The Teachable Moment: Screening and Brief Intervention for Admitted Trauma Patients

The goal of this study is to guide further policy development regarding effective alcohol screening by: (a) comparing the effectiveness of two new, shorter screening tools for risky drinking patterns with the longer screening tool in current use; (b) assessing the outcomes of two different brief counseling interventions (BIs) with trauma patients screened to have risky drinking behaviors; and (c) examining the impact of the implementation of this new policy in a Level I Trauma Center.

The Specific Aims will be accomplished by:

• Screening patients who are admitted to the Trauma Center, and conducting BIs for all who screen positive;
• Collecting formative qualitative data regarding participants' perceptions of benefits of drunken states, their individual risks, and perceived healthier alternatives;
• Collecting quantitative data (injury severity score and hospital length of stay) and correlating these data with patient demographics and responses on the different screening methods;
• Collecting follow-up data by telephone on self-reported alcohol use and trauma recidivism, using an interviewer-administered assessment;
• Collecting data on trauma recidivism from ED data, publicly available records, and patient self-report at 6-month telephone follow-up;
• Surveying trauma staff and physicians at three intervals regarding the process of implementing the new ACS policy, any perceived difficulties, and the perceived impact

Inclusion criteria

• Inpatient on trauma service
• 18 years or older
• Speaks either English or Spanish

One or more of the following:

• Patient answered yes to either admission screening question
• Patient has a positive BAL of less than or equal to 79 and also has a positive Audit score (men greater than or equal to 8; women greater than or equal to 4)
• Patient has a BAL of 80 or higher
• patient has no record of a BAL on file and they have a positive Audit score

Exclusion criteria

• Patient unable or unwilling to provide informed consent
• Patient refusal contact at six months
• Patient has a positive BAL of less than or equal to 79 and negative AUDIT score
• Patient deemed unable to complete a BI