Titre : | Emergency department-based brief intervention to reduce risky driving and hazardous/harmful drinking in young adults: a randomized controlled trial (2013) |
Auteurs : | M. S. SOMMERS ; M. S. LYONS ; J. D. FARGO ; B. D. SOMMERS ; C. C. McDONALD ; J. T. SHOPE ; M. F. FLEMING |
Type de document : | Article : Périodique |
Dans : | Alcoholism: Clinical and Experimental Research (Vol.37, n°10, October 2013) |
Article en page(s) : | 1753-1762 |
Langues: | Anglais |
Discipline : | TRA (Traitement et prise en charge / Treatment and care) |
Mots-clés : |
Thésaurus géographique ETATS-UNISThésaurus mots-clés URGENCE ; ETUDE RANDOMISEE ; INTERVENTION BREVE ; CONDUITE DE VEHICULE ; REDUCTION DE CONSOMMATION ; ALCOOL ; JEUNE ADULTE ; EFFICACITE |
Mots-clés: | SBIRT |
Résumé : |
BACKGROUND: Risky driving and hazardous drinking are associated with significant human and economic costs. Brief interventions for more than one risky behavior have the potential to reduce health-compromising behaviors in populations with multiple risk-taking behaviors such as young adults. Emergency department (ED) visits provide a window of opportunity for interventions meant to reduce both risky driving and hazardous drinking.
METHODS: We determined the efficacy of a Screening, Brief Intervention, and Referral to Treatment (SBIRT) protocol addressing risky driving and hazardous drinking. We used a randomized controlled trial design with follow-ups through 12 months. ED patients aged 18 to 44 who screened positive for both behaviors (n = 476) were randomized to brief intervention (BIG), contact control (CCG), or no-contact control (NCG) groups. The BIG (n = 150) received a 20-minute assessment and two 20-minute interventions. The CCG (n = 162) received a 20-minute assessment at baseline and no intervention. The NCG (n = 164) were asked for contact information at baseline and had no assessment or intervention. Outcomes at 3, 6, 9, and 12 months were self-reported driving behaviors and alcohol consumption. RESULTS: Outcomes were significantly lower in BIG compared with CCG through 6 or 9 months, but not at 12 months: Safety belt use at 3 months (adjusted odds ratio [AOR], 0.22; 95% confidence interval [CI], 0.08 to 0.65); 6 months (AOR, 0.13; 95% CI, 0.04 to 0.42); and 9 months (AOR, 0.18; 95% CI, 0.06 to 0.56); binge drinking at 3 months (adjusted rate ratio [ARR] 0.84; 95% CI, 0.74 to 0.97) and 6 months (ARR, 0.81; 95% CI, 0.67 to 0.97); and >=5 standard drinks/d at 3 months (AOR, 0.43; 95% CI, 0.20 to 0.91) and 6 months (AOR, 0.41; 95% CI, 0.17 to 0.98). No substantial differences were observed between BIG and NCG at 12 months. CONCLUSIONS: Our findings indicate that SBIRT reduced risky driving and hazardous drinking in young adults, but its effects did not persist after 9 months. Future research should explore methods for extending the intervention effect. |
Domaine : | Alcool / Alcohol |
Affiliation : | School of Nursing , University of Pennsylvania, Philadelphia, Pennsylvania, USA |
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