The Teachable Moment: Screening and Brief Intervention for Admitted Trauma Patients

The goal of this study is to guide further policy development regarding effective alcohol
screening by: (a) comparing the effectiveness of two new, shorter screening tools for risky
drinking patterns with the longer screening tool in current use; (b) assessing the outcomes
of two different brief counseling interventions (BIs) with trauma patients screened to have
risky drinking behaviors; and (c) examining the impact of the implementation of this new
policy in a Level I Trauma Center.

The Specific Aims will be accomplished by:

1. Screening patients who are admitted to the Trauma Center, and conducting BIs for all who
screen positive;

2. Collecting formative qualitative data regarding participants' perceptions of benefits of
drunken states, their individual risks, and perceived healthier alternatives;

3. Collecting quantitative data (injury severity score and hospital length of stay) and
correlating these data with patient demographics and responses on the different
screening methods;

4. Collecting follow-up data by telephone on self-reported alcohol use and trauma
recidivism, using an interviewer-administered assessment;

5. Collecting data on trauma recidivism from ED data, publicly available records, and
patient self-report at 6-month telephone follow-up;

6. Surveying trauma staff and physicians at three intervals regarding the process of
implementing the new ACS policy, any perceived difficulties, and the perceived impact

Inclusion Criteria:

- Inpatient on trauma service

- 18 years or older

- Speaks either English or Spanish

One or more of the following:

- Patient answered yes to either admission screening question

- Patient has a positive BAL of less than or equal to 79 and also has a positive Audit
score (men greater than or equal to 8; women greater than or equal to 4)

- Patient has a BAL of 80 or higher

- patient has no record of a BAL on file and they have a positive Audit score

Exclusion Criteria:

- Patient unable or unwilling to provide informed consent

- Patient refusal contact at six months

- Patient has a positive BAL of less than or equal to 79 and negative AUDIT score

- Patient deemed unable to complete a BI