Examining motor vehicle crash involvement and readiness to change on drinking and driving behaviors among injured emergency department patients

Abstract

Objective: To measure the effect of motor vehicle crash (MVC) involvement and readiness to change drinking and driving behaviors on subsequent driving and drinking behaviors among injured emergency department (ED) patients who use alcohol at harmful levels. Methods: A secondary analyses of a randomized controlled trial of injured ED patients who screened positive for harmful alcohol use, who at recruitment reported driving in the past 12 months and received at least one of the intended intervention sessions (brief behavioral intervention versus attention placebo control [N = 407]). Outcome variables were: 1) change in six impaired driving behaviors, 2) report of MVCs and traffic violations in the 12 months following recruitment; predictor variables were: 1) treatment assignment, 2) MVC involvement at recruitment, and 3) baseline readiness to change alcohol use and drinking and driving. Results: Modeling of change in the six impaired driving variables indicated that neither the recruitment visits being MVC-related, nor baseline readiness to change alcohol use and drinking and driving behaviors, predicted greater changes in impaired driving over time. Baseline reports of past moving traffic violations and the ED visit being MVC related predicted a greater likelihood of each behavior at 12 months following study recruitment. Conclusions: This study and others have demonstrated that ED patients with harmful alcohol use are willing to engage in behavioral interventions directed at changing risky behaviors. However, this study did not demonstrate that patients considered having the potential to be more engaged with the intervention, because their ED visit was MVC-related and/or they had expressed intent to change their risky alcohol use and drinking and driving behaviors, were more likely to change these risky behaviors.

The Impact of Protective Devices Across the Spectrum of Trauma Care and Across Racial Groupings

“…This is further reflected in the increased need for emergent operative intervention within 6 hours of arrival among patients without protective devices. Our data cannot assess for other “risky behaviors” 9,28 such as driving at high speed which may additionally contribute to risk of complications or death from the trauma. The ISS differences are also reflected in trauma related complications and ultimately an increased risk of death.…”