Participant report of therapist-delivered active ingredients in a telephone-delivered brief motivational intervention predicts taking steps towards change.

Objective: Given the widespread potential for disseminating Motivational Interviewing (MI) through technology, the question of whether MI active ingredients are present when not delivered in person is critical to assure high treatment quality. The Participant Rating Form (PRF) was developed and used to evaluate therapist-delivered active ingredients in phone-delivered MI with hazardous drinking Emergency Department patients.

Method: A factor analysis of all PRFs completed after receiving one call (=256) was conducted.

Brief intervention to increase emergency department uptake of combined rapid human immunodeficiency virus and hepatitis C screening among a drug misusing population.

Objectives: In this study, Increasing Viral Testing in the Emergency Department (InVITED), the authors investigated if a brief intervention about human immunodeficiency virus (HIV) and hepatitis C virus (HCV) risk-taking behaviors and drug use and misuse in addition to a self-administered risk assessment, compared to a self-administered risk assessment alone, increased uptake of combined screening for HIV and HCV, self-perception of HIV/HCV risk, and impacted beliefs and opinions on HIV/HCV screening.

Methods: InVITED was a randomized, controlled trial conducted at two urban emergency departments (EDs) from February 2011 to March 2012. ED patients who self-reported drug use within the past 3 months were invited to enroll.

Feasibility and acceptability of a pediatric emergency department alcohol prevention intervention for young adolescents.

Objective: The objective of this study was to determine feasibility and acceptability of a brief pediatric emergency department (PED) prevention intervention to delay/prevent initiation of alcohol use in 12-to 14-year-olds.

Methods: Medically stable 12- to 14-year-olds presenting to the PED who were accompanied by a parent and who had not initiated alcohol use were eligible. Adolescent-parent dyads completed a computerized assessment and were randomized to either brief targeted prevention intervention (BPI) or enhanced standard care (ESC).

Energy drink and other substance use among adolescent and young adult emergency department patients.

Objective: This study aimed to understand current patterns of energy drink use and compare the extent of usage of energy drinks and other commonly used and misused substances between adolescent (13-17-years-old) and young adult (18-25-years-old) emergency department (ED) patients.

Methods: During a 6-week period between June and August 2010, all patients presenting to an adult or pediatric ED were asked to complete a computer-based, anonymous questionnaire regarding use of energy drinks and other substances. Wilcoxon rank-sum, 2-sample tests of binomial proportions, Pearson χ(2) testing, and regression models were used to compare energy drink and substance use by age groups.

Treatment may influence self-report and jeopardize our understanding of outcome.

Objective: Standardized measures of self-reported alcohol use are the predominant method by which change in alcohol use following interventions is evaluated. This study examined whether the invariance of the test-retest pretreatment Alcohol Use Disorders Identification Test (AUDIT) was affected by the treatment experience. In this study, the intervening exposure was to motivational interviewing (MI) versus community service (CS), the treatment-as-usual control group.

Behavioral and physiologic adverse effects in adolescent and young adult emergency department patients reporting use of energy drinks and caffeine.

Introduction: This pilot study assessed the prevalence of physiologic and behavioral adverse effects among adolescent (13-17 years) and adult (18-25 years) emergency department patients who reported energy drink and/or caffeinated-only beverage use within the 30 days prior to emergency department presentation. It was hypothesized that energy drink users would report more adverse effects than those who used only traditional caffeinated beverages such as coffee, tea, or soft drinks.

Methods: This cross-sectional pilot study was conducted in two urban emergency departments, one adult and one pediatric.

The effect of group-adapted motivational interviewing on traffic convictions and driving behaviors of court-adjudicated youth.

Objective: To evaluate the effect of a 20 hr prevention program (The Reducing Dangerous Driving Program, RYDD) in reducing traffic citation recidivism and high-risk driving behaviors among 16- to 20-year-olds referred by the Rhode Island courts for traffic citation events.

Methods: Participants were randomized to receive either the Adapted Group Motivational Interviewing (AGMI) or the Community Service (CS) arm of the study. Participants completed a survey at baseline and at 6 and 12 months post-RYDD completion.

Interrelationship of alcohol misuse, HIV sexual risk and HIV screening uptake among emergency department patients.

Background: Emergency department (ED) patients comprise a high-risk population for alcohol misuse and sexual risk for HIV. In order to design future interventions to increase HIV screening uptake, we examined the interrelationship among alcohol misuse, sexual risk for HIV and HIV screening uptake among these patients.

Methods: A random sample of 18-64-year-old English- or Spanish-speaking patients at two EDs during July-August 2009 completed a self-administered questionnaire about their alcohol use using the Alcohol Use Questionnaire, the Alcohol Use Disorders Identification Test (AUDIT), and the HIV Sexual Risk Questionnaire.

Translation of alcohol screening and brief intervention guidelines to pediatric trauma centers.

Background: As part of the American College of Surgeons verification to be a Level 1 trauma center, centers are required to have the capacity to identify trauma patients with risky alcohol use and provide an intervention. Despite supporting scientific evidence and national policy statements encouraging alcohol Screening, Brief Intervention and Referral to Treatment (SBIRT), barriers still exist, which prevent the integration of SBIRT into clinical care. Study objectives of this multisite translational research study were to identify best practices for integrating SBIRT services into routine care for pediatric trauma patients, to measure changes in practice with adoption and implementation of a SBIRT policy, and to define barriers and opportunities for adoption and implementation of SBIRT services at pediatric trauma centers.

Motivational counseling reduces future police charges in court referred youth.

By the age of 18, between 16 and 27% of adolescents in the U.S. have been arrested for an offense and by the age of 23 this increases to a staggering 25-41%.

Project reduce: reducing alcohol and marijuana misuse: effects of a brief intervention in the emergency department.

Study Objective: Brief interventions (BI) for alcohol misuse and recently for marijuana use for emergency department patients have demonstrated effectiveness. We report a 12-month outcome data of a randomized controlled trial of emergency department (ED) patients using a novel model of BI that addresses both alcohol and marijuana use.

Methods: ED research assistants recruited adult patients who admitted alcohol use in the last month, and marijuana use in the last year.

Sex differences in alcohol misuse and estimated blood alcohol concentrations among emergency department patients: implications for brief interventions.

Objectives: The objective was to assess the relationship between alcohol use and misuse and patient sex among emergency department (ED) patients by comparing self-reported estimates of quantity and frequency of alcohol use, estimated blood alcohol concentrations (eBACs) when typically drinking and during heavy episodic drinking (binging), and alcohol misuse severity, to understand sex differences in alcohol use and misuse for this population.

Methods: The authors surveyed a random sample of nonintoxicated, subcritically ill or injured, 18- to 64-year-old English- or Spanish-speaking patients on randomly selected dates and times at two EDs during July 2009 and August 2009. Participants self-administered a questionnaire about their self-reported alcohol use during a typical month within the past 12 months and the Alcohol Use Disorders Identification Test (AUDIT).

DIAL: a randomised trial of a telephone brief intervention for alcohol.

Background: Decreasing Injuries from ALcohol (DIAL) is a randomised control trial of a telephone brief intervention (BI) with injured emergency department (ED) patients with high-risk alcohol use. Here the authors examine 12-month outcomes of the intervention's effect on alcohol use, alcohol-related injuries and alcohol-related negative consequences.

Methods: ED research assistants recruited adult injured patients who screened positive for high-risk alcohol use and were to be discharged home.

Identifying subtypes of dual alcohol and marijuana users: a methodological approach using cluster analysis.

Alcohol is the most common psychoactive substance used with marijuana. However, little is known about the potential impact of different levels of use of both alcohol and marijuana and their influence on risky behaviors, injuries and psychosocial functioning. A systematic approach to identifying patterns of alcohol and marijuana use associated with increased risks has not yet been identified in the literature.

Change plan as an active ingredient of brief motivational interventions for reducing negative consequences of drinking in hazardous drinking emergency-department patients.

Objective: Few studies have examined the effects of brief motivational intervention components, such as change-plan completion, on treatment outcomes. This secondary analysis of an opportunistically recruited emergency-department sample of hazardous injured drinkers examines the potential predictive role of an alcohol-related change plan on treatment outcomes after accounting for pretreatment readiness. Written change plans were independently rated.

A cross-sectional study of the self-report of stress among emergency department patients.

Background: There is a lack of information about the prevalence of stress and types of stressors experienced by Emergency Department (ED) patients.

Objective: The present aim is to study the prevalence of stress, types of stressful situations and the relationship with other health issues within the ED population.

Materials And Methods: This is a cross-sectional study performed in an ED at a level-1 urban trauma center for four months.

Project integrate: translating screening and brief interventions for alcohol problems to a community hospital emergency department.

Screening and brief intervention (SBI) for alcohol problems in the emergency department (ED) is effective. The objective of this study was to examine the translation of SBI into a busy community ED environment. The authors assessed key stakeholders views of SBI delivery model, then utilized feedback to adapt model.

Readiness to change as a mediator of the effect of a brief motivational intervention on posttreatment alcohol-related consequences of injured emergency department hazardous drinkers.

Brief motivational interventions (BMIs) are usually effective for reducing alcohol use and consequences in primary care settings. We examined readiness to change drinking as a mediator of the effects of BMI on alcohol-related consequences. Participants were randomized into three conditions: (a) standard care plus assessment (SC), (b) SC plus BMI (BI), and (c) BI plus a booster session (BIB).

Injuries, negative consequences, and risk behaviors among both injured and uninjured emergency department patients who report using alcohol and marijuana.

Background: Brief intervention (BI) to reduce hazardous drinking and negative consequences such as injury has been effective when given in the emergency department (ED). The effectiveness and effect of BI has varied between injured and uninjured ED patients. This study compares injured and uninjured ED patients who admit to alcohol and marijuana use to determine their need and their readiness for BI.

DIAL: a telephone brief intervention for high-risk alcohol use with injured emergency department patients.

Study Objective: Brief interventions for high-risk alcohol use for injured emergency department (ED) patients have demonstrated effectiveness and may have a more pronounced effect with motor vehicle crash patients. We report on 3-month outcome data of a randomized controlled trial of injured patients, using a novel model of telephone-delivered brief interventions after ED discharge.

Methods: ED research assistants recruited adult injured patients who screened positive for high-risk alcohol use and were to be discharged home.

A systematic review of emergency care brief alcohol interventions for injury patients.

This article examines 14 studies that assessed the effectiveness of brief interventions (BIs) delivered to injury patients in emergency care settings. The aims were to review findings concerning the effectiveness of providing BI in these settings and to explore factors contributing to its effectiveness. Of the 12 studies that compared pre- and post-BI results, 11 observed a significant effect of BI on at least some of the outcomes: alcohol intake, risky drinking practices, alcohol-related negative consequences, and injury frequency.

Treatment completion in a brief motivational intervention in the emergency department: the effect of multiple interventions and therapists' behavior.

Background: The aim of this study was to identify therapist behaviors during a brief motivational intervention (BMI) given to injured emergency department patients that predicted participant return for a second BMI session and 12-month alcohol-related outcomes.

Method: This was a secondary data analysis of a randomized controlled trial (n = 539) previously demonstrating that random assignment to a BMI and booster session resulted in a significant reduction of 12-month post-intervention alcohol-related injuries and negative consequences relative to standard care.

Results: Participants who actually received 2 BMI sessions had significantly less alcohol-related negative consequences than those who received only 1 BMI session.

Do patient intervention ratings predict alcohol-related consequences?

Little is known about treatment process for behavior change for brief interventions. Patient ratings of treatment process during a patient-centered brief intervention for alcohol were used to predict post-treatment alcohol use and consequences. We use data from a randomized clinical trial that compared the effects of BI (1 session) to BI and booster (BIB, 2 sessions) to reduce harmful drinking and alcohol consequences.