Young adults’ change talk within brief motivational intervention in the emergency department and booster sessions is associated with a decrease in heavy drinking over 1 year.

Abstract

Objective: Investigate the effect of change talk (CT) within successive brief motivational interventions (BMIs) as a mechanism of change for alcohol use. Method: We conducted a secondary analysis of data from a randomized controlled trial in which 344 young adults (18-35 years old) admitted to a Swiss emergency department with alcohol intoxication received either BMI (N = 171) or brief advice (N = 173). Participants with a baseline audio-recorded BMI were included (N = 140; median age 23 [Q1-Q3: 20-27], 72.9% men). Up to three booster sessions by phone were offered at 1 week, 1 month, and 3 months. Percent CT and CT Average Strength were used as predictor variables. The outcome was the number of heavy drinking days (HDD) over the 30 days prior to research assessments at 1-, 3-, 6-, and 12-month follow-up. A latent growth curve modeling framework was first used to estimate predictor and outcome variable growth parameters (i.e., intercept and slope) over time, and then to regress HDD growth parameters on CT growth parameters. Results: CT increased specifically from baseline to the 1-week booster session and thereafter remained stable. Higher baseline CT was associated with lower HDD at 1 month (Percent CT: b = −0.04, 95% confidence interval [−0.06, −0.01]; Average Strength: b = −0.99 [−1.67, −0.31]). An increase in CT from baseline to the 1-week booster session was related to a decrease in HDD from 1 month to 12 months (Percent CT: b = −0.08 [−0.14, −0.03]; Average Strength: b = −2.29 [−3.52, −1.07]). Conclusions: Both baseline CT and CT trajectory over the first week are meaningful predictors of HDD. Public Health Significance StatementThis study indicates that young adults admitted to the emergency department with alcohol intoxication who spoke more in favor of changing their alcohol consumption within an initial brief motivational intervention, as well as those who increased their language toward change across successive early booster sessions, reduced heavy drinking over 1 year.