Adaptive interventions for alcohol misuse and violent behaviors among adolescents and emerging adults in the emergency department: Outcomes from a sequential multiple assignment randomized controlled trial

IF 3.9 2区医学 Q1 PSYCHIATRY

Drug and alcohol dependence Pub Date : 2025-02-21 DOI:10.1016/j.drugalcdep.2025.112615

Maureen A. Walton , Laura Seewald , Patrick M. Carter , Quyen Ngo , Frederic C. Blow , Carrie Bourque , Claire Pearson , Katherine A. Battisti , Larry An , Mari Wank , Yanruyu Zhu , Kelley M. Kidwell

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Abstract

Introduction

Harnessing technology for delivery of behavioral health interventions to reduce alcohol use and aggression may reduce morbidity among youth. This paper describes the outcomes from a sequential, multiple assignment, randomized trial (SMART) testing interventions for youth (ages 14–20) in the emergency department (ED).

Methods

Youth (n = 400) in the ED screening positive for binge drinking and aggression received the SafERteens brief intervention (BI) and were randomly assigned to boosters: Text Messages (TM) or Health Coach (HC) (1st stage; weeks 1–4). Participants completed 8 weekly surveys, with outcomes assessed at 4- and 8-months. After the 1st stage, response/non-response was determined (e.g., binge drinking or aggression). Responders were re-randomized to continued or minimized condition; non-responders were re-randomized to continued or intensified condition (2nd stage; weeks 5–8). Analyses examined outcomes from the initial randomization; and comparisons between responders and non-responders on primary (alcohol consumption, aggression), secondary (alcohol consequences, violence consequences) and exploratory (alcohol misuse, victimization, drug use, drug consequences) outcomes.

Results

There were no significant differences in outcomes between 1st stage boosters or 2nd stage boosters for non-responder or responder groups. However, significant changes over time were observed across all participants, with the odds of abstaining from alcohol increased at 4 (OR 3.97, 95 % CI 2.46–6.41) and 8-months (OR 4.36, 95 % CI 2.11–9.02), while the odds of aggression (OR 0.39, 95 % CI 0.16–0.94) decreased at 8-months; significant decreases were also observed for other outcomes.

Conclusions

Findings support the promise of digital health interventions for youth with binge drinking and aggression.

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来源期刊

Drug and alcohol dependence 医学-精神病学

CiteScore

7.40

自引率

7.10%

发文量

409

审稿时长

41 days

期刊介绍： Drug and Alcohol Dependence is an international journal devoted to publishing original research, scholarly reviews, commentaries, and policy analyses in the area of drug, alcohol and tobacco use and dependence. Articles range from studies of the chemistry of substances of abuse, their actions at molecular and cellular sites, in vitro and in vivo investigations of their biochemical, pharmacological and behavioural actions, laboratory-based and clinical research in humans, substance abuse treatment and prevention research, and studies employing methods from epidemiology, sociology, and economics.