Sommers Marilyn S, Dyehouse Janice M, Howe Steven R, Fleming Michael, Fargo Jamison D, Schafer John C
School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA.
J Trauma. 2006 Sep;61(3):523-31; discussion 532-3. doi: 10.1097/01.ta.0000221756.67126.91.
Because 40% of motor vehicle fatalities in the United States are alcohol-related, interventions delivered by trauma clinicians targeted to reduce drinking are of particular importance to public health. The objective of this study was to test the effectiveness of hospital-based brief intervention strategies to reduce alcohol consumption and other health-related outcomes in the year after an alcohol-related vehicular injury. Brief interventions are clinically based strategies including assessment and direct feedback about drinking alcohol, goal setting, behavioral modification techniques, and the use of a self-help manual.
The study was a randomized controlled trial of two types of brief intervention with a 12-month follow-up. Participants with alcohol-related vehicular injury who were admitted to Level I trauma centers were eligible for enrollment. Enrolled participants were randomized to a control, simple advice, or brief counseling condition. Primary outcome variables were alcohol consumption (standard drinks/month, binges/month), adverse driving events (driving citations, traffic crashes), and changes in health status (hospital and emergency department admissions).
The study enrolled 187 participants at baseline and retained 100 across 12 months. Participants had a significant decrease in alcohol consumption and traffic citations at 12 months as compared with baseline. Mean standard drinks/month declined from 56.80 (SD 63.89) at baseline to 32.10 (SD 53.20) at 12 months. Mean binges/month declined from 5.79 (SD 6.98) at baseline to 3.21 (SD 6.17) at 12 months. There were no differences in alcohol consumption, adverse driving events, or health status by condition.
Whether the reductions in alcohol consumption and traffic citations were a result of the crash, hospitalization for injury, screening for alcohol use, or combination of these factors is difficult to determine. Further work is needed to understand the mechanisms involved in reductions of health-related outcomes and the role of brief intervention in this population.
在美国，40%的机动车死亡事故与酒精有关，因此创伤临床医生实施旨在减少饮酒的干预措施对公众健康尤为重要。本研究的目的是测试以医院为基础的简短干预策略在酒精相关车辆损伤后一年内减少酒精消费及其他与健康相关结果的有效性。简短干预是基于临床的策略，包括对饮酒的评估和直接反馈、目标设定、行为改变技巧以及使用自助手册。
该研究是一项对两种类型简短干预进行为期12个月随访的随机对照试验。入住一级创伤中心的酒精相关车辆损伤参与者符合纳入条件。纳入的参与者被随机分配到对照组、简单建议组或简短咨询组。主要结局变量包括酒精消费（每月标准饮酒量、每月暴饮次数）、不良驾驶事件（驾驶罚单、交通事故）以及健康状况变化（住院和急诊就诊情况）。
该研究在基线时纳入了187名参与者，12个月后保留了100名。与基线相比，参与者在12个月时酒精消费和交通罚单显著减少。平均每月标准饮酒量从基线时的56.80（标准差63.89）降至12个月时的32.10（标准差53.20）。平均每月暴饮次数从基线时的5.79（标准差6.98）降至12个月时的3.21（标准差6.17）。不同组在酒精消费、不良驾驶事件或健康状况方面没有差异。
饮酒量和交通罚单的减少是由于事故、受伤住院、酒精使用筛查还是这些因素的综合作用，很难确定。需要进一步开展工作来了解与健康相关结果减少所涉及的机制以及简短干预在该人群中的作用。
