Emergency department-based brief intervention to reduce risky driving and hazardous/harmful drinking in young adults: A randomized controlled trial.
Authors: Marilyn Sawyer Sommers, Michael S. Lyons, Jamison D. Fargo, Benjamin D. Sommers, C. McDonald, Jean T. Shope, M. Fleming.
Background: Risky driving and hazardous drinking are associated with signiﬁcant human and economic costs. Brief interventions for more than one risky behavior have the potential to reduce healthcompromising behaviors in populations with multiple risk-taking behaviors such as young adults. Emergency department (ED) visits provide a window of opportunity for interventions meant to reduce both risky driving and hazardous drinking. Methods: We determined the eﬃcacy of a Screening, Brief Intervention, and Referral to Treatment (SBIRT) protocol addressing risky driving and hazardous drinking. We used a randomized controlled trial design with follow-ups through 12 months. ED patients aged 18 to 44 who screened positive for both behaviors (n = 476) were randomized to brief intervention (BIG), contact control (CCG), or nocontact control (NCG) groups. The BIG (n = 150) received a 20-minute assessment and two 20-minute interventions. The CCG (n = 162) received a 20-minute assessment at baseline and no intervention. The NCG (n = 164) were asked for contact information at baseline and had no assessment or intervention. Outcomes at 3, 6, 9, and 12 months were self-reported driving behaviors and alcohol consumption. Results: Outcomes were signiﬁcantly lower in BIG compared with CCG through 6 or 9 months, but not at 12 months: Safety belt use at 3 months (adjusted odds ratio [AOR], 0.22; 95% conﬁdence interval [CI], 0.08 to 0.65); 6 months (AOR, 0.13; 95% CI, 0.04 to 0.42); and 9 months (AOR, 0.18; 95% CI, 0.06 to 0.56); binge drinking at 3 months (adjusted rate ratio [ARR] 0.84; 95% CI, 0.74 to 0.97) and 6 months (ARR, 0.81; 95% CI, 0.67 to 0.97); and 5 standard drinks/d at 3 months (AOR, 0.43; 95% CI, 0.20 to 0.91) and 6 months (AOR, 0.41; 95% CI, 0.17 to 0.98). No substantial diﬀerences were observed between BIG and NCG at 12 months. Conclusions: Our ﬁndings indicate that SBIRT reduced risky driving and hazardous drinking in young adults [...]