Adults between the ages of 20 to 50 years old use the emergency room more frequently than any other age group and account for more than 30 percent of all visits in a given year, and new research from the University of Pennsylvania School of Nursing has found that emergency department visits provide a window of opportunity for interventions meant to reduce both risky driving and hazardous drinking.
Researchers examined data from 834 young adults, defined as ages 18-44, that were admitted to the emergency room and determined that after interventions patients’ risky behavior significantly decreased for at least nine months.
“The risky driving behaviors that were significantly decreased at nine months in the intervention group included such lifesaving behaviors such as increased safety belt use, increased adherence to traffic signals, reduced speeding, and reduced driving after drinking,” said lead author Marilyn Sommers, PhD, RN, FAAN, Lillian S. Brunner Professor of Medical-Surgical Nursing at Penn Nursing. “The National Highway Traffic Safety Administration reports that safety belts save over 11,000 traffic deaths a year and conversely, running red lights cause up to 900 fatal crashes a year. Changing these behaviors has the potential for significant health benefits.”
Researchers considered hazardous drinking as alcohol consumption exceeding dietary guidelines for males up to 14 drinks per week and no more than four on drinking days, and for non-pregnant females up to seven drinks per week and more than three on drinking days. Risky driving behaviors, which account for nearly $40 billion or 17 percent of all economic costs from crashes, were considered driving 20 miles per hour over the speed limit, driving through a yellow light as it changed to red, and wearing a seat belt only some of the time or never.
Emergency room patients were randomized into three groups, brief interventions (BIG), contact-control (CCG), or no-contact-control groups (NCG). The BIG received a 20-minute assessment and two, 20 minute interventions, the CCG received a 20 minute assessment and no intervention, and the NCG had no assessment or intervention. Participants self-reported driving behaviors and alcohol consumption at three, six, nine, and 12 months.
“Our results support the efficacy of an emergency room intervention for risky driving up to nine months and for hazardous drinking up to six months in a population of non-alcohol dependent young adults who screen positive for both health-compromising behaviors,” said Dr. Sommers. “The recent decision by the Joint Commission to include screening and brief interventions related to alcohol use as one of its national hospital inpatient quality measures reflects the growing evidence that such interventions have a valuable role to play at the intersection of public health and clinical care.”
This research was funded by the Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. The findings were published in Alcoholism: Clinical and Experimental Research and Clinical Nursing Research.