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A Multisite Randomized Controlled Trial of Brief Intervention to Reduce Drinking in the Trauma Care Setting: How Brief Is Brief?

Field, Craig PhD, MPH*,¶; Walters, Scott PhD; Marti, C. Nathan PhD; Jun, Jina MA*; Foreman, Michael MD§; Brown, Carlos MD

Annals of Surgery:
doi: 10.1097/SLA.0000000000000339
Randomized Controlled Trials
Abstract

Objective: Determine the efficacy of 3 brief intervention strategies that address heavy drinking among injured patients.

Background: The content or structure of brief interventions most effective at reducing alcohol misuse after traumatic injury is not known.

Methods: Injured patients from 3 trauma centers were screened for heavy drinking and randomly assigned to brief advice (n = 200), brief motivational intervention (BMI) (n = 203), or BMI plus a telephone booster using personalized feedback or BMI + B (n = 193). Among those randomly assigned, 57% met criteria for moderate to severe alcohol problems. The primary drinking outcomes were assessed at 3, 6, and 12 months.

Results: Compared with brief advice and BMI, BMI + B showed significant reductions in the number of standard drinks consumed per week at 3 (Δ adjusted means: −1.22, 95% confidence interval [CI]: −0.99, approximately −1.49, P = 0.01) and 6 months (Δ adjusted means: −1.42, 95% CI: −1.14, approximately −1.76, P = 0.02), percent days of heavy drinking at 6 months (Δ adjusted means: −5.90, 95% CI: −11.40, approximately −0.40, P = 0.04), maximum number of standard drinks consumed in 1 day at 3 (Δ adjusted means: −1.38, 95% CI: −1.18, approximately −1.62, P = 0.003) and 12 months (Δ adjusted means: −1.71, 95% CI: −1.47, approximately −1.99, P = 0.02), and number of standard drinks consumed per drinking day at 3 (Δ adjusted means: −1.49, 95% CI: −1.35, approximately −1.65, P = 0.002) and 6 months (Δ adjusted means: −1.28, 95% CI: −1.17, approximately −1.40, P = 0.01).

Conclusions: Brief interventions based on motivational interviewing with a telephone booster using personalized feedback were most effective at achieving reductions in alcohol intake across the 3 trauma centers.

In Brief

This multisite randomized clinical trial examines the type and intensity of brief interventions that most effectively reduce drinking among drinkers admitted to level I trauma centers. Interventions based on motivational interviewing involving a single session with a telephone booster using personalized feedback were found to be most effective.

Author Information

*University of Texas at Austin, Health Behavior Research and Training Institute, Austin, TX

University of North Texas Health Science Center, School of Public Health–Behavioral and Community Health, Fort Worth, TX

Department of Psychology, University of Texas at Austin, Austin, TX

§Trauma Department, Baylor University Medical Center, Dallas, TX

Trauma Department, University Medical Center Brackenridge, Austin, TX.

Reprints: Craig Field, PhD, MPH, University of Texas at Austin, Health Behavior Research and Training Institute, 1717 W 6th St, Ste 285, Austin, TX 78703. E-mail: craig.field@austin.utexas.edu.

Disclosure: This study was funded by the National Institute on Alcohol Abuse and Alcoholism (R01-AA-015439). The authors declare no conflicts of interest.

Trial registration clinicaltrials.gov identifier: NCT00428181.

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© 2014 by Lippincott Williams & Wilkins.