Tailored Teen Alcohol and Violence Prevention in the Emergency Room (ER)

This study will screen ~3000 adolescents in the ED (ages 14-18) over 30 months. Eligible adolescents will be asked to participate in the longitudinal study, stratified by age and gender and randomized to conditions (n=225/group): Computer Prevention Program, Counselor Prevention Program, or an informational handout control condition. Primary outcomes will be evaluated at 3, 6 and 12-months and include alcohol use/misuse, violent behaviors, illicit drug use, unintentional injury, delinquency, and weapon carriage. The proposed study integrates brief intervention strategies for alcohol misuse and violent behaviors using state-of-the-art technology to tailor the interventions to the specific risk factors of the adolescent. Tailored computerized programs use available technology to replace the need for clinical staff in the ED setting, where there is limited staff time to effect behavior change. This project will provide the critical first step toward the implementation of an integrated prevention program addressing overlapping risk factors that has the potential to be delivered to the millions of adolescents visiting urban Emergency Departments each year.

Inclusion criteria

• adolescents (ages 14-18) presenting to the ED for a medical injury or illness (except exclusions as noted below)
• adolescents ability to provide informed assent/consent depending on age
• access to a parent or guardian to provide informed consent

Exclusion criteria

• adolescents who do not understand English
• prisoners
• adolescents classified by medical staff as "Level 1" trauma
• adolescents deemed unable to provide informed consent
• adolescents treated in the ED for suicide attempts
• adolescents triaged to the psychiatric ED