141st APHA Annual Meeting and Exposition

In This section

280922
Phone delivered motivational intervention for emergency department patients who report risky drinking

Tuesday, November 5, 2013 : 12:50 PM - 1:10 PM

Christina Lee, PhD , Department of Emergency Medicine, Injury Prevention Center, Rhode Island Hospital, Brown University, Providence, RI
Michael J. Mello, MD, MPH , Department of Emergency Medicine, Injury Prevention Center, Rhode Island Hospital, Brown University, Providence, RI
Janette Baird, PhD , Department of Emergency Medicine, Injury Prevention Center, Rhode Island Hospital, Brown University, Providence, RI
Valerie Strezsak, MS, CCRP , Department of Emergency Medicine, Injury Prevention Center, Rhode Island Hospital, Brown University, Providence, RI
Ted Nirenberg, PhD , Department of Emergency Medicine, Injury Prevention Center, Rhode Island Hospital, Brown University, Providence, RI
Richard Longabaugh, EdD , Department of Emergency Medicine, Injury Prevention Center, Rhode Island Hospital, Brown University, Providence, RI
Background/Purpose: Hazardous drinking accounts for as much death and disability globally as tobacco and hypertension. Despite the public health mandate to disseminate early alcohol interventions, few protocols exist. We report on the feasibility of manualized phone-based brief motivational intervention delivered to 351 injured Emergency Department (ED) patients at a Level 1 Trauma Center in the Northeast. Methods: Therapist training: Interventionists were trained in motivational interviewing (MI) and the manualized protocol. The Motivational Interviewing Treatment Integrity (MITI) system and protocol adherence checklist were used to rate taped pilot calls. At least two consecutive calls following protocol had to meet criterion before the interventionist was deemed MI competent (> 3 for all MITI domains). Weekly supervision (MINT trainer) reviewed tapes. Manualized Protocol: The call provided all MI elements directed at participants' alcohol use. Calls 2 and 3 were boosters. Therapists completed treatment fidelity forms after each call and participants completed an assessment regarding the intervention. Results/Outcomes: 67% male, 31 years average age (SD = 11.46, range 18-86), 38% no insurance, 77.9% needed brief intervention (average ASSIST score 20.53, SD = 7.89, range 11-39). Phone contact rate following ED visit: Call 1, 75.4%. Treatment completion rates: Call 2 , 82.2%; Call 3, 72.8%. Range of pilot calls for MI competence: 1-13. 66% of patients received at least one call. Conclusions: Retention rates for phone delivered MI is higher than multi-session in-person delivered MI. Phone-based motivational interviewing is a feasible alternative model for delivery of an alcohol BI with broader potential reach.

Learning Areas:
Administer health education strategies, interventions and programs
Implementation of health education strategies, interventions and programs
Planning of health education strategies, interventions, and programs
Provision of health care to the public
Public health or related research
Social and behavioral sciences

Learning Objectives:
List public health benefits of delivering Motivational Interventions for Alcohol (MIA) by phone. Identify and address logistical and clinical issues on design/implementation of phone based MIA. Describe key therapeutic elements of manualized phone-based Motivational Interventions for alcohol.

Keywords: Alcohol Problems, Technology

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been principal or co-principal investigator of multiple federally funded grants focusing on the use of motivational interviewing for alcohol interventions, both in the community and in primary care settings. Among my scientific interests are dissemination approaches for motivational interviewing and treatment process research for motivational interviewing.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.