Alcohol-positive trauma patients are more likely to be readmitted to a trauma center or die from a subsequent injury than are alcohol-negative trauma patients. Despite their increased risk, there are few empirically-supported treatments available for this population. Admission to a trauma unit may represent a """"""""teachable moment"""""""", where patients are particularly willing to discuss their alcohol use. Therefore, interventions delivered in the trauma unit may be particularly effective. Motivational Interviewing (MI), a brief, directive, non-confrontational intervention, has demonstrated some promise in this setting. Further, inclusion of a significant other (SO) in prolonged, intensive alcohol treatment appears to improve treatment retention and efficacy. Although inclusion of an SO in MI has been suggested, there are few data to support this endorsement. Accordingly, this study (N=300) will address whether motivational interviewing including both the trauma patient and an SO can more effectively decrease and maintain reductions in alcohol use and alcohol-related problems 6 and 12 months following discharge from the trauma unit than MI with the individual patient or an assessment-only condition. The 2 MI groups will each receive 2 intervention sessions timed to occur in the hospital, and 1 booster session, occurring 1 month following discharge. In the assessment-only condition, patients will receive only assessment of their drinking at baseline. This proposal will allow us to address the next phase of our program of research designed to develop easily disseminable treatments for these high-risk populations in medical settings. This study will also address potential mediators (motivation to change alcohol use, self-efficacy, alcohol treatment attendance, and social support for abstinence) and moderators of MI effects. The cost-effectiveness of the intervention will also be addressed. Thus, this study will address both a significant public health problem and provide important information about MI mechanisms that may be relevant to the broader addiction treatment community.

Agency
National Institute of Health (NIH)
Institute
National Institute on Alcohol Abuse and Alcoholism (NIAAA)
Type
Research Project (R01)
Project #
3R01AA009892-15S1
Application #
7885864
Study Section
Health Services Research Review Subcommittee (AA)
Program Officer
Shirley, Mariela
Project Start
2009-07-20
Project End
2010-10-31
Budget Start
2009-07-20
Budget End
2010-10-31
Support Year
15
Fiscal Year
2009
Total Cost
$154,741
Indirect Cost
Name
Brown University
Department
Miscellaneous
Type
Schools of Medicine
DUNS #
001785542
City
Providence
State
RI
Country
United States
Zip Code
02912
Laws, M Barton; Magill, Molly; Mastroleo, Nadine R et al. (2018) A sequential analysis of motivational interviewing technical skills and client responses. J Subst Abuse Treat 92:27-34
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
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
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
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
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
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
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

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