and two 20-minute interventions. The CCG (n=162) received a 20-minute assessment at baseline and no intervention. The NCG (n=164) were asked for contact information at baseline and had no assessment or intervention. Outcomes at 3, 6, 9, and 12months were self-reported driving behaviors and alcohol consumption. %26lt;br%26gt;ResultsOutcomes were significantly lower in BIG compared with CCG through 6 or 9months, but not at 12months: Safety belt use at 3months (adjusted odds ratio [AOR], 0.22; 95% confidence interval [CI], 0.08 to 0.65); 6months (AOR, 0.13; 95% CI, 0.04 to 0.42); and 9months (AOR, 0.18; 95% CI, 0.06 to 0.56); binge drinking at 3months (adjusted rate ratio [ARR] 0.84; 95% CI, 0.74 to 0.97) and 6months (ARR, 0.81; 95% CI, 0.67 to 0.97); and 5 standard drinks/d at 3months (AOR, 0.43; 95% CI, 0.20 to 0.91) and 6months (AOR, 0.41; 95% CI, 0.17 to 0.98). No substantial differences were observed between BIG and NCG at 12months. %26lt;br%26gt;ConclusionsOur findings indicate that SBIRT reduced risky driving and hazardous drinking in young adults, but its effects did not persist after 9months. Future research should explore methods for extending the intervention effect.

• 出版日期2013-10
• 单位西北大学