Gender, violence and brief interventions for alcohol in the emergency department

Esther Choo, Alyson J. McGregor, Michael J. Mello, Janette Baird

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Background: The impact of gender and violence on brief interventions (BIs) for alcohol use in the emergency department (ED) has not been studied. Our objective was to examine the effectiveness of alcohol BIs in an ED population stratified by gender and violence. Methods: This was a secondary analysis of datasets pooled from three ED-based randomized controlled studies of alcohol BIs. AUDIT-C was the primary outcome measure; secondary outcomes were binge drinking and achievement of NIAAA safe drinking levels. We conducted univariate comparisons and developed generalized linear models (GLM) for the primary outcome and generalized estimating equation (GEE) models for secondary outcomes to examine the intervention effect on the whole study group, gender-stratified subgroups, and gender- and violence-stratified subgroups. Results: Of 1219 participants enrolled, 30% were female; 31% of women and 42% of men reported violence involvement at baseline. In univariate analysis, no differences in outcomes were found between intervention and control groups for any subgroup. However, in multivariable models, men demonstrated an intervention effect for likelihood of safe drinking limits. Stratifying further by violence, only men without violence involvement demonstrated a positive intervention effect for safe drinking limits. There was no evidence of an intervention effect on women. Conclusions: Analyzing the overall effect of ED-based BI may mask its ability to improve alcohol-related outcomes in a subset of the population. Alternatively, interventions may need to be significantly improved in subsets of the ED population, e.g., in women and in men with involvement in violence.

Original languageEnglish (US)
Pages (from-to)115-121
Number of pages7
JournalDrug and Alcohol Dependence
Volume127
Issue number1-3
DOIs
StatePublished - Jan 1 2013
Externally publishedYes

Fingerprint

Violence
Hospital Emergency Service
Alcohols
Drinking
National Institute on Alcohol Abuse and Alcoholism (U.S.)
Population
Binge Drinking
Aptitude
Masks
Linear Models
Outcome Assessment (Health Care)
Control Groups

Keywords

  • Alcohol-related disorders
  • Emergency medicine
  • Gender
  • Violence

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Toxicology
  • Pharmacology
  • Pharmacology (medical)

Cite this

Gender, violence and brief interventions for alcohol in the emergency department. / Choo, Esther; McGregor, Alyson J.; Mello, Michael J.; Baird, Janette.

In: Drug and Alcohol Dependence, Vol. 127, No. 1-3, 01.01.2013, p. 115-121.

Research output: Contribution to journalArticle

Choo, Esther ; McGregor, Alyson J. ; Mello, Michael J. ; Baird, Janette. / Gender, violence and brief interventions for alcohol in the emergency department. In: Drug and Alcohol Dependence. 2013 ; Vol. 127, No. 1-3. pp. 115-121.
@article{68ea6d2bdced4f2f9f3d13fcc46e15d6,
title = "Gender, violence and brief interventions for alcohol in the emergency department",
abstract = "Background: The impact of gender and violence on brief interventions (BIs) for alcohol use in the emergency department (ED) has not been studied. Our objective was to examine the effectiveness of alcohol BIs in an ED population stratified by gender and violence. Methods: This was a secondary analysis of datasets pooled from three ED-based randomized controlled studies of alcohol BIs. AUDIT-C was the primary outcome measure; secondary outcomes were binge drinking and achievement of NIAAA safe drinking levels. We conducted univariate comparisons and developed generalized linear models (GLM) for the primary outcome and generalized estimating equation (GEE) models for secondary outcomes to examine the intervention effect on the whole study group, gender-stratified subgroups, and gender- and violence-stratified subgroups. Results: Of 1219 participants enrolled, 30{\%} were female; 31{\%} of women and 42{\%} of men reported violence involvement at baseline. In univariate analysis, no differences in outcomes were found between intervention and control groups for any subgroup. However, in multivariable models, men demonstrated an intervention effect for likelihood of safe drinking limits. Stratifying further by violence, only men without violence involvement demonstrated a positive intervention effect for safe drinking limits. There was no evidence of an intervention effect on women. Conclusions: Analyzing the overall effect of ED-based BI may mask its ability to improve alcohol-related outcomes in a subset of the population. Alternatively, interventions may need to be significantly improved in subsets of the ED population, e.g., in women and in men with involvement in violence.",
keywords = "Alcohol-related disorders, Emergency medicine, Gender, Violence",
author = "Esther Choo and McGregor, {Alyson J.} and Mello, {Michael J.} and Janette Baird",
year = "2013",
month = "1",
day = "1",
doi = "10.1016/j.drugalcdep.2012.06.021",
language = "English (US)",
volume = "127",
pages = "115--121",
journal = "Drug and Alcohol Dependence",
issn = "0376-8716",
publisher = "Elsevier Ireland Ltd",
number = "1-3",

}

TY - JOUR

T1 - Gender, violence and brief interventions for alcohol in the emergency department

AU - Choo, Esther

AU - McGregor, Alyson J.

AU - Mello, Michael J.

AU - Baird, Janette

PY - 2013/1/1

Y1 - 2013/1/1

N2 - Background: The impact of gender and violence on brief interventions (BIs) for alcohol use in the emergency department (ED) has not been studied. Our objective was to examine the effectiveness of alcohol BIs in an ED population stratified by gender and violence. Methods: This was a secondary analysis of datasets pooled from three ED-based randomized controlled studies of alcohol BIs. AUDIT-C was the primary outcome measure; secondary outcomes were binge drinking and achievement of NIAAA safe drinking levels. We conducted univariate comparisons and developed generalized linear models (GLM) for the primary outcome and generalized estimating equation (GEE) models for secondary outcomes to examine the intervention effect on the whole study group, gender-stratified subgroups, and gender- and violence-stratified subgroups. Results: Of 1219 participants enrolled, 30% were female; 31% of women and 42% of men reported violence involvement at baseline. In univariate analysis, no differences in outcomes were found between intervention and control groups for any subgroup. However, in multivariable models, men demonstrated an intervention effect for likelihood of safe drinking limits. Stratifying further by violence, only men without violence involvement demonstrated a positive intervention effect for safe drinking limits. There was no evidence of an intervention effect on women. Conclusions: Analyzing the overall effect of ED-based BI may mask its ability to improve alcohol-related outcomes in a subset of the population. Alternatively, interventions may need to be significantly improved in subsets of the ED population, e.g., in women and in men with involvement in violence.

AB - Background: The impact of gender and violence on brief interventions (BIs) for alcohol use in the emergency department (ED) has not been studied. Our objective was to examine the effectiveness of alcohol BIs in an ED population stratified by gender and violence. Methods: This was a secondary analysis of datasets pooled from three ED-based randomized controlled studies of alcohol BIs. AUDIT-C was the primary outcome measure; secondary outcomes were binge drinking and achievement of NIAAA safe drinking levels. We conducted univariate comparisons and developed generalized linear models (GLM) for the primary outcome and generalized estimating equation (GEE) models for secondary outcomes to examine the intervention effect on the whole study group, gender-stratified subgroups, and gender- and violence-stratified subgroups. Results: Of 1219 participants enrolled, 30% were female; 31% of women and 42% of men reported violence involvement at baseline. In univariate analysis, no differences in outcomes were found between intervention and control groups for any subgroup. However, in multivariable models, men demonstrated an intervention effect for likelihood of safe drinking limits. Stratifying further by violence, only men without violence involvement demonstrated a positive intervention effect for safe drinking limits. There was no evidence of an intervention effect on women. Conclusions: Analyzing the overall effect of ED-based BI may mask its ability to improve alcohol-related outcomes in a subset of the population. Alternatively, interventions may need to be significantly improved in subsets of the ED population, e.g., in women and in men with involvement in violence.

KW - Alcohol-related disorders

KW - Emergency medicine

KW - Gender

KW - Violence

UR - http://www.scopus.com/inward/record.url?scp=84870871869&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84870871869&partnerID=8YFLogxK

U2 - 10.1016/j.drugalcdep.2012.06.021

DO - 10.1016/j.drugalcdep.2012.06.021

M3 - Article

C2 - 22818512

AN - SCOPUS:84870871869

VL - 127

SP - 115

EP - 121

JO - Drug and Alcohol Dependence

JF - Drug and Alcohol Dependence

SN - 0376-8716

IS - 1-3

ER -