Feasibility of alcohol screening and brief intervention

Background: A variety of policy groups recommend that screening and brief intervention (SBI) programs for alcohol-use disorders be widely implemented in health care settings. This article reports the extent to which trauma surgeons support SBI programs and the feasibility of implementing these programs in trauma centers. Methods: Trauma surgeons were surveyed to assess their support for implementing alcohol screening and brief intervention in trauma centers. To assess feasibility of implementation, three trauma centers implemented such programs. Each trauma center used one half-time research assistant who screened trauma inpatients for alcohol-use disorders and provided brief interventions for at-risk drinkers. The research assistant also recorded time spent screening and performing interventions, patient satisfaction with the intervention, and whether standard intervention elements were performed. Results: most surgeons surveyed supported alcohol screening, and 72% supported brief interventions. Research assistants who had no previous training in alcohol screening and brief interventions were successfully trained to screen and interview patients. One half-time research assistant was able to screen the eligible inpatient trauma population, with the exception of patients who were hospitalized on the weekends. Nearly 17% of patients at one trauma center were not screened because of language barriers. On any given day, roughly half the patients could not be screened because of the severity of their injuries. However, most of the patients were eventually screened during their hospital stay. Patient satisfaction was high. Conclusion: most trauma surgeons supported alcohol screening and interventions. Preliminary data showed that one half-time research assistant at each facility could successfully screen most injured patients and implement brief interventions. An alcohol screening and brief intervention program seems feasible in any trauma center committed to implementation.