title: Brief Motivational Intervention for Intimate Partner Violence and Heavy Drinking in the Emergency Department: A Randomized Clinical Trial.
abstract: OBJECTIVE
  Intimate partner violence (IPV) and heavy drinking are co-occurring public health problems, but integrated brief interventions for these conditions have not been tested.
  
  
  OBJECTIVE
  To determine whether a brief motivational intervention provided at the time of an emergency department (ED) visit reduces IPV and heavy drinking.
  
  
  METHODS
  A randomized clinical trial conducted at 2 US academic urban EDs between January 2011 and December 2014 to assess the effectiveness of a motivational intervention for IPV-involved female ED patients (ages: 18-64 years; N = 600) who exceeded sex-specific safe drinking limits. All received social service referrals; 2:2:1 to brief intervention (n = 242), assessed control (n = 237), or no-contact control (n = 121).
  
  
  METHODS
  A 20- to 30-minute manual-guided motivational intervention (recorded and monitored for fidelity) delivered by master's-level therapists with a follow-up telephone booster. The assessed control group received the same number of assessments as the brief intervention group; the no-contact control group was assessed only once at 3 months.
  
  
  METHODS
  Incidents of heavy drinking and experiencing IPV measured over prespecified, 12 weekly assessments using an interactive voice response system.
  
  
  RESULTS
  Of 600 participants, 80% were black women with a mean age of 32 years. Retention was 89% for 2 or more interactive voice response system calls. Seventy-eight percent of women completed the 3-month interview, 79% at 6 months, and 71% at 12 months. During the 12-week period following the brief motivational intervention, there were no significant differences between the intervention group and the assessed control group on weekly assessments for experiencing IPV (odds ratio [OR], 1.02; 95% CI, 0.98-1.06) or heavy drinking (OR, 0.99; 95% CI, 0.96-1.03). From baseline to 12 weeks, the number of women with any IPV in the past week decreased from 57% (134 of 237) in the intervention group to 43% (83 of 194) and from 63% (145 of 231) in the assessed control group to 41% (77 of 187) (absolute difference of 8%). From baseline to 12 weeks, the number of women with past week heavy drinking decreased from 51% (120 of 236) in the intervention group to 43% (83 of 194) and from 46% (107 of 231) in the assessed control group to 41% (77 of 187) (absolute difference of 3%). At 12 months, 43% (71 of 165) of the intervention group and 47% (78 of 165) of the assessed control group reported no IPV during the previous 3 months and 19% (29 of 152) of the intervention group and 24% (37 of 153) of the control group had reduced their alcohol consumption to sex-specific National Institute on Alcohol Abuse and Alcoholism safe drinking levels.
  
  
  CONCLUSIONS
  For women experiencing IPV and heavy drinking, the use of a brief motivational intervention in the ED compared with assessed and no-contact controls did not significantly reduce the days of heavy drinking or incidents of IPV. These findings do not support a brief motivational intervention in this setting.
  
  
  BACKGROUND
  clinicaltrials.gov Identifer: NCT01207258.
authors.affiliation: Perelman School of Medicine, University of Pennsylvania, Philadelphia.|School of Social Policy and Practice, University of Pennsylvania, Philadelphia.
authors.forename: Karin V
authors.initials: KV
authors.lastname: Rhodes
authors.affiliation: Perelman School of Medicine, University of Pennsylvania, Philadelphia.
authors.forename: Melissa
authors.initials: M
authors.lastname: Rodgers
authors.affiliation: School of Nursing, University of Pennsylvania, Philadelphia.
authors.forename: Marilyn
authors.initials: M
authors.lastname: Sommers
authors.affiliation: School of Nursing, University of Pennsylvania, Philadelphia.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Hanlon
authors.affiliation: School of Nursing, University of Pennsylvania, Philadelphia.
authors.forename: Jesse
authors.initials: J
authors.lastname: Chittams
authors.affiliation: School of Social Policy and Practice, University of Pennsylvania, Philadelphia.
authors.forename: Andrea
authors.initials: A
authors.lastname: Doyle
authors.affiliation: Perelman School of Medicine, University of Pennsylvania, Philadelphia.|Philadelphia VA Medical Center, Philadelphia, Pennsylvania.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Datner
authors.affiliation: Perelman School of Medicine, University of Pennsylvania, Philadelphia.
authors.forename: Paul
authors.initials: P
authors.lastname: Crits-Christoph
mesh_terms: D000293:Adolescent; D000328:Adult; D000428:Alcohol Drinking; D004636:Emergency Service, Hospital; D005260:Female; D006786:Hospitals, Urban; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation; D013179:Spouse Abuse / Q000517:prevention & control*; D016896:Treatment Outcome; D055815:Young Adult