title: Examining motor vehicle crash involvement and readiness to change on drinking and driving behaviors among injured emergency department patients.
abstract: To measure the effect of motor vehicle crash (MVC) involvement and readiness to change drinking and driving behaviors on subsequent driving and drinking behaviors among injured emergency department (ED) patients who use alcohol at harmful levels.
  
  
  
  This was a secondary analysis of a randomized controlled trial of injured ED patients who screened positive for harmful alcohol use, who at recruitment reported driving in the past 12 months and received at least one of the intended intervention sessions (brief behavioral intervention versus attention placebo control; N = 407). Outcome variables were as follows: (1) change in 6 impaired driving behaviors and (2) report of MVCs and traffic violations in the 12 months following recruitment; predictor variables were as follows: (1) treatment assignment, (2) MVC involvement at recruitment, and (3) baseline readiness to change alcohol use and drinking and driving.
  
  
  
  Modeling of change in the 6 impaired driving variables indicated that neither the recruitment visits being MVC related nor baseline readiness to change alcohol use and drinking and driving behaviors predicted greater changes in impaired driving over time. Baseline reports of past moving traffic violations and the ED visit being MVC related predicted a greater likelihood of each behavior at 12 months following study recruitment.
  
  
  
  This study and others have demonstrated that ED patients with harmful alcohol use are willing to engage in behavioral interventions directed at changing risky behaviors. However, this study did not demonstrate that patients considered having the potential to be more engaged with the intervention because their ED visit was MVC related and/or they had expressed intent to change their risky alcohol use and drinking and driving behaviors were more likely to change these risky behaviors.
authors.affiliation: a Injury Prevention Center at Rhode Island Hospital , Providence , Rhode Island.|b Department of Emergency Medicine , Alpert School of Medicine at Brown University , Providence , Rhode Island.
authors.forename: Janette
authors.initials: J
authors.lastname: Baird
authors.affiliation: a Injury Prevention Center at Rhode Island Hospital , Providence , Rhode Island.
authors.forename: Eunice
authors.initials: E
authors.lastname: Yang
authors.affiliation: a Injury Prevention Center at Rhode Island Hospital , Providence , Rhode Island.|c Department of Epidemiology , Brown University School of Public Health , Providence , Rhode Island.
authors.forename: Valerie
authors.initials: V
authors.lastname: Strezsak
authors.affiliation: a Injury Prevention Center at Rhode Island Hospital , Providence , Rhode Island.|b Department of Emergency Medicine , Alpert School of Medicine at Brown University , Providence , Rhode Island.|d Department of Health Service , Practice and Policy, Brown University School of Public Health , Providence , Rhode Island.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Mello
mesh_terms: D000063:Accidents, Traffic / Q000706:statistics & numerical data*; D000293:Adolescent; D000328:Adult; D000428:Alcohol Drinking / Q000523:psychology*; D000066448:Driving Under the Influence / Q000523:psychology*; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012309:Risk-Taking; D014947:Wounds and Injuries / Q000209:etiology*; D055815:Young Adult
keywords: behavioral interventions; drinking and driving; motor vehicle crash