The long-term goal of the present program of research is to reduce impaired driving, risky drinking and alcohol- related injuries among injured patients who present in a hospital emergency department (ED). The current proposed project, ReDIAL, will conceptually replicate, strengthen and seek to understand the findings of DIAL (recently completed CDC-funded RCT), which established the acceptability and effectiveness of telephone- delivered brief intervention (TBI) in reducing impaired driving and decreasing the frequency of alcohol-related injuries among injured ED patients with risky alcohol use. ReDIAL primary aims are to: examine the effects of a more intensive telephone BI (added booster session of TBI) on 1) risky alcohol use and alcohol related injuries;2) impaired driving and other driving related negative consequences;3) estimate the cost effectiveness of screening plus TBI 4) identify mechanisms of change and the active ingredients of treatment that explain the effect of TBI on proximal and distal outcomes;and 5) identify and assess the effect that patient predispositions have on the relationship between TBI and changes in risky driving and alcohol injuries. This study will recruit injured ED patients who screen positive for risky alcohol use (i.e. exceed NIAAA quanity/frequency guidelines). Eligible patients will be consented in the ED and will receive an appointment for an initial contact call within 1 week. At the initial telephone call the research participant will receive an assessment and then will be randomized into one of two conditions: 1) TBI or 2) a comparison control group with a home safety educational program. Both will be provided over three telephone sessions: the initial call (immediately following randomization) and two booster calls at 2 weeks and 6 weeks after randomization. Participants are assessed for levels of risky alcohol use, alcohol-related injuries, impaired driving, and other driving related negative consequences at 4, 8, and 12 months post-randomization. ReDIAL addresses a focus area in the NIAAA 2008-2013 strategic plan in identifying strategies to enhance screening, brief interventions, and appropriate referrals to additional services and PA-07-066 research objectives: identification and evaluation of mechanisms underlying the actions of behavioral therapies and the development of effective strategies aimed at assisting systems to identify and implement appropriate empirically-supported interventions. With 30 million yearly US ED visits for injuries and the prevalence of risky alcohol use between 20-30% in ED patients, ReDIAL's success in achieving its aims has the potential for TBI to become an accepted part of routine ED clinical care and prevent future injury occurrence.

Public Health Relevance

Risky alcohol use significantly increase risk for negative health and psychosocial consequences. The ED is an appropriate site to access individuals engaging in these behaviors, and telephone BI allows us to deliver interventions to patients who may have difficulty accessing care. Furthermore a brief intervention that was cost-effective would be would be valuable to implement in this opportunistic setting. This study will also allow us to test mechanisms of behavior change and active treatment ingredients that will advance the field.

Agency
National Institute of Health (NIH)
Institute
National Institute on Alcohol Abuse and Alcoholism (NIAAA)
Type
Research Project (R01)
Project #
5R01AA017895-02
Application #
8037159
Study Section
Risk, Prevention and Intervention for Addictions Study Section (RPIA)
Program Officer
Lowman, Cherry
Project Start
2010-03-01
Project End
2015-02-28
Budget Start
2011-03-01
Budget End
2012-02-29
Support Year
2
Fiscal Year
2011
Total Cost
$715,068
Indirect Cost
Name
Rhode Island Hospital
Department
Type
DUNS #
075710996
City
Providence
State
RI
Country
United States
Zip Code
02903
Baird, Janette; Yang, Eunice; Strezsak, Valerie et al. (2017) Examining motor vehicle crash involvement and readiness to change on drinking and driving behaviors among injured emergency department patients. Traffic Inj Prev 18:463-469
Mello, Michael J; Baird, Janette; Lee, Christina et al. (2016) A Randomized Controlled Trial of a Telephone Intervention for Alcohol Misuse With Injured Emergency Department Patients. Ann Emerg Med 67:263-75
Lee, Christina S; Longabaugh, Richard; Baird, Janette et al. (2015) Participant report of therapist-delivered active ingredients in a telephone-delivered brief motivational intervention predicts taking steps towards change. Addict Res Theory 23:421-428
Field, Craig A; Baird, Janette; Saitz, Richard et al. (2010) The mixed evidence for brief intervention in emergency departments, trauma care centers, and inpatient hospital settings: what should we do? Alcohol Clin Exp Res 34:2004-10
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