The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #60297

A. Haque, MBBS, MPH, L. Leontieva, MD, J. C. Helmkamp, PhD, K. Horn, EdD, MSW, J. M. Williams, MD, and P. Ehrlich, MD. Center for Rural Emergency Medicine, West Virginia University, P.O. Box 9151, Morgantown, WV 26505, 304.293.6682, ahaque@hsc.wvu.edu

OBJECTIVES: To determine if baseline stages of change (pre-contemplation, contemplation, preparation, and action) are predictive of the effectiveness of a brief intervention for patients identified with self-reported alcohol problems during their Emergency Department visit. METHODS: From August 1998 through December 2000, the Alcohol Disorder Identification Test (AUDIT) was administered to consented patients aged 18-29 years. A brief motivational intervention was provided to screen-positive patients (AUDIT score >5 out of 40). Decrease in the AUDIT domains of alcohol intake, harm-related behavior, and dependency symptoms were measured at the 3-month follow-up. Logistic regression was used to analyze predictability of stages of change among the AUDIT domains. RESULTS: Sixty percent (805/1304) of screen-positive patients were successfully followed. At follow-up, 48% were pre-contemplators, 24% were contemplators, 5% were in the preparation stage, and 23% were taking action. Compared to pre-contemplation stage patients, those in the action stage were twice as likely to reduce their alcohol intake (OR=2.2, 95%CI=1.1-4.7), nearly three times as likely to reduce their alcohol-related harm behavior (OR=2.8, CI=1.6-4.9), and almost four times more likely to decrease their dependency symptoms (OR =3.6, CI=1.9-6.6). Compared to pre-contemplation patients, those in the contemplation stage were nearly twice as likely to reduce their alcohol-related harm (OR=1.9, CI=1.0-3.3) and those in the preparation stage were more than twice as likely to reduce their dependency symptoms (OR=2.2, CI=1.1-4.3). CONCLUSIONS: Different stages of change at baseline appeared to be significant predictors for young adults in reducing alcohol intake, alcohol-related harm, and dependency symptoms following a brief intervention.

Learning Objectives:

At the conclusion of this session participants (learners) of this session will be able to:
• list four stages of change that people with addiction/problematic behavior are going through on their way to recovery
• understand the main thoughts/reasoning that people usually have according to their stage of change
• state what stage of change is the most predictive for decrease in alcohol consumption, alcohol-related harm behavior, and alcohol dependency symptoms

Keywords: Alcohol Problems, Behavioral Research

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Handout (.ppt format, 582.5 kb)