This report describes a project that sought to mitigate alcohol use among adolescents, noting its related violent behaviors and impacts on morbidity and mortality; the authors describe the study’s design, setting and population, and protocol, they provide a description of the SafERteens intervention program, along with a table of key program elements, and discuss the results.
For this study, the authors hypothesized that universal computer screening of teens in an inner-city emergency department (ED), followed by a brief intervention (BI), would be: feasible, as measured by participation and completion of BI during the ED visit, and well-received by teens, as measured by posttest process measures of intervention acceptability; and effective at changing known precursors to behavior change such as attitudes, self-efficacy, and readiness to change alcohol use and violence. The authors screened a total of 2,523 adolescent patients, ages 14–18 years, at an urban ED to complete a computerized survey, from September 2006 through November 2008. Adolescents reporting both alcohol use and violence in the past year were randomized to a control group, or a 35-minute BI delivered by a computer or therapist, as part of the SafERteens study. The authors administered validated measures, including demographics, alcohol use, attitudes toward alcohol and violence, self-efficacy for alcohol and violence, readiness to change alcohol and violence, and process questions, including likeability of intervention. At post-test, significant reductions in positive attitudes for alcohol use and violence and significant increases in self-efficacy related to alcohol/violence were found for both therapist and computer interventions. At the three-month follow-up there was 81 percent retention and generalized estimating equations (GEE) analysis showed that participants in both interventions had significant reductions in positive attitudes for alcohol use and violence, and significant increases in self-efficacy related to violence; alcohol self-efficacy improved in the therapist BI condition only. Readiness to change was not significantly improved. The authors conclude that their initial evaluation of the SafERteens study shows that universal computerized screening and BI for multiple risk behaviors among adolescents is feasible, well received, and effective at altering attitudes and self-efficacy. Publisher Abstract Provided