The stages of change questionnaire as a predictor of trauma patients most likely to decrease alcohol use.

Area of Science:

• Trauma care
• Addiction medicine
• Behavioral science

Background:

• Negative consequences of drinking predict behavior change in trauma patients with positive blood alcohol levels.
• Previous research focused only on patients with detectable blood alcohol levels at admission.

Purpose of the Study:

• To determine if readiness to change, assessed by the Short Form Stages of Change (SFSC), predicts behavioral changes in alcohol consumption among all adult trauma patients.
• To extend previous findings by including patients regardless of their blood alcohol level at admission.

Main Methods:

• Adult trauma patients (≥18 years) admitted to a Level II trauma center were enrolled.
• Patients were screened for alcohol use (Alcohol Use Disorders Identification Test - AUDIT) and readiness to change (SFSC) within 2 days of discharge.
• Blood alcohol level (BAL) was measured, and patients were followed up 6–18 months post-discharge using the AUDIT; multiple regression analyzed SFSC's predictive ability.

Main Results:

• Of 146 enrolled patients, 57 had positive BALs, with 23% and 47% meeting AUDIT criteria for harmful and dependent drinking, respectively.
• Harmful or dependent drinking was identified in 11% of patients with undetectable BALs.
• The SFSC significantly predicted changes in drinking behavior at follow-up (p=0.05); greater readiness to change correlated with decreased consumption.

Conclusions:

• The SFSC is an effective tool for identifying trauma patients willing to change their drinking behavior.
• Administering the SFSC to all trauma patients and offering assistance to those ready to change may reduce problem alcohol use.