“That's Where the Arguments Come in”: A Qualitative Analysis of Booster Sessions following a Brief Intervention for Drug Use and Intimate Partner Violence in the Emergency Department

Abstract

Although booster phone calls have been used to enhance the impact of brief interventions in the emergency department, there has been less number of studies describing the content of these boosters. We conducted a qualitative analysis of booster calls occurring two weeks after an initial Web-based intervention for drug use and intimate partner violence (IPV) among women presenting for emergency care, with the objective of identifying the following: progress toward goals set during the initial emergency department visit, barriers to positive change, and additional resources and services needed in order to inform improvements in future booster sessions. The initial thematic framework was developed by summarizing codes by major themes and subthemes; the study team collaboratively decided on a final thematic framework. Eighteen participants completed the booster call. Most of them described a therapeutic purpose for their drug use. Altering the social milieu was the primary means of drug use change; this seemed to increase isolation of women already in abusive relationships. Women described IPV as interwoven with drug use. Participants identified challenges in attending substance use treatment service and domestic violence agencies. Women with substance use disorders and in abusive relationships face specific barriers to reducing drug use and to seeking help after a brief intervention.

BSAFER: A Web-Based Intervention for Drug use and Intimate Partner Violence Demonstrates Feasibility and Acceptability among Women in the Emergency Department

“…Therefore, marijuana use is increasingly normalized; in this study, many patients who used marijuana described therapeutic uses of the drug and seemed unenthusiastic about engaging in discussions around changing drug use. 32 Although recent SBIRT drug studies 38 , 39 have had broad inclusion criteria with regards to types of substance use, our subgroup analysis hinted that the population of ED patients whose only drug use was marijuana may not be a target receptive to change. Future studies powered to examine the differences between subgroups of individuals using drugs will be needed to inform us more about the specific populations most likely to benefit from ED-based interventions.…”

“…However, as a preliminary examination of the change we might expect to see in a larger clinical trial, we did examine estimates of changes in drug use and IPV occurrence, both for all participants and in the subset of participants reporting use of drugs other than marijuana, given evidence for stronger motivation to change illicit drug use in this population. 31 , 32…”