title: Readiness to change problematic drinking assessed in the emergency department as a predictor of change.
abstract: OBJECTIVE
  The goal of this study was to determine if baseline readiness to change the drinking behavior (pre-contemplation, contemplation, preparation, and action stages) was predictive of change in drinking after unrelated emergency department (ED) visit and screening and interviewing for alcohol problems.
  
  
  METHODS
  From August 1998 through December 2000, the Alcohol Use Disorders Identification Test (AUDIT) was administered to all consented ED patients aged 18 to 29 years. A brief motivational interviewing was provided to screen-positive patients (AUDIT score >5 of 40). Outcome at 3-month follow-up was measured as a decrease in the scores within the AUDIT domains of alcohol intake, harm, and dependency.
  
  
  RESULTS
  Sixty percent of the screen-positive patients continued to drink at 3 months. Patients became more open to change their drinking behavior. Compared with patients in the pre-contemplation stage, those in the action stage were twice as likely to reduce their alcohol intake (OR, 2.24; 95% CI, 1.06-4.72), nearly 3 times as likely to reduce their alcohol-related harm behavior (OR, 2.80; 95% CI, 1.59-4.91), and almost 4 times more likely to decrease their dependency symptoms (OR, 3.59; 95% CI, 1.97-6.57). Compared with pre-contemplation patients, those in the contemplation stage were nearly twice as likely to reduce their alcohol-related harm (OR, 1.85; 95% CI, 1.02-3.33) and those in the preparation stage were more than twice as likely to reduce their dependency symptoms (OR, 2.20, 95% CI, 1.13-4.27).
  
  
  CONCLUSIONS
  Stages of change at baseline appeared to be significant predictors of change in alcohol intake, harm, and dependency symptoms among young adult ED patients.
authors.affiliation: Center for Rural Emergency Medicine, West Virginia University, Morgantown, WV, USA. leontil@upstate.edu
authors.forename: Luba
authors.initials: L
authors.lastname: Leontieva
authors.forename: Kimberly
authors.initials: K
authors.lastname: Horn
authors.forename: Arshadul
authors.initials: A
authors.lastname: Haque
authors.forename: Jim
authors.initials: J
authors.lastname: Helmkamp
authors.forename: Peter
authors.initials: P
authors.lastname: Ehrlich
authors.forename: Janet
authors.initials: J
authors.lastname: Williams
mesh_terms: D000293:Adolescent; D000328:Adult; D000428:Alcohol Drinking / Q000523:psychology; D000437:Alcoholism / Q000175:diagnosis* / Q000523:psychology*; D015331:Cohort Studies; D003376:Counseling; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D008297:Male; D009042:Motivation; D012189:Retrospective Studies; D012737:Sex Factors; D012959:Socioeconomic Factors