Project U Connect - Optimizing Brief Alcohol Intervention for Underage Drinkers in the ER
Condition: Alcohol Misuse
Study type: Interventional

Summary: 
      The Emergency Department (ED) setting is a unique point of access for reaching underage
      drinkers (age 14-20). With the aid of computer technology, this study will screen underage
      drinkers in the ED and fully test promising ED-based brief intervention and 3-month follow-up
      brief treatment approaches for alcohol misuse. Developing methods to efficiently and
      effectively optimize these approaches has powerful public health implications for improving
      outcomes for underage drinkers.
    

Detailed description: 
      The proposed study will use computerized screening using touchscreen computer tablets with
      audio (~5,700 patients) and will test a developmentally appropriate, tailored intervention.
      Specifically, 900 patients aged 14-20 in the ED who screen positive for problematic alcohol
      use in the past 3 months will be randomized to the combinations of three ED-based conditions:
      1) computer brief intervention-CBI; 2) therapist/intervener delivered brief intervention-IBI;
      or 3) enhanced usual care-EUC. All participants will be randomized to one of two follow-up
      conditions: 1) adapted motivational enhancement therapy-AMET; or 2) enhanced usual care-EUC
      that will take place 3 months post-ED. All participants will receive written information
      regarding community resources; individuals who meet alcohol use disorder criteria will
      additionally receive substance use treatment referrals.

      Recognizing that brief interventions are important, but not necessarily sufficient, for
      change in all adolescents and young adults who misuse alcohol, the primary specific aims of
      the proposed study will determine the independent effectiveness of immediate "on-the-spot"
      ED-based brief intervention conditions, 3-month follow-up brief treatment conditions, and
      combinations of conditions, for decreasing alcohol use and improving health-related outcomes
      (including injury, mental health, and other risk behaviors) at 6- and 12-months follow-up.
    

Intervention name(s): Computer-delivered Brief Intervention (CBI); Intervener-delivered Brief Intervention (IBI); Adapted Motivational Enhancement Therapy (AMET)
Intervention type(s): Behavioral; Behavioral; Behavioral
Intervention description(s): The multimedia, interactive CBI condition will be delivered using touch-screen tablet computers with audio delivered via headphones. The interventions are highly individualized and designed to address the primary target behavior of alcohol use, and will include a tailored review of participants' goals/values, feedback regarding their present alcohol use patterns and consequences (either actual experiences or potential based on risk behaviors), developing a discrepancy between their alcohol use and ability to meet goals and values through a decisional balance exercise, and formulation of a "change plan" tailored for each participant.; The IBI condition will be delivered by a master's-level clinician with the aid of graphics. The interventions are highly individualized and designed to address the primary target behavior of alcohol use, and will include a tailored review of participants' goals/values, feedback regarding their present alcohol use patterns and consequences (either actual experiences or potential based on risk behaviors), developing a discrepancy between their alcohol use and ability to meet goals and values through a decisional balance exercise, and formulation of a "change plan" tailored for each participant.; The AMET session will have a similar general outline (~45 minutes) to the BI in the ED, including a review of participants' goals and values, alcohol use and consequences, decisional balance exercises, and change plan.
Allocation: Randomized
Intervention model: Factorial Assignment
Masking: None (Open Label)
Primary purpose: Health Services Research
Keywords: alcohol use; brief intervention; risk behaviors