Readiness to change and reasons for intended reduction of alcohol consumption in emergency department versus trauma population.
BACKGROUND
The primary objective was to identify the most common reasons for intending to cut back on alcohol use, in emergency department (ED) and trauma patient populations. The secondary objective was to determine the association between reason to cut back on alcohol and education level.


METHODS
We conducted the study at a level one trauma center in California between 2008 and 2012. This was a retrospective analysis of data collected from computerized alcohol screening and intervention (CASI). We excluded patients who drank too little, and those whose scores were consistent with dependency (Alcohol Use Disorders Identification Test [AUDIT]>19). The CASI database includes the patient's age, gender, language, education level, an AUDIT score (1-40 scale), a readiness to change score (1-10), and the option to choose any of 10 "reasons to cut back" on their alcohol consumption.


RESULTS
From 10,537 patients, 1,202 met criteria for the study (848 ED, 354 trauma). Overall, the most common reasons cited for cutting back on alcohol were "To avoid health problems" (68.5%), "To avoid getting a DUI" (43.6%), "It could save me money" (42.0%), and "To avoid situations where I could get hurt" (41.0%). Trauma patients cited the following reasons significantly more than ED patients: "To avoid situations where I could get hurt" (46.3% versus 38.8%, respectively), "So I can be in control of my behavior" (40.7% versus 32.2%), and "My partner or spouse wants me to stop" (20.1% versus 15.0%). Additionally, those patients who cited "To avoid health problems" reported 1.2 points higher than average (p<0.001) on the 10-point readiness to change scale. Those who have completed some college or an associate degree cited "To avoid health problems" less often than high school graduates (odds ratio [OR] 0.45), while they cited "To avoid situations where I could get hurt" (OR 2.5) and "To avoid being in a car crash caused by alcohol use" (OR 3.8) more often than high school graduates.


CONCLUSIONS
Health, injury, finances, and legal issues remain top concerns for patients, while trauma patients specifically had proportionately more concerns with situations where they could get hurt.
Center for Trauma and Injury Prevention Research, Department of Emergency Medicine, School of Medicine, University of California Irvine, Irvine, California.
Craig
C
Harrison
Center for Trauma and Injury Prevention Research, Department of Emergency Medicine, School of Medicine, University of California Irvine, Irvine, California.
Wirachin
W
Hoonpongsimanont
Center for Trauma and Injury Prevention Research, Department of Emergency Medicine, School of Medicine, University of California Irvine, Irvine, California.
Craig L
CL
Anderson
Center for Trauma and Injury Prevention Research, Department of Emergency Medicine, School of Medicine, University of California Irvine, Irvine, California.
Samer
S
Roumani
Department of Health Science, California State University Fullerton, Fullerton, California.
Jie
J
Weiss
Center for Trauma and Injury Prevention Research, Department of Emergency Medicine, School of Medicine, University of California Irvine, Irvine, California.
Bharath
B
Chakravarthy
Center for Trauma and Injury Prevention Research, Department of Emergency Medicine, School of Medicine, University of California Irvine, Irvine, California.
Shahram
S
Lotfipour
D000328:Adult; D000428:Alcohol Drinking / Q000517:prevention & control / Q000523:psychology*; D019973:Alcohol-Related Disorders / Q000517:prevention & control / Q000523:psychology*; D002140:California / Q000453:epidemiology; D004522:Educational Status; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D033182:Intention; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000523:psychology* / Q000706:statistics & numerical data; D012189:Retrospective Studies; D013813:Therapy, Computer-Assisted; D014947:Wounds and Injuries / Q000517:prevention & control / Q000523:psychology*