Screening and Brief Intervention in the ED Among Mexican-origin Young Adults
Condition: Problem Drinking; Alcohol Dependence
MeSH terms: Alcoholism
Study type: Interventional
Phase: Phase 2

Summary: 
      The aims of this study are to: 1) examine the effectiveness of Screening, Brief Intervention
      and Referral to Treatment (SBIRT) among Mexican-origin young adults (age 18-25), using a
      motivational intervention delivered by a Health Promotion Advocate, relative to standard care
      with and without assessment, on a reduction in heavy drinking and alcohol-related problems in
      the emergency department (ED) at the U.S.-Mexico border; and, 2) identify variables that are
      related to effectiveness of the intervention and that predict successful treatment outcome.
      Patients will be re-assessed by telephone at three and twelve months to evaluate outcomes.The
      specific hypotheses to be examined in this proposal are: 1) the motivational interview will
      lead to significantly greater reductions in the maximum number of drinks on an occasion and
      in Rapid Alcohol Problem Screen (RAPS4) score at the 12-month follow-up compared to standard
      care without assessment (those who screen positive but are not assessed) as well as compared
      to standard care with assessment; 2) the motivational interview will lead to significantly
      greater reductions in number of drinking days per week, average number of drinks per day,
      maximum number of drinks on an occasion, RAPS4 score, and number of negative consequences of
      drinking at 3-month and 12-month follow-up compared to standard care with assessment; 3) a
      positive breath alcohol concentration (BAC) at the time of the ED visit and/or self-reported
      drinking prior to the event resulting in the ED visit will be positively predictive of
      effectiveness of the intervention; 4) attributing a causal association of drinking and the
      reason for the ED visit will be positively associated with effectiveness of brief
      intervention; 5) readiness to change (and stage of change) will be positively associated with
      effectiveness of brief intervention; 6) risk taking/impulsivity and sensation seeking
      dispositions will be negatively associated with effectiveness of brief intervention.
    

Detailed description: 
      This is a randomized controlled brief intervention trial for dependent and at-risk drinking,
      among Mexican origin young adults (18-30) admitted to Texas Tech Health Sciences Center ER in
      El Paso, Texas, using Screening, Brief Intervention and Referral to Treatment (SBIRT)
      Patients are randomized into one of three groups: 1) screened only, 2) screened plus
      assessment, 3) screened plus assessment plus intervention with three-month outcome follow-up
      for the assessed and intervention groups and 12-month outcome follow-up for all three groups.
    

Intervention name(s): Brief Motivational Intervention
Intervention type(s): Behavioral
Intervention description(s): A short discussion is held with patients identifying pros and cons of their drinking, readiness for change is assessed, and a brief prescription drawn for behavior change signed by the patient.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: Alcohol; SBIRT (Screening, Brief Intervention, Referral to Treatment)