Background The impact of alcohol use has been widely studied and is considered a public health issue. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) recommends Screening and Brief Intervention and Referral Treatment (SBIRT) but the actual practice in the Emergency Department (ED) is constrained due to limited provider time and financial resources. Objectives To assess the effectiveness of alcohol screening using Computerized Alcohol Screening and brief Intervention (CASI) compared to alcohol screening by triage nurse during Medical Screening Examination (MSE) in the ED. Methods Retrospective review of CASI/MSE database from January 2008 through December 2009, collected in the tertiary, level I Trauma ED was performed. Inclusion criteria included age ≥18, and completion of both the MSE and CASI. We analyzed the database by comparing age, gender, primary language (English, Spanish), and Alcohol Use Disorders Identification Test (AUDIT) scores using McNemar’s analysis. Results Data was available for 5,835 patients. CASI showed a significant increase in detection of at-risk drinking over MSE across all ages, gender, and primary language (p<.05). MSE found 2.5% at-risk drinkers while CASI found 11.5% at risk drinkers (Odds ratio 8.88, 95%CI 6.89–11.61). Similar results were found in 18 to 20 year-old patients. MSE identified 1.7% at-risk drinkers and CASI reported 15.94%. (Odds ratio 19.33, 95% CI 6.29–96.74) Conclusion CASI increased detection of at-risk alcohol drinkers compared with MSE across all ages, gender, and primary language. CASI is a promising innovative method for alcohol screening in the ED for the adult population including under-aged drinkers.

Purpose Trauma patient readiness to change score and its relationship to the Alcohol Use Disorder Identification Test (AUDIT) score were assessed in addition to the feasibility of Computerized Alcohol Screening and Brief Intervention (CASI). Methods A bilingual computerized tablet for trauma patients was utilized and the data was analyzed using Stata. Results Twenty-five percent of 1,145 trauma patients drank more than recommended and 4% were dependent. As many Spanish-speaking as English-speaking males did not drink, but a higher percentage of Spanish-speaking males drank more than recommended and were dependent. Half of patients who drank more than recommended rated themselves eight or higher on a 10-point readiness-to-change scale. CASI also provided personalized feedback. A high percentage of trauma patients (92%) found CASI easy and a comfort in use (87%). Conclusion Bilingual computerized technology for trauma patients is feasible, acceptable, and an innovative approach to alcohol screening, brief intervention and referral to treatment in a tertiary care university.

Objective To assess drinking patterns of Spanish-speaking patients using a bilingual Computerized Alcohol Screening and brief Intervention (CASI) tablet computer equipped with the Alcohol Use Disorders Identification Test (AUDIT). Methods This retrospective study was conducted in a tertiary university hospital emergency department (ED) between 2006 and 2010. Data from 1,816 Spanish-speaking ED patients was analyzed using descriptive statistics, the chi-square test for independence, and the Kruskal-Wallis rank sum test for comparisons using quantitative variables. Results Overall, 15% of Spanish-speaking patients were at-risk drinkers, and 5% had an AUDIT score consistent with alcohol dependency (≥20). A higher percentage of Spanish-speaking males than females were at-risk drinkers or likely dependent. Spanish speaking males exhibited higher frequency of drinking days per week and higher number of drinks per day compared to females. Among older patients, non-drinking behavior increased and at-risk drinkers decreased. The majority of males and females were ready to change their behavior after the CASI intervention; 61% and 69% respectively scored 8-10. Conclusions This study indicated that CASI was an effective tool for detecting at-risk and likely dependent drinking behavior in Spanish-speaking ED patients. The majority of patients were ready to change their drinking behavior. More alcohol screening and brief intervention tools should be tested and become readily accessible for Spanish-speaking patients.

BackgroundPrevious studies of alcohol use have recognized several trends in consumption patterns among gender and age yet few have examined ethnic differences. This study examines the intra- and inter-ethnic differences in alcohol consumption among a population of patients seen in the emergency department.MethodsThis is a cross-sectional study conducted in the emergency department in a large urban setting. Information on drinking behavior and ethnicity was collected using the Computerized Alcohol Screening and Brief Intervention (CASI) tool. We explored differences in drinking patterns using a multivariate multinomial logistic regression model.ResultsWe analyzed the drinking habits of 2,444 patients surveyed between November 2012 and May 2014. The results indicate that when compared to non-Hispanic whites, Asians have the lowest odds of drinking within normal limits or excessively, followed by other Latinos, and Mexicans. Age and gender consistently showed statistically significant associations with alcohol-use. The odds of drinking within normal limits or excessively are inversely associated with age and were lower among females. The predicted probabilities show a marked gender-specific difference in alcohol use both between and within ethnic/racial groups. They also highlight an age-related convergence in alcohol use between men and women within ethnic groups.DiscussionThe results of this study show intra-racial/ethnic variability associated with sex and education. The highlighted differences within and between ethnic groups reinforce the need to use refined categories when examining alcohol use among minorities.ConclusionThe results of this study confirm some alcohol consumption trends among ethnic minorities observed in literature. It provides empirical evidence of the marked gender differences and highlights an age-related convergence for gender-specific alcohol use. Health-care personnel should be aware of these differences when screening and counseling.