Citation

Cunningham R, Walton MAL, Zimmerman M, Stanley R, Chermack S, Bingham R, Shope JT. Acad. Emerg. Med. 2007; 14(Suppl 1): S106-S107.

Affiliation

University of Michigan

Copyright

(Copyright © 2007, Society for Academic Emergency Medicine, Publisher John Wiley and Sons)

DOI

10.1197/j.aem.2007.03.996

PMID

17463489

Abstract

Violent injury is a leading cause of morbidity for urban teens and is often associated with alcohol misuse.

Objectives

We hypothesize that universal computer screening of teens in an urban ED, followed by a brief intervention (BI) for violence will be well received by teens and effective at changing attitudes towards violence and alcohol.

Methods

Findings from the recruitment phase of a randomized controlled trial are reported. Patients age 14-18 on 3-11 shift, 7 days/wk at a Urban Level 1 ED from Sept-Nov 2006 were approached to complete a computerized survey of risk behaviors including violence and alcohol use. Teens who presented with suicide attempt, sexual assault, or unstable vitals were excluded. Measures: recruitment rates, alcohol, violence and weapon carriage attitudes and behaviors, and BI process questions. Teens with past year violence-alcohol use were randomly assigned to control group, or 30-min interactive BI delivered by computer or research therapist containing: review of goals, tailored feedback on risk behaviors, role plays for practicing risk reduction, and referrals.

Results

353 eligible teens were approached, 290 were screened (18% refused): 48% male; 50% African American; and 39% injured/61% medical. Seventy teens (24%) met risk/eligible criteria for BI of which 64 (91%) completed the BI prior to ED discharge: 18 computer, 25 therapist, 19 control. Immediate computerized post-test indicated 81% "liked" the BI, 26% noting they "liked it a lot". Few teens required assistance with computer survey (6%) or intervention (2%). Paired t-tests found significant reduction pre/post in alcohol (p < 0.001), violence (p < 0.001), and weapon carriage (p < 0.001) attitudes.

Conclusions

This study found universal computerized screening and BI during an ED visit is feasible, well-received and effective at changing violence and alcohol attitudes. Further work is needed to evaluate the effectiveness of the BI on reducing violent behavior among urban teens in the ED.

Language: en