ETHNIC DIFFERENCES IN RESPONSE TO BRIEF INTERVENTION IN THE TRAUMA CARE SETTING

Abstract

Background: There is sufficient evidence to suggest that brief interventions in the trauma care setting reduce drinking, subsequent injury and DUI arrest (Gentilello, 1999, Schermer, 2006). The current study evaluates the relative efficacy of brief intervention among Whites, Blacks and Hispanics.Methods: A randomized controlled trial of brief intervention based on motivation interviewing in comparison to a semi‐structured assessment was conducted in an urban level I trauma center. The current study includes 1493 trauma patients including 668 Whites, 288 Blacks, and 537 Hispanics. hierarchical linear modeling was used to evaluate ethnic differences in drinking outcomes including volume per week, frequency of five or more per occasion, maximum amount consumed in one day, percent days abstinent and percent days heavy drinking at 6 and 12 month follow up. Analyses controlled for age, gender, employment status, marital status, prior alcohol treatment, type of injury and injury severity. Special emphasis was given to ethnicity and testing of a potential interaction effect between ethnicity and brief intervention efficacy.Results: Across ethnic groups,patients in both intervention and control groups reduced their drinking. Across drinking outcomes, there were significant interactions between treatment and ethnicity (p<.05). Among Hispanics, brief intervention in comparison to control significantly reduced average volume per week at 12 month follow up (β=‐.56, SE=.23, p<.05), maximum amount consumed in one day at 6 and 12 month follow up (β=‐.32, SE=.12, p=.01; β=.42, SE=.13, p<.01, respectively), frequency of five or more per occasion at 12 month follow up (β=‐.49, SE=.25, p<.05) and percent days heavy drinking at 12 months (β=‐.16, SE.06, p=.01).Conclusions: All three ethnic groups evidenced reductions in drinking at 6 and 12 month follow up independent of treatment. Among Hispanics, brief intervention significantly reduced drinking patterns typically associated with injury and other negative health consequences.