Opportunistic Interventions to Treat Alcohol Problems in emergency Department Settings: Is There a Role for social work and Other Non-physician Health Professions?

Degree awarded: Ph.D. Social Work. The Catholic University of AmericaThis dissertation can be viewed by CUA users only.A public health approach to the harms that arise from alcohol misuse requires that alcohol problems be identified early and intervened with before serious social and medical consequences occur. An intervention directed at at-risk drinkers, known as alcohol brief intervention, has well established efficacy when delivered by physicians working in primary health care clinics and some hospital Emergency Departments. However, the adoption by physicians has not been widespread, due to a number of barriers including lack of physician time, skill, and knowledge about alcohol. An important question thereby arose as to whether other health professionals, including social workers, achieve the same positive patient outcomes as physicians when delivering the intervention. Using data from the largest effectiveness study of alcohol brief intervention in Emergency Departments (ED's) to date (Academic Emergency Department Screening, Brief Intervention, and Referral to Treatment Research Collaborative), changes in alcohol use from patients who were treated by physicians were compared to changes in those patients treated by non-physician health professionals. Participants in the current study (n=279) were drinking at levels above the National Institutes of Health limits. Patients were divided into two groups: 137 received the intervention from a physician and 142 received the intervention from a non-physician health professional. In addition to baseline data on demographic, education and health variables, measures on three quantity and frequency of alcohol use variables were collected at baseline and at 3-months post intervention. Results of an Analysis of Co-Varience that adjusted for differences in baseline drinking, indicated that controlling for gender, marital status, education level, and severity of addiction, the ED patients who received the alcohol brief intervention from trained non-physician health providers did as well as at 3-month follow-up on the three assessed outcomes of reduction in alcohol use as those patients who received the intervention from a physician. Findings suggest that non-physician health professionals who are trained in alcohol brief intervention be considered to provide the intervention, removing significant barriers to physician delivery that currently exist, and increasing opportunities for wide-spread implementation of this efficacious public health approach to reducing the harms of alcohol misuse.Made available in DSpace on 2012-09-11T17:08:24Z (GMT). No. of bitstreams: 1 Murray_cua_0043A_10128display.pdf: 660002 bytes, checksum: eae0385f6b3adf66169618748e47ef4d (MD5