Project Health Link: Connecting Patients With Services

Study Overview
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Brief Summary
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This study will compare three alternative interventions in the emergency department (ED) to promote substance abuse assessment, referral, and treatment entry: 1) a 5 session strengths-based case management model (SBCM); 2) a 2-session motivational enhancement therapy (MET); or 3) a one-time brief informational feedback (BIF) session. The primary outcome variables for this trial include follow-through on receiving an assessment and referral, and treatment engagement. Additional outcomes include degree of treatment completion, alcohol-related measures, health service utilization, health status changes, and psychosocial factors.

Official Title
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Services Interventions for Injured ED Problem Drinkers

Conditions
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Alcohol Abuse

Intervention / Treatment
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* Behavioral: Strengths Based Case Management
* Behavioral: Motivational Enhancement Therapy
* Behavioral: Brief Informational Feedback


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: (1) adults age 19 - 60 presenting to the Emergency Department at Hurley Medical Center within 24 hours of an injury; (2) ability to provide informed consent. For intervention portion of the project: (1) meets DSM-IV criteria for alcohol abuse or dependence in the following year. (Patients who meet abuse/dependence criteria for alcohol may also be using other drugs. They will be included in the study only if they do not meet criteria for past year drug abuse/dependence). Exclusion Criteria: (1) adult patients who do not understand English; (2) prisoners; (3) pregnant women; (4) institutionalized patients (e.g. nursing home residents); (5) adults classified by medical staff as Level 1 trauma; (6) adults deemed unable to provide informed consent (e.g. intoxication, mental incompetence, under guardianship); (7) patients treated in the ED for suicide attempts and sexual assault; (8) patients meeting past year drug abuse/dependence criteria; and (9) patients who have been in treatment for alcohol or other drug abuse/dependence in the previous year.

Ages Eligible for Study
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Minimum Age: 19 Years
Maximum Age: 60 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Strengths Based Case Management Model (SBCM)<br>The Strengths Based Case Management Model (SBCM) consists of 5 case-management sessions designed to promote linkage and engagement in assessment and treatment services, while assisting with the patient's perceived needs, as well as personal strengths and barriers to linkage and engagement. | Behavioral: Strengths Based Case Management<br> <br> |
| Active Comparator: Motivational Enhancement Therapy (MET)<br>The MET therapist will conduct 2 motivational enhancement sessions to work through the content of an educational workbook targeting the participant's alcohol use/abuse with the goal of negotiating a 'contract' to: 1) link to services, with the eventual goal of seeking and receiving specialized alcohol treatment; or 2) provide a strategy to self-monitor alcohol use, consider consequences, and later seek assessment. | Behavioral: Motivational Enhancement Therapy<br> <br> |
| Active Comparator: Brief Informational Feedback (BIF) session<br>Subjects will receive brief informational feedback on the results of their alcohol screening and assessment and encouragement to seek treatment. | Behavioral: Brief Informational Feedback<br> <br> |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| receipt of assessment |  | 3 and 6 months post-baseline | 
| treatment entry |  | 3 and 6 months post-baseline |