Assessing Readiness to Change and Identifying Risk Factors Leading to an Alcohol-Related Injury

Alcohol use is a leading risk factor in injuries and accounts for nearly half of all patients in the emergency room. Brief interventions are conducted in the ER setting to target patients who are seeking medical attention and who screen positive for alcohol misuse. It is believed that providing treatment in alternative settings will more effectively reach patients with alcohol problems, thereby decreasing their risk of future injury. From May 2003 to May 2005, approximately 1,500 trauma patients at an urban hospital participated in a study to assess risk factors associated with alcohol-related injuries. The primary aim of this study was to assess factors associated with readiness to change for patients seeking medical attention due to an alcohol-related injury. Multivariate analysis demonstrated that older patients, patients with increased causal attribution, and patients reporting increased recent alcohol-related problems were significantly more likely to be ready to make a change in their alcohol use. Also of interest in the study were factors associated with acute intoxication and drinking beyond normal limits, patient's perception of the relationship between their alcohol use and subsequent injury, and ethnic influences on these variables. It was found that acutely intoxicated patients were more likely to not be employed for wages, have an intentional injury, and to have experienced more alcohol-related problems in the past 12 months compared to patients who drank beyond normal limits. It was further found that Hispanics, patients reporting having been a little bit, somewhat, and very affected by alcohol at the time they were injured, and patients reporting increased recent alcohol-related problems were significantly more likely to have increased causal attribution. Having an intentional injury and screening positive by either drinking beyond normal limits or on an alcohol questionnaire were negatively associated with causal attribution. Hispanics significantly differed from Whites and Blacks on causal attribution. These findings show that accounting for certain risk factors may facilitate treatment for alcohol problems by improved understanding of the patient's readiness to change.