Brief Intervention for Problem Drinking and Partner Violence
Condition: Domestic Violence; Alcohol Abuse
MeSH terms: Alcoholism
Study type: Interventional
Phase: Phase 2

Summary: 
      This study is a randomized controlled trial of a brief intervention for women Emergency
      Department patients with involvement in both Intimate Partner Violence (IPV) and problem
      drinking (defined as the full spectrum of hazardous, harmful, or dependent drinking). The
      study is designed to explore the effectiveness of a low-intensity, gender-sensitive brief
      motivational intervention, delivered by social workers in the Emergency Department setting,
      in decreasing IPV and episodes of heavy drinking and increasing rates of follow-up with
      resources. Social work graduate students and/or staff will be trained to provide brief
      motivational enhancement therapy (MET) intervention for decreasing heavy drinking and
      IPV-related injury in women Emergency Department patients.
    

Detailed description: 
      The investigators will enroll a total of 600 eligible consenting women patients who will be
      randomized to a Brief Intervention Group (BIG) n=240, an Assessed Care Group (ACG) n=240 or
      to a No Contact Control Group (NCCG) n=120, that is screened for eligibility and provides
      basic demographic information but has no further contact with researchers until they are
      assessed for outcomes only at 3 months. All participants will complete an initial Social
      Health Survey, a form distributed routinely to all patients in the ED which gives patients an
      opportunity to self-disclose a variety of social and behavioral risks as part of routine
      care. As part of the study, patients who disclose any IPV or drinking risk will be asked to
      complete a further screening (CTS2S and AUDIT) to confirm eligibility prior to randomization.
      The experimental group (BIG) will receive a 20 minute manual driven, optionally
      audio-recorded MET intervention by a Motivational Interview (MI)-trained therapist during
      their ED visit and a 10-15 minute phone booster at 7 to 10 days. The BIG and ACG will be
      assessed at baseline using the Women's Health Interview to identify potential moderators of
      the intervention and followed weekly for IPV and drinking outcomes using an Interactive Voice
      Response System (IVRS) for 12 weeks and phone assessments at 3, 6, and 12 months.

      Primary outcomes, assessed for all groups at 3 months, will be the number of heavy drinking
      days and the incidents of IPV in the last month. Secondary outcomes include number of severe
      IPV incidents and average weekly alcohol consumption. The investigators will also assess
      likely mediators of the intervention. Protocol for follow-up contact will be determined by a
      plan developed by the participant and the MET interventionist. Should a participant decide
      that it is unsafe to be contacted via telephone, she will be given the option to complete any
      or all follow-up in the ED. Each time the patient is contacted for follow-up, the researcher
      will ask if the plan for contact has changed and will implement the necessary changes during
      the subsequent contacts. In addition, participants will be told that they can contact the PI
      using the contact information provided on the study's consent materials if the plan changes
      between contacts. Participants will also be asked at each follow-up contact if they are still
      interested in participating in the Women's Health Study to ensure ongoing consent. They may
      decide not to continue participation, and do not need to provide a reason for withdrawal from
      the study.
    

Intervention name(s): Motivational Enhancement Therapy
Intervention type(s): Behavioral
Intervention description(s): 20 minute manual-driven, optionally audio-recorded Motivational Enhancement Training intervention by a MI-trained therapist during their ED visit and a 10-15 minute phone booster at 7 to 10 days.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Triple (Participant, Investigator, Outcomes Assessor)
Primary purpose: Treatment
Keywords: Motivational Interviewing; Brief Intervention; Intimate Partner Violence; Domestic Violence; Alcohol Abuse