Effectiveness of brief interventions after alcohol-related vehicular injury: A randomized controlled trial.
BACKGROUND
Because 40% of motor vehicle fatalities in the United States are alcohol-related, interventions delivered by trauma clinicians targeted to reduce drinking are of particular importance to public health. The objective of this study was to test the effectiveness of hospital-based brief intervention strategies to reduce alcohol consumption and other health-related outcomes in the year after an alcohol-related vehicular injury. Brief interventions are clinically based strategies including assessment and direct feedback about drinking alcohol, goal setting, behavioral modification techniques, and the use of a self-help manual.


METHODS
The study was a randomized controlled trial of two types of brief intervention with a 12-month follow-up. Participants with alcohol-related vehicular injury who were admitted to Level I trauma centers were eligible for enrollment. Enrolled participants were randomized to a control, simple advice, or brief counseling condition. Primary outcome variables were alcohol consumption (standard drinks/month, binges/month), adverse driving events (driving citations, traffic crashes), and changes in health status (hospital and emergency department admissions).


RESULTS
The study enrolled 187 participants at baseline and retained 100 across 12 months. Participants had a significant decrease in alcohol consumption and traffic citations at 12 months as compared with baseline. Mean standard drinks/month declined from 56.80 (SD 63.89) at baseline to 32.10 (SD 53.20) at 12 months. Mean binges/month declined from 5.79 (SD 6.98) at baseline to 3.21 (SD 6.17) at 12 months. There were no differences in alcohol consumption, adverse driving events, or health status by condition.


CONCLUSIONS
Whether the reductions in alcohol consumption and traffic citations were a result of the crash, hospitalization for injury, screening for alcohol use, or combination of these factors is difficult to determine. Further work is needed to understand the mechanisms involved in reductions of health-related outcomes and the role of brief intervention in this population.
Sommers
Marilyn S
MS
School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA. ssommer@nursing.upenn.edu
Dyehouse
Janice M
JM
Howe
Steven R
SR
Fleming
Michael
M
Fargo
Jamison D
JD
Schafer
John C
JC
D000063:Accidents, Traffic; D000328:Adult; D000437:Alcoholism / Q000517:prevention & control*; D001334:Automobile Driving / Q000331:legislation & jurisprudence; D003376:Counseling / Q000379:methods*; D000431:Ethanol / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D015438:Health Behavior; D006304:Health Status; D006801:Humans; D008297:Male; D012307:Risk Factors; D014194:Traumatology / Q000379:methods*; D016896:Treatment Outcome; D014947:Wounds and Injuries / Q000209:etiology*
D000431:Ethanol