Individual and family motivational interventions for alcohol-positive adolescents treated in an emergency department: results of a randomized clinical trial

Abstract

Objective: To determine whether a brief individual motivational interview (IMI) plus a family motivational interview (Family Check-Up [FCU]) would reduce alcohol use in adolescents treated in an emergency department after an alcohol-related event more effectively than would an IMI only.

Design: Two-group randomized design with 3 follow-up time points.

Setting: An urban regional level I trauma center.

Participants: Adolescents aged 13 to 17 years (N = 125) with a positive blood alcohol concentration as tested using blood, breath, or saliva.

Interventions: Either IMI or IMI plus FCU.

Main outcome measures: Drinking frequency (days per month), quantity (drinks per occasion), and frequency of high-volume drinking (≥5 drinks per occasion).

Results: Both conditions resulted in a reduction in all drinking outcomes at all follow-up points (P < .001 for all), with the strongest effects at 3 and 6 months. Adding the FCU to the IMI resulted in a somewhat better outcome than did the IMI only on high-volume drinking days at 3-month follow-up (14.6% vs 32.1%, P = .048; odds ratio, 2.76; 95% confidence interval, 0.99-7.75).

Conclusions: Motivational interventions have a positive effect on drinking outcomes in the short term after an alcohol-related emergency department visit. Adding the FCU to an IMI resulted in somewhat better effects on high-volume drinking at short-term follow-up than did an IMI only. The cost of extra sessions necessary to complete the FCU should be weighed against the potential benefit of reducing high-volume drinking when considering adding the FCU to an IMI for this population.

Trial registration: ClinicalTrials.gov NCT00247221.

Figures

Figure 1

Consolidated Standards of Reporting Trials (CONSORT) flow diagram.

Figure 2

Percentage of the sample that reported any drinking in the previous 3 months by condition. FCU indicates Family Check-Up; IMI, individual motivational interview.

Figure 3

Percentage of the sample who reported any high-volume drinking (≥5 drinks) in the previous 3 months by condition. FCU indicates Family Check-Up; IMI, individual motivational interview.