Cross-Cultural Alcohol Screening and Referral Model

Tufts Medical Center, Boston MA

Investigators

Abstract

DESCRIPTION (provided by applicant): Alcohol-related problems account for at least 30% of the 100 million emergency department (ED) visits per year. The ED visit provides a "teachable moment" for a focused intervention with patients who drink harmful or hazardous amounts. ED physicians miss opportunities for alcohol screening and brief intervention due to lack of: knowledge in alcohol abuse treatment, training in brief intervention methods, and lack of feedback that targeted interactions with patients reduce problem-drinking. Based on our previous participation in National Alcohol Screening Day (NASD) and other alcohol-related projects at Tufts-New England Medical Center (T-NEMC), we propose to participate as a local site for a multi-centered educational study designed to test the effectiveness of screening, brief intervention and referral to treatment (SBIRT) as practiced by ED practitioners; and to use training provided by the ED alcohol education project to increase adoption of SBIRT by ED staff. In this two phase study, patients will be enrolled and screened regarding alcohol use. During the control period, ED personnel will provide only written handouts regarding harmful and hazardous alcohol consumption and detoxification referrals. Then, ED staff will be instructed on SBIRT techniques. During the interventional phase, ED practitioners will provide patients with SBIRT. We hypothesize that among patients identified with at-risk drinking, SBIRT will result in a significantly decreased frequency and quantity of self reported alcohol use, and increased completion of referrals in the intervention group at 3 and 6 month follow up, compared to the control group. We also hypothesize that training in SBIRT in the intervention period will enhance SBIRT use by ED personnel. T-NEMC is an urban tertiary care hospital serving a multicultural population but is unique due to its extensive Asian access program with 24-hour Asian interpreter services. Our participation in this project will increase the use of SBIRT by our staff and help decrease problem drinking in our patients.