Brief Motivational Interviewing Intervention for Peer Violence and Alcohol Use in Teens: One-Year Follow-up

Departments of Emergency Medicine, University of Michigan, Ann Arbor, Michigan 48106-5570, USA.
PEDIATRICS (Impact Factor: 5.47). 05/2012; 129(6):1083-90. DOI: 10.1542/peds.2011-3419
Source: PubMed


Emergency department (ED) visits present an opportunity to deliver brief interventions (BIs) to reduce violence and alcohol misuse among urban adolescents at risk for future injury. Previous analyses demonstrated that a BI resulted in reductions in violence and alcohol consequences up to 6 months. This article describes findings examining the efficacy of BIs on peer violence and alcohol misuse at 12 months.
Patients (14-18 years of age) at an ED reporting past year alcohol use and aggression were enrolled in the randomized control trial, which included computerized assessment, random assignment to control group or BI delivered by a computer or therapist assisted by a computer. The main outcome measures (at baseline and 12 months) included violence (peer aggression, peer victimization, violence-related consequences) and alcohol (alcohol misuse, binge drinking, alcohol-related consequences).
A total of 3338 adolescents were screened (88% participation). Of those, 726 screened positive for violence and alcohol use and were randomly selected; 84% completed 12-month follow-up. In comparison with the control group, the therapist assisted by a computer group showed significant reductions in peer aggression (P < .01) and peer victimization (P < .05) at 12 months. BI and control groups did not differ on alcohol-related variables at 12 months.
Evaluation of the SafERteens intervention 1 year after an ED visit provides support for the efficacy of computer-assisted therapist brief intervention for reducing peer violence.

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    • "Similarly, of the 24 studies included in Foxcroft et al. for the analysis of alcohol problems, our recalculation showed that two studies changed the direction of SMDs: Larimer et al. (2001; reported SMD ϭ – 0.09 vs. our calculation ϭ 0.09) and Terlecki (2011 [indicated as " Terlecki, 2010a " volunteer students] reported SMD ϭ 0.11 vs. our calculation ϭ –0.29). In addition, for Cunningham et al. (2012), the direction of SMDs differed depending on the source of the data (i.e., 2 ϫ 2 outcome data or generalized estimating equation analysis, which treat missing data differently). Note also that sample size for studies was inconsistently coded in Foxcroft et al., which, consequently, affects SMD and SE calculation. "
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    ABSTRACT: Foxcroft, Coombes, Wood, Allen, and Almeida Santimano (2014) recently conducted a meta-analysis evaluating the effectiveness of motivational interviewing (MI) in reducing alcohol misuse for youth up to Age 25. They concluded that the overall effect sizes of MI in this population were too small to be clinically meaningful. The present article critically reviews the Foxcroft et al. meta-analysis, highlighting weaknesses such as problems with search strategies, flawed screening and reviews of full-text articles, incorrect data abstraction and coding, and, accordingly, improper effect size estimation. In addition, between-study heterogeneity and complex data structures were not thoughtfully considered or handled using best practices for meta-analysis. These limitations undermine the reported estimates and broad conclusion made by Foxcroft et al. about the lack of MI effectiveness for youth. We call for new evidence on this question from better-executed studies by independent researchers. Meta-analysis has many important utilities for translational research. When implemented well, the overall effectiveness, as well as different effectiveness for different populations, can be examined via meta-analysis. Emerging methods utilizing individual participant-level data, such as integrative data analysis, may be particularly helpful for identifying the sources of clinical and methodological heterogeneity that matter. The need to better understand the mechanisms of alcohol interventions has never been louder in the addiction field. Through more concerted efforts throughout all phases of generating evidence, we may achieve large-scale evidence that is efficient and robust and provides critical answers for the field. (PsycINFO Database Record (c) 2015 APA, all rights reserved).
    Psychology of Addictive Behaviors 08/2015; DOI:10.1037/adb0000100 · 2.09 Impact Factor
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    • "Although death is the most severe consequence of violence , and homicide is the leading cause of death among African American adolescents (CDC, 2009), nonfatal injuries are far more common. In 2011, more than 707,000 10-24 year olds in the United States were treated in emergency departments for injuries caused by violence (CDC, 2012) and the ED is increasingly recognized as an important contact location for youth at risk for future violent injury (Cunningham et al., 2012) In addition, a recent study among youth (Cunningham et al., 2006, Epstein-Ngo et al., 2012; White, Fite, PArdini, Mun, & Loeber, 2012,Walton et al., 2009). The National Survey on Drug Use and Health, for example, indicated that youth who used any illicit drug in the past year were almost twice as likely to have engaged in violence compared to youth who did not report use of illicit drugs (SAHMSA, 2006) In most instances, however, these studies indicated that the frequency of alcohol or drug use was correlated with the reported frequency of involvement in aggression during the same time period (e.g., past year). "
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    ABSTRACT: Background: While researchers have identified factors that contribute to youth violence, less is known about the details of violent incidents. In addition, substance use has been linked to youth violence; however, little is known about actual substance use on days in which violence occurs. Objective: This study examined reasons for peer violence and the association between substance use and violence using daily calendar-based analyses among at-risk urban youth. Methods: Data were collected from Emergency Department (ED) patients (ages 14–24; n = 599; 59% male, 65% African American) who screened positive for substance use in the past 6 months. Daily data regarding past 30-day substance use and violence and reasons for violent incidents were obtained via semi-structured interviews. Multi-level multinomial regression models were conducted to test the associations between substance use and peer violence incidents (i.e., none, moderate and severe). Results: Conflict over ‘personal belongings’ was a common reason for violence among males; ‘jealousy’/‘rumors’ were common reasons among females. Moderate victimization was more likely to be reported on days in which participants reported alcohol and cocaine use. Severe victimization was more likely to be reported on days in which participants reported alcohol use. Moderate or severe aggression was more likely to be reported on days in which participants reported alcohol and non-medical sedative use. Conclusions: Results suggest that youth violence prevention that addresses differential reasons for violence among males and females as well as substance use would be beneficial.
    Substance Use &amp Misuse 12/2014; 50(3). DOI:10.3109/10826084.2014.980953 · 1.23 Impact Factor
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    • "Two trials (Cunningham et al. 2012; Walton et al. 2014) directly compared a 35-minute therapist-delivered SBI and a selfguided computerized SBI provided to adolescent ED patients. Both modalities showed similar reductions in alcohol-related consequences and positive changes in psy­ chological precursors to behavior change compared with a standard-care control (Cunningham et al. 2012; Walton et al. 2014). Other studies and reviews comparing face-to-face and technology-facilitated SBIs outside medical settings find an edge for face-to-face (Carey et al. 2012; Donoghue et al. 2014 "
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    ABSTRACT: Alcohol is strongly linked to the leading causes of adoles-cent and adult mortality and health problems, making medical settings such as primary care and emergency departments important venues for addressing alcohol use. Extensive research evidence supports the effective-ness of alcohol screening and brief interventions (SBIs) in medical settings, but this valuable strategy remains underused, with medical staff citing lack of time and training as major implementation barriers. Technology-based tools may offer a way to improve efficiency and quality of SBI delivery in such settings. This review describes the latest research examining the feasibility and efficacy of computer- or other technology-based alcohol SBI tools in medical settings, as they relate to the following three patient populations: adults (18 years or older); pregnant women; and adolescents (17 years or younger).The small but growing evidence base generally shows strong feasibility and acceptability of technology-based SBI in medical settings. However, evidence for effectiveness in changing alcohol use is limited in this young field.
    Alcohol research : current reviews 09/2014; 36(1):63-79.
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