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OBJECTIVE Alcoholism is the leading risk factor for injury. The authors hypothesized that providing brief alcohol interventions as a routine component of trauma care would significantly reduce alcohol consumption and would decrease the rate of trauma recidivism. METHODS This study was a randomized, prospective controlled trial in a level 1 trauma center.(More)
AIMS To examine the effectiveness of brief behavioral interventions adapting the principles and techniques of Motivational Interviewing (MI) to four behavioral domains: substance abuse, smoking, HIV risk and diet/exercise. DESIGN We conducted a systematic review of 29 randomized trials of MI interventions. Data on methodological quality were extracted and(More)
CONTEXT Although posttraumatic stress disorder (PTSD) and alcohol abuse frequently occur among acutely injured trauma survivors, few real-world interventions have targeted these disorders. OBJECTIVE We tested the effectiveness of a multifaceted collaborative care (CC) intervention for PTSD and alcohol abuse. DESIGN Randomized effectiveness trial. (More)
BACKGROUND To improve reinjury prevention strategies targeting hazardous drinking, we determined its predictors and longitudinal course in the year after injury. METHODS This was a prospective study of 101 randomly selected hospitalized trauma patients who before injury represented the full range of substance abuse, from severe to none. We hypothesized(More)
OBJECTIVE To test the effectiveness of a stepped care intervention model targeting posttraumatic stress disorder (PTSD) symptoms after injury. BACKGROUND Few investigations have evaluated interventions for injured patients with PTSD and related impairments that can be feasibly implemented in trauma surgical settings. METHODS The investigation was a(More)
OBJECTIVE To determine whether a brief session of behavior change counseling (BCC), offered to injured adolescents in the emergency department (ED) as a therapeutic intervention, could be used to change injury-related risk behaviors and the risk of reinjury. STUDY DESIGN A randomized, controlled trial. PARTICIPANTS Adolescents between 12 and 20 years(More)
BACKGROUND There has been increased attention on identifying alcohol problems among individuals admitted to trauma centers. Reports about patients' drinking made by significant others represent one potential method to address both concerns about the validity of patients' self-reports and the need to have a proxy measure for trauma patients who are unable to(More)
Nearly half of all trauma beds are occupied by patients who were injured while under the influence of alcohol. Alcoholism plays such a significant role in trauma that efforts to reduce injury recurrence are unlikely to be successful if it remains untreated. An injury requiring hospitalization creates a unique opportunity to intervene and to motivate(More)
IMPORTANCE Although brief intervention is effective for reducing problem alcohol use, few data exist on its effectiveness for reducing problem drug use, a common issue in disadvantaged populations seeking care in safety-net medical settings (hospitals and community health clinics serving low-income patients with limited or no insurance). OBJECTIVE To(More)
This paper presents the results of implementing on-site alcohol or drug (AOD) brief intervention services across several medical, surgical, and psychiatric services in a county hospital. These integrated brief interventions (IBI) included patient substance abuse assessment, feedback to patient, and referral/recommendations. Three hundred sixty-three(More)