Assessment of Readiness to Change and Relationship to AUDIT Score in a Trauma Population Utilizing Computerized Alcohol Screening and Brief Intervention

Lotfipour, Shahram; Cisneros, Victor; Chakravarthy, Bharath; Barrios, Cristobal; Anderson, Craig L.; Fox, J. Christian; Roumani, Samer; Hoonpongsimanont, Wirachin; Vaca, Federico E.

doi:10.1080/08897077.2011.645951

Cited by 17 publications

(19 citation statements)

References 21 publications

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“…Generally speaking, computer self-administered tools have promise for facilitating substance use screening, assessment, and even treatment interventions in time-pressured medical settings (Harris et al, 2012; Lotfipour et al, 2012; Murphy et al., 2013; Proctor & Hoffmann, 2012; Vaca, Winn, Anderson, Kim, & Arcila, 2010). Brief screeners such as the single-item drug screening question (Smith et al, 2010), may be adequate for identifying individuals with unhealthy drug use, but require further assessment to determine what drugs are being used, and at what level of risk, in order to guide the clinical intervention.…”

Section: Discussionmentioning

confidence: 99%

Test–retest reliability of a self-administered Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) in primary care patients

McNeely

Strauß

Wright

et al. 2014

Journal of Substance Abuse Treatment

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The time required to conduct drug and alcohol screening has been a major barrier to its implementation in mainstream healthcare settings. Because patient self-administered tools are potentially more efficient, we translated the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) into an audio guided computer assisted self interview (ACASI) format. This study reports on the test-retest reliability of the ACASI ASSIST in an adult primary care population. Adult primary care patients completed the ACASI ASSIST, in English or Spanish, twice within a 1–4 week period. Among the 101 participants, there were no significant differences between test administrations in detecting moderate to high risk use for tobacco, alcohol, or any other drug class. Substance risk scores from the two administrations had excellent concordance (90–98%) and high correlation (ICC 0.90–0.97) for tobacco, alcohol, and drugs. The ACASI ASSIST has good test-retest reliability, and warrants additional study to evaluate its validity for detecting unhealthy substance use.

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Section: Discussionmentioning

confidence: 99%

Test–retest reliability of a self-administered Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) in primary care patients

McNeely

Strauß

Wright

et al. 2014

Journal of Substance Abuse Treatment

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“…Especially for those who had listed “To avoid health problems,” it is particularly important to take advantage of their reported higher readiness to change. Furthermore, trauma patients had proportionately more concerns with situations where they could get hurt, as an example, and this is critical information that could be leveraged into a teachable moment 12. Taking into account the education level of the respondent may also further direct treatment plans to those most interested 7.…”

Section: Discussionmentioning

confidence: 99%

Readiness to Change and Reasons for Intended Reduction of Alcohol Consumption in Emergency Department versus Trauma Population

Harrison¹,

Hoonpongsimanont²,

Anderson³

et al. 2014

WestJEM

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IntroductionThe primary objective was to identify the most common reasons for intending to cut back on alcohol use, in emergency department (ED) and trauma patient populations. The secondary objective was to determine the association between reason to cut back on alcohol and education level.MethodsWe conducted the study at a level one trauma center in California between 2008 and 2012. This was a retrospective analysis of data collected from computerized alcohol screening and intervention (CASI). We excluded patients who drank too little, and those whose scores were consistent with dependency (Alcohol Use Disorders Identification Test [AUDIT]>19). The CASI database includes the patient’s age, gender, language, education level, an AUDIT score (1–40 scale), a readiness to change score (1–10), and the option to choose any of 10 “reasons to cut back” on their alcohol consumption.ResultsFrom 10,537 patients, 1,202 met criteria for the study (848 ED, 354 trauma). Overall, the most common reasons cited for cutting back on alcohol were “To avoid health problems” (68.5%), “To avoid getting a DUI” (43.6%), “It could save me money” (42.0%), and “To avoid situations where I could get hurt” (41.0%). Trauma patients cited the following reasons significantly more than ED patients: “To avoid situations where I could get hurt” (46.3% versus 38.8%, respectively), “So I can be in control of my behavior” (40.7% versus 32.2%), and “My partner or spouse wants me to stop” (20.1% versus 15.0%). Additionally, those patients who cited “To avoid health problems” reported 1.2 points higher than average (p<0.001) on the 10-point readiness to change scale. Those who have completed some college or an associate degree cited “To avoid health problems” less often than high school graduates (odds ratio [OR] 0.45), while they cited “To avoid situations where I could get hurt” (OR 2.5) and “To avoid being in a car crash caused by alcohol use” (OR 3.8) more often than high school graduates.ConclusionHealth, injury, finances, and legal issues remain top concerns for patients, while trauma patients specifically had proportionately more concerns with situations where they could get hurt.

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“…It also recorded patients’ responses and the length of time with the module. A personalized alcohol-reduction plan, along with counseling referral information, was wirelessly printed on a department printer [20, 21]. …”

Section: Methodsmentioning

confidence: 99%

Computerized alcohol screening identified more at-risk drinkers in a level 2 than a level 1 trauma center

et al. 2017

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BackgroundAlcohol abuse is recognized as a significant contributor to injury. It is therefore essential that trauma centers implement screening and brief intervention (SBI) to identify patients who are problem drinkers. Although, the utility of SBI in identifying at-risk drinkers have been widely studied in level 1 trauma centers, few studies have been done in level 2 centers. This study evaluates the usefulness of SBI in identifying at-risk drinkers and to investigate the pattern of alcohol drinking among level 2 trauma patients.MethodsThis is a retrospective study of a convenience sample of trauma patients participating in computerized alcohol screening, brief intervention, and referral to treatment (CASI) in an academic level 1 trauma center and a nearby suburban community hospital level 2 trauma center. CASI utilized Alcohol Use Disorders Identification Test (AUDIT) to screen patients. We compared the pattern of alcohol drinking, demographic factors, and readiness-to-change scores between those screened in a level 2 and 1 trauma center.ResultsA total of 3,850 and 1,933 admitted trauma patients were screened in level 1 and 2 trauma centers respectively. There was no difference in mean age, gender, and language between the two centers. Of those screened, 10.2% of the level 1 and 14.4% of the level 2 trauma patients scored at-risk (AUDIT 8–19) (p < 0.005). Overall, 3.7% of the level 1 and 7.2% of the level 2 trauma patients had an AUDIT score consistent with dependency (AUDIT > =20) (p < 0.005). After adjusting for age, sex, education, and language, the odds of being a drinker at the level 2 center was two times of those at the level 1 center (p < 0.005). The odds of being an at-risk or dependent drinker at level 2 trauma center were 1.72 times of those at the level 1 center (p < 0.005).ConclusionsFindings suggest that SBI is effective in identifying at-risk drinkers in level 2 trauma center. SBI was able to identify all drinkers, including at-risk and dependent drinkers at higher rates in level 2 versus level 1 trauma centers. Further studies to evaluate the effectiveness of SBI in altering drinking patterns among level 2 trauma patients are warranted.

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Assessment of Readiness to Change and Relationship to AUDIT Score in a Trauma Population Utilizing Computerized Alcohol Screening and Brief Intervention

Cited by 17 publications

References 21 publications

Test–retest reliability of a self-administered Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) in primary care patients

Test–retest reliability of a self-administered Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) in primary care patients

Readiness to Change and Reasons for Intended Reduction of Alcohol Consumption in Emergency Department versus Trauma Population

Computerized alcohol screening identified more at-risk drinkers in a level 2 than a level 1 trauma center

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