Intervention attendance among emergency department patients with alcohol- and drug-use disorders.
OBJECTIVE
The emergency department (ED) visit provides a window of opportunity for screening and linkage to services for inner-city adults with substance-use disorders (SUDs). This article examines predictors of intervention attendance among ED patients who screen positive for an SUD (alcohol or other drug).


METHODS
As part of a large randomized control trial, medical and injured patients (ages 19-60) in an inner-city ED completed a computerized screening survey. Based on random assignment, those screening positive for an SUD either were scheduled to attend a post-discharge intervention or received a referral brochure. Interventions (brief motivational intervention vs. case management intervention) focused on linking participants to substance-use treatment. Independent variables assessed included demographics, ED visit reason, health functioning, readiness to change, self-efficacy, and substance use. Intervention attendance (yes/no) was the dependent variable.


RESULTS
Overall, 957 (62.3% male; 58.3% African-American; M(age) = 33.2 years) were randomized to interventions (brief motivational intervention/case management intervention) and are the focus of subsequent analyses. There were no differences in the pattern of predictors of intervention attendance for brief motivational intervention versus case management intervention. Bivariate analyses compared those who attended the post-ED intervention with those who did not attend. Participants who attended the intervention (50%) were significantly more likely to be older, unmarried, insured, unemployed, and in the "action" stage of change.


CONCLUSIONS
The present findings highlight the relative importance of assessing and attending to readiness to change as well as demographic factors such as insurance and employment (and potentially associated barriers) in ED-based screening, brief intervention, and referral to treatment protocols.
Blow
Frederic C
FC
Department of Psychiatry, Rachel Upjohn Building, University of Michigan, 4250 Plymouth Road, Ann Arbor, Michigan 48105, USA. fredblow@umich.edu
Walton
Maureen A
MA
Murray
Regan
R
Cunningham
Rebecca M
RM
Chermack
Stephen T
ST
Barry
Kristen L
KL
Ilgen
Mark A
MA
Booth
Brenda M
BM
D000328:Adult; D004636:Emergency Service, Hospital / Q000639:trends*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000523:psychology*; D019966:Substance-Related Disorders / Q000523:psychology* / Q000628:therapy*; D014505:Urban Population / Q000639:trends*; D055815:Young Adult