In the U.S., half of the estimated one hundred thousand deaths attributed to alcohol each year are due to injuries. Randomized controlled trials have demonstrated reduced injury risk after brief interventions for problem drinking among patients seen in the emergency department or hospitalized for acute injury. However, it is often not feasible for injured patients to receive brief interventions in the emergency department or hospital, due to time constraints, logistical considerations (e.g., lack of privacy), or discharge circumstances. The proposed feasibility study will inform the development of a randomized controlled trial to evaluate alternative strategies to deliver brief intervention among acutely injured problem drinkers. The primary aim of the trial will be to evaluate the effect of a brief telephone intervention on subsequent problem drinking and injury recurrence, when delivered to patients recently seen for care of acute injuries who have problem drinking. Telephone intervention will be compared to several alternative communication strategies. The intervention trial addresses Healthy People 2010 Objectives to reduce alcohol-related unintentional injuries and violence, harmful and hazardous drinking, and the treatment gap for alcohol problems. Such a trial would require screening many injured patients in order to identify patients with problem drinking. This study will assess the feasibility of telephone screening for problem drinking among acutely injured patients recently seen for urgent or emergent care, and of recruiting identified problem drinkers to an intervention trial. Telephone screening will be compared to screening by oral, paper, and electronic questionnaires administered to acutely injured patients in the clinic or emergency department while they are awaiting care. The results will inform development of the intervention trial. If the intervention trial identifies an effective and cost-effective strategy for providing brief intervention to acutely injured patients with problem drinking, emergency departments and urgent care clinics may adopt such a strategy, thus increasing access to treatment. Increased access to brief interventions is likely to reduce both problem drinking and associated injuries.

R03AA013708

2002-09-30

2004-09-29