Linkages between alcohol use and HIV/sexual risk behaviors have been observed in multiple groups and each behavior has been successfully treated individually. Indeed, some studies suggest these behaviors can be successfully treated together. The Emergency Department (ED) provides a venue through which many patients with multiple risks are treated. Yet, to date no study has addressed these behaviors together in an ED, where admission may represent an opportunistic moment when patients are particularly willing to discuss these risky behaviors. Motivational Interviewing (MI) has demonstrated promise with alcohol risk in the ED in several of our previous studies, and has shown promise with sexual risk populations as well. Accordingly, this study (N=302) will address whether a two session multiple risk MI can more effectively decrease and maintain reduction in alcohol use, alcohol related problems, and sexual risk taking following discharge from the ED than Brief Advice (BA). Baseline, MI Session 1 and BA will be administered in the ED. MI Session 2 will occur 7- 10 days following MI Session 1. Follow-ups will be conducted at 3, 6 and 12 months. This proposal will allow us to address the next phase of our program of research that has been designed to develop easily disseminable treatments for high-risk populations in medical settings. This study will also address potential mediators (motivation to change risk taking, self-efficacy) of MI effects. We will also examine whether reductions in sexual risk associated with MI compared to BA are accounted for by reduced drinking. A tertiary aim will examine the moderating effect of co-occurring substance use on outcomes. The cost-effectiveness of the interventions will also be addressed. Thus, this study will address two significant Public Health problems and provide significant information about MI mechanisms that may be relevant to the treatment community.

Public Health Relevance

This brief alcohol and sexual risk taking intervention has the potential to influence the public health by reducing alcohol use and sexual risk taking behavior in individuals who are seeking treatment in an Emergency Department.

Agency
National Institute of Health (NIH)
Institute
National Institute on Alcohol Abuse and Alcoholism (NIAAA)
Type
Research Project (R01)
Project #
5R01AA009892-17
Application #
8130579
Study Section
Special Emphasis Panel (ZRG1-AARR-G (02))
Program Officer
Shirley, Mariela
Project Start
1994-06-01
Project End
2015-08-31
Budget Start
2011-09-01
Budget End
2012-08-31
Support Year
17
Fiscal Year
2011
Total Cost
$746,534
Indirect Cost
Name
Brown University
Department
Public Health & Prev Medicine
Type
Schools of Public Health
DUNS #
001785542
City
Providence
State
RI
Country
United States
Zip Code
02912
Celio, Mark A; Mastroleo, Nadine R; DiGuiseppi, Graham et al. (2017) Using Video Conferencing to Deliver a Brief Motivational Intervention for Alcohol and Sex Risk to Emergency Department Patients: A Proof-of-Concept Pilot Study. Addict Res Theory 25:318-325
Borsari, Brian; Apodaca, Timothy R; Yurasek, Ali et al. (2017) Does mental status impact therapist and patient communication in emergency department brief interventions addressing alcohol use? J Subst Abuse Treat 73:1-8
Kahler, Christopher W; Caswell, Amy J; Laws, M Barton et al. (2016) Using topic coding to understand the nature of change language in a motivational intervention to reduce alcohol and sex risk behaviors in emergency department patients. Patient Educ Couns 99:1595-602
Hernandez, Lynn; Cancilliere, Mary Kathryn; Graves, Hannah et al. (2016) Substance Use and Depressive Symptoms among Adolescents Treated in a Pediatric Emergency Department. J Child Adolesc Subst Abuse 25:124-133
Monti, Peter M; Mastroleo, Nadine R; Barnett, Nancy P et al. (2016) Brief motivational intervention to reduce alcohol and HIV/sexual risk behavior in emergency department patients: A randomized controlled trial. J Consult Clin Psychol 84:580-91
Celio, Mark A; MacKillop, James; Caswell, Amy J et al. (2016) Interactive Relationships Between Sex-Related Alcohol Expectancies and Delay Discounting on Risky Sex. Alcohol Clin Exp Res 40:638-46
Shepard, Donald S; Lwin, Aung K; Barnett, Nancy P et al. (2016) Cost-effectiveness of motivational intervention with significant others for patients with alcohol misuse. Addiction 111:832-9
MacKillop, James; Celio, Mark A; Mastroleo, Nadine R et al. (2015) Behavioral economic decision making and alcohol-related sexual risk behavior. AIDS Behav 19:450-8
Mastroleo, Nadine R; Operario, Don; Barnett, Nancy P et al. (2015) Prevalence of Heavy Drinking and Risky Sexual Behaviors in Adult Emergency Department Patients. Alcohol Clin Exp Res 39:1997-2002
Wray, Tyler B; Celio, Mark A; Kahler, Christopher W et al. (2015) Daily co-occurrence of alcohol use and high-risk sexual behavior among heterosexual, heavy drinking emergency department patients. Drug Alcohol Depend 152:109-15

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