Effects of brief intervention on subgroups of injured patients who drink at risk levels

Cochran, Gerald; Field, Craig A.; Foreman, Michael L.; Ylioja, Thomas; Brown, Carlos V R

doi:10.1136/injuryprev-2015-041596

Cited by 4 publications

(6 citation statements)

References 31 publications

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“…We tested the possibility that the effect of BI on the risk of recidivism might be modified by PHTx, but the interaction term between these two variables in the model was not significant. If the effectiveness of BI does not depend on a patient’s past trauma history, this variable may be useful to identify subgroups of high-risk patients for whom SBIRT programs should be prioritized [ 51 , 52 ], especially in situations when the lack of resources prevents the use of these programs for all patients who screen positive for alcohol or illicit drug use in the hospital emergency department.…”

Section: Discussionmentioning

confidence: 99%

Effect of a brief intervention for alcohol and illicit drug use on trauma recidivism in a cohort of trauma patients

et al. 2017

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ObjectiveEstimate the effectiveness of brief interventions in reducing trauma recidivism in hospitalized trauma patients who screened positive for alcohol and/or illicit drug use.MethodsDynamic cohort study based on registry data from 1818 patients included in a screening and brief intervention program for alcohol and illicit drug use for hospitalized trauma patients. Three subcohorts emerged from the data analysis: patients who screened negative, those who screened positive and were offered brief intervention, and those who screened positive and were not offered brief intervention. Follow-up lasted from 10 to 52 months. Trauma-free survival, adjusted hazard rate ratios (aHRR) and adjusted incidence rate ratios (aIRR) were calculated, and complier average causal effect (CACE) analysis was used.ResultsWe found a higher cumulative risk of trauma recidivism in the subcohort who screened positive. In this subcohort, an aHRR of 0.63 (95% CI: 0.41–0.95) was obtained for the group offered brief intervention compared to the group not offered intervention. CACE analysis yielded an estimated 52% reduction in trauma recidivism associated with the brief intervention.ConclusionThe brief intervention offered during hospitalization in trauma patients positive for alcohol and/or illicit drug use can halve the incidence of trauma recidivism.

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Section: Discussionmentioning

confidence: 99%

Effect of a brief intervention for alcohol and illicit drug use on trauma recidivism in a cohort of trauma patients

et al. 2017

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“…Only these two groups showed significant decreases in alcohol use as far as 12 months post-intervention. 27 In the second study, investigators conducted subgroup analyses to examine the influence of type of injury event on brief intervention effects. 28 They found significant effects of brief intervention on self-report of alcohol-related negative consequences and alcohol-related injuries at the 12-month follow-up only for patients who experienced an injury from a motor vehicle crash versus a non-motor vehicle crash injury.…”

Section: The Sentinel Event Effect and Brief Interventions For Alcoho...mentioning

confidence: 99%

“…In one study, investigators used latent class analysis to identify five subgroups of participants based on self-reported injury-related risk behavior and alcohol related consequences (as measured by the Short Inventory of Problems þ 6). [25][26][27] Two subgroups were characterized by the experience of injuries. Only these two groups showed significant decreases in alcohol use as far as 12 months post-intervention.…”

mentioning

confidence: 99%

Mechanisms of Change in Drinking following an Alcohol-Related Injury: A Qualitative Examination of the Sentinel Event Effect

et al. 2021

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Background Sentinel events are negative health-related events that trigger change in risky health behaviors. Despite its presumed major role in behavior change, the sentinel event effect has received little empirical attention. Through analysis of qualitative interviews, we explored how sentinel events trigger behavior change. Methods Thematic analysis and concept mapping were used to develop a preliminary model of the sentinel event effect among a sample of 24 adult heavy drinking Mexican-origin men previously admitted to a hospital due to injury. The model was checked against cases that did versus did not report change in alcohol use following an alcohol-related negative event. Results Findings suggest that sentinel events may arouse negative emotional reactions, encourage reflection on the negative consequences of drinking, and cause reevaluation of the severity and significance of drinking. These processes may increase motivation to change. Conclusions Findings support the concept of the sentinel event as a natural intervention, and identifies potential social-cognitive and motivational mechanisms through which it influences change. Findings stand to inform research on mechanisms underlying brief intervention effects, and research that seeks to identify treatment targets.

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“…The two most common behavioral therapies used in SBIRT programs are brief versions of cognitive behavioral therapy and motivational interviewing, or some combination of the two. There is substantial research on the effectiveness of SBIRT in reducing risky alcohol consumption (Bertholet et al 2005; Cochran et al 2015; Kaner et al 2009; Landy et al 2015; Ouimet et al 2013; Patton et al 2014; Steinka-Fry et al 2015; Teeters et al 2015; Whitlock et al 2004; Wojnar and Jakubczyk 2014). …”

Section: Five Important But Not Highest Priority Strategiesmentioning

confidence: 99%

Can progress in reducing alcohol-impaired driving fatalities be resumed? Results of a workshop sponsored by the Transportation Research Board, Alcohol, Other Drugs, and Transportation Committee (ANB50)

Fell

Beirness

Voas

et al. 2016

Traffic Injury Prevention

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Objective Despite successes in the 1980s and early 1990s, progress in reducing impaired driving fatalities in the United States has stagnated in recent years. Since 1997, the percentage of drivers involved in fatal crashes with illegal blood alcohol concentration (BAC) levels has remained at approximately 20% to 22%. Many experts believe that public complacency, competing social and public health issues, and the lack of political fortitude have all contributed to this stagnation. The number of alcohol-related crashes, injuries, and fatalities is still unacceptable, and most are preventable. The public needs to be aware that the problem presented by drinking drivers has not been solved. Political leaders need guidance on which measures will affect the problem, and stakeholders need to be motivated once again to implement effective strategies. Methods The National Academy of Sciences (NAS) Transportation Research Board (TRB) Alcohol, Other Drugs, and Transportation Committee (ANB50) sponsored a workshop held at the NAS facility in Woods Hole, MA, on August 24–25, 2015, to discuss the lack of progress in reducing impaired driving and to make recommendations for future progress. A total of 26 experts in research and policy related to alcohol-impaired driving participated in the workshop. The workshop began by examining the static situation in the rate of alcohol-impaired driving fatal crashes to determine what factors may be inhibiting further progress. The workshop then discussed eight effective strategies that have not been fully implemented in the United States. Workshop participants (16 of the 26) rated their top three strategies. Results Three strategies received the most support: Impose administrative sanctions for drivers with BACs = .05 to .08 g/dL.Require alcohol ignition interlocks for all alcohol-impaired driving offenders.Increase the frequency of sobriety checkpoints, including enacting legislation to allow them in the 11 states that currently prohibit them. Five other important strategies included the following: (a) increase alcohol taxes to raise the price and reduce alcohol consumption; (b) re-engage the public and raise the priority of impaired driving; (c) lower the illegal per se BAC limit to .05 for a criminal offense; (d) develop and implement in-vehicle alcohol detection systems; and (e) expand the use of screening and brief interventions in medical facilities. Conclusions Each of these strategies is proven to be effective, yet all are substantially underutilized. Each is used in some jurisdictions in the United States or Canada, but none is used extensively. Any one of the three strategies implemented on a widespread basis would decrease impaired driving crashes, injuries, and fatalities. Based on the research, all three together would have a substantial impact on the problem.

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Effects of brief intervention on subgroups of injured patients who drink at risk levels

Cited by 4 publications

References 31 publications

Effect of a brief intervention for alcohol and illicit drug use on trauma recidivism in a cohort of trauma patients

Effect of a brief intervention for alcohol and illicit drug use on trauma recidivism in a cohort of trauma patients

Mechanisms of Change in Drinking following an Alcohol-Related Injury: A Qualitative Examination of the Sentinel Event Effect

Can progress in reducing alcohol-impaired driving fatalities be resumed? Results of a workshop sponsored by the Transportation Research Board, Alcohol, Other Drugs, and Transportation Committee (ANB50)

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