Greater readiness to cut down on drinking behaviors increases effects of a digital behavioral health intervention tool in reducing unhealthy alcohol use among Latino emergency department patients.

Abstract

Background: This study examined the association between readiness to change and reductions in unhealthy alcohol use among Latino adults in the emergency department (ED) who used the Automated Bilingual Computerized Alcohol Screening Intervention (AB-CASI), a digital behavioral health intervention tool.

Methods: The study included 310 self-identified US Latino ED patients with unhealthy drinking. The primary independent variable was baseline readiness to reduce alcohol consumption. Outcomes included binge drinking episodes in the past 28 days and average weekly drinks, assessed at baseline and 1-, 6-, and 12-month follow-ups. Alcohol severity was measured via the Alcohol Use Disorders Identification Test scores, with gender and language preference (English vs Spanish) as covariates. Generalized linear mixed models in SAS accounted for within-subject variability across time points for analysis.

Results: Binge drinking ratios comparing those "more ready" to cut down to those "less ready" were 0.61 at 1 month [95% confidence interval (CI): 0.42, 0.90; P = .013], 0.46 at 6 months (95% CI: 0.31, 0.69; P < .0001), and 0.61 at 12 months (95% CI: 0.41, 0.89; P = .011). Weekly drinks ratios were 0.60 at 1 month (95% CI: 0.40, 0.90; P = .001), 0.45 at 6 months (95% CI: 0.29, 0.71; P < .0001), and 0.63 at 12 months (95% CI: 0.41, 0.97; P = .006).

Conclusion: In the original AB-CASI clinical trial, Latino ED patients more ready to reduce alcohol intake showed significant decreases in drinking after the intervention. This highlights the importance of readiness-to-change models in alcohol interventions for vulnerable ED populations. AB-CASI's bilingual, culturally sensitive design effectively promotes behavioral health, supporting both English- and Spanish-speaking patients in reducing unhealthy drinking behaviors.