Teaching An Alcohol Intervention To Pediatric ER Staff

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DESCRIPTION (provided by applicant): In the United States it is estimated that the overall annual cost of alcohol use is $100 billion. In adolescents, it is a leading cause of injuries and death. Numerous studies of adults and one of older adolescents have demonstrated the efficacy of brief interventions in reducing alcohol consumption and related injuries. In all of these studies however, interventions were administered by a research team, not the clinical staff who worked in the medical settings. As medical institutions are unlikely to hire extra personnel specifically to perform these interventions, important questions remain unanswered. Can these interventions be translated from the research setting into "real world" clinical settings? Can and will medical staff administer such interventions? Are these interventions effective when administered by such staff? An Emergency Department (ED) is an ideal setting to investigate this question. Many patients seen in ED's are at high risk for alcohol related problems. The ED is often the exclusive source of health care for these patients. Additionally, an ED visit and/or an injury itself may be unique "teachable moment" not found in other medical settings. Such an injury or visit may be a powerful motivation to change alcohol related behaviors. Study subjects will be the physicians and nurses of a Pediatric ED. Staff will be assessed for current attitudes, understanding, and practices regarding treatment of alcohol problems. Potential barriers to learning brief interventions (BI) will also be identified. An educational intervention will be developed and administered to ED staff, to teach them an alcohol BI. Post-intervention, ED staff will be retested for their knowledge of alcohol Bl's, as well as monitored for how often they administer the BI and how well they adhere to BI principles. The knowledge gained will be used to develop future educational interventions and ultimately to test the efficacy of alcohol Brs administered by medical personnel. This proposal includes a 5 year training plan to ensure successful completion of the research protocol. The training proposal includes: seminars in addiction theory, journal club, research and grant writing seminars, biostatistics, 2-3 hours per week of mentoring, field experiences, data analysis, and manuscript preparation and submission.