Brief Emergency Department Intervention Tested for Young People Who Use Alcohol

    • July 23, 2009

Ralph W. Hingson, ScD
Professor
Boston University School of Public Health
Boston, Mass.
Director, Division of Epidemiology and Prevention Research
National Institute on Alcohol Abuse and Alcoholism
National Institute of Health
Bethesda, Md.

The project: Ralph W. Hingson's work contributed to legislation making it illegal for people under age 21 to drive after drinking and lowering the allowable blood alcohol limit for adult drivers to .08 percent.

In 2001, Hingson received an Innovators Combating Substance Abuse award and got a chance to advance his work. The Robert Wood Johnson Foundation (RWJF) created the Innovators program to nurture and promote innovation in combating substance abuse. Between 2000 and 2003, some 20 senior researchers, practitioners and policy-makers received Innovators awards.

Hingson used his Innovators award to pilot-test the effectiveness of a brief motivational intervention used with young people who screened positive for risky drinking upon admission to a hospital emergency department. He trained youth workers stationed in the emergency department to deliver the intervention, which included providing feedback about alcohol use, assessing readiness to change and negotiating behavior change. The workers then linked these patients to primary care follow-up and alcohol treatment resources.

In the pilot study, 490 pediatric emergency department patients were screened for alcohol use. Some 120 patients ages 14–20 had results indicating that their drinking should be considered a problem. Researchers randomly assigned 76 of them to receive either the brief motivational intervention or services as usual. They followed-up with 54 patients six months later.

Findings

Hingson reported the following key findings from his work to RWJF:

  • At the six-month follow-up, the mean number of drinks reported to be consumed per month by people receiving the motivational intervention declined from 78 at baseline to eight (a 90% reduction). The number of drinks reported to be consumed per month by members of the control group declined from 61 to 27 (a 56% reduction).

  • At the six-month follow-up, the mean number of drinking days reported in the past month declined from 37 percent of days to 11 percent of days among people receiving the motivational intervention (a 70% decline). Past month drinking reported by members of the control group declined from 31 percent of days to 21 percent of days (a 32% decline).

Based on the results of the pilot study, in 2004, Hingson received a grant from the National Institute on Alcohol Abuse and Alcoholism to conduct a randomized, controlled study of young adult patients at Boston Medical Center. As of December 2007, 7,116 patients had been screened for alcohol problems. Investigators were still analyzing the data from that study when the RWJF Innovators grant ended.