Brief Intervention to Reduce Injury in Minorities

说明(申请人提供)：伤害不是孤立事件或一次性事件，伤害已被确定为一个重要的公共卫生问题。在与伤害和伤害复发相关的危险因素中，最被广泛认识的是酒精使用，大约50%的伤害与酒精有关。总体而言，饮酒和饮酒模式因种族而异，频繁酗酒和相关问题在黑人和西班牙裔中更为常见。总的来说，尽管黑人的弃权率高于白人和西班牙裔，但黑人遭受的酒精问题比例不成比例。拉美裔美国人通常也比白人遭受更多与酒精有关的问题。总体而言，在较贫穷的少数民族人口和酗酒的个人中，伤害累犯率更高。在医院急诊科和创伤护理中心等紧急护理环境中，短暂的酒精干预的有效性是一个相对较新的研究领域。短暂的酒精干预似乎减少了酒精摄入量和住院后的伤害率；然而，有必要评估这些短暂干预在不同种族群体中的效果。这项拟议的研究包括一项随机对照试验，在动机访谈和减少伤害的基础上进行短暂的酒精干预，以减少进入急诊室或创伤科治疗伤害后的酒精消耗和伤害。拟议项目的主要目的是确定在白人、黑人和西班牙裔美国人的创伤护理和急诊室环境中应用这一干预措施的效果。感兴趣的三个结果包括：1)酒精消耗量，以每周标准饮酒量和每次饮酒五次或五次以上的频率衡量，参与与伤害有关的危险行为，以及3)伤害复发率。据推测，短暂的酒精干预将对白人的酒精消费、伤害相关危险行为和伤害再犯罪率产生比黑人和墨西哥裔美国人更大的影响。此外，假设在控制了文化适应、文化适应压力和社会人口学特征后，短暂的酒精干预对在美国出生的墨西哥裔美国人的饮酒、伤害相关危险行为和伤害再犯率的影响小于在墨西哥出生的墨西哥裔美国人。

DESCRIPTION (provided by applicant): Injuries are not isolated events or one time occurrences and injury has been identified as an important public health problem. Among the risk factors associated with injury and injury recidivism, the most widely recognized is alcohol use with approximately 50% of all injuries associated with alcohol. In general, alcohol use and drinking patterns vary by ethnicity, with frequent heavy drinking and associated problems more common among Blacks and Hispanics. Blacks, in general, suffer a disproportionate level of alcohol problems, despite having higher rates of abstention than Whites and Hispanics. Hispanics also generally suffer more alcohol-related problems than whites. Overall, injury recidivism is higher among poorer, minority populations and among individuals who abuse alcohol. The efficacy of brief alcohol interventions in the emergency care setting such as hospital emergency departments and trauma care centers is a relatively new area of research. Brief alcohol interventions appear to reduce alcohol intake and rates of injury following hospitalization; however, there is a need to evaluate the efficacy of these brief interventions in various ethnic groups. The proposed research involves a randomized controlled trial of a brief alcohol intervention based upon motivational interviewing and harm reduction to reduce alcohol consumption and injury following admission to an emergency room or trauma department for treatment of an injury. The primary aim of the proposed project is to determine the efficacy of this intervention as applied in the trauma care and emergency room setting among Whites, Blacks and Hispanics. The three outcomes of interest include 1) Alcohol consumption as measured by number of standard drinks consumed per week and frequency of drinking five or more drinks per occasion engagement in injury related risk behaviors and 3) injury recidivism rates. It is hypothesized that the brief alcohol intervention will have a greater impact on alcohol consumption, injury related risk behaviors and injury recidivism among Whites than Blacks and Mexican Americans. In addition, it is hypothesized that the that the brief alcohol intervention will have less of an impact on alcohol consumption, injury related risk behaviors and injury recidivism among Mexican Americans born in the United States than among those born in Mexico after controlling for acculturation, acculturation stress and sociodemographic characteristics.