Who benefits from brief motivational intervention among young adults presenting to the emergency department with alcohol intoxication: A latent-class moderation analysis

TY - JOUR

T1 - Who benefits from brief motivational intervention among young adults presenting to the emergency department with alcohol intoxication

T2 - A latent-class moderation analysis

AU - Gaume, Jacques

AU - Blanc, Stéphanie

AU - Magill, Molly

AU - McCambridge, Jim

AU - Bertholet, Nicolas

AU - Hugli, Olivier

AU - Daeppen, Jean Bernard

N1 - Funding Information: We gratefully thank Ms. Afroditi Kapsaridi and Dr. Sophie Mantzouranis-Baudat for their participation and insights in the preliminary analyses of this study, and Dr. Joseph Studer for his statistical support. Open access funding provided by Universite de Lausanne. Funding Information: This work was supported by the Swiss National Science Foundation (Grant 105319_163123) and the Swiss Foundation for Alcohol Research (Grant 318). Publisher Copyright: © 2023 The Authors. Alcohol: Clinical and Experimental Research published by Wiley Periodicals LLC on behalf of Research Society on Alcohol.

PY - 2023/8/1

Y1 - 2023/8/1

N2 - Background: Research has not identified which patients optimally benefit from brief Motivational Interviewing (bMI) for heavy drinking when delivered to young adults in the Emergency Department (ED). Methods: We conducted secondary analyses of data from a randomized controlled trial in which 344 young adults (18–35 years) presenting to the ED with alcohol intoxication received either bMI or Brief Advice (BA, control group). We used Latent Class Analysis to derive participants' profiles from baseline characteristics (i.e., sex, age, severity of alcohol use disorder, attribution of ED admission to alcohol use, importance, and confidence to change, cognitive discrepancy, anxiety, depression, and trait reactance). We then conducted a moderation analysis to assess the number of heavy drinking days at short-term (1-month) and long-term (12-month) follow-up using negative binomial regressions with interactions between the intervention and derived classes. Results: Fit statistics indicated that a 4-class solution best fit the data. Class 3 (high severity, importance and discrepancy, and low confidence and anxiety) benefitted more from bMI than BA at short- and long-term follow-up than Class 1 (younger; lowest severity, importance, discrepancy, reactance, anxiety and depression, and highest confidence). Class 2 (older; highest severity, importance, discrepancy, reactance, anxiety and depression, and lowest confidence) also benefitted more from bMI than BA than did Class 1 at short-term follow-up. In these significant contrasts, Class 1 benefitted more from BA than bMI. There were no significant interactions involving Class 4 (more likely to be women; low severity; high levels of anxiety, depression, and reactance). Conclusions: This study identified the patient profiles that benefitted more from bMI than BA among nontreatment-seeking young adults who present intoxicated to the ED. The findings have implications for intervention design and argue for the importance of research aimed at developing intervention content tailored to patient profiles.

AB - Background: Research has not identified which patients optimally benefit from brief Motivational Interviewing (bMI) for heavy drinking when delivered to young adults in the Emergency Department (ED). Methods: We conducted secondary analyses of data from a randomized controlled trial in which 344 young adults (18–35 years) presenting to the ED with alcohol intoxication received either bMI or Brief Advice (BA, control group). We used Latent Class Analysis to derive participants' profiles from baseline characteristics (i.e., sex, age, severity of alcohol use disorder, attribution of ED admission to alcohol use, importance, and confidence to change, cognitive discrepancy, anxiety, depression, and trait reactance). We then conducted a moderation analysis to assess the number of heavy drinking days at short-term (1-month) and long-term (12-month) follow-up using negative binomial regressions with interactions between the intervention and derived classes. Results: Fit statistics indicated that a 4-class solution best fit the data. Class 3 (high severity, importance and discrepancy, and low confidence and anxiety) benefitted more from bMI than BA at short- and long-term follow-up than Class 1 (younger; lowest severity, importance, discrepancy, reactance, anxiety and depression, and highest confidence). Class 2 (older; highest severity, importance, discrepancy, reactance, anxiety and depression, and lowest confidence) also benefitted more from bMI than BA than did Class 1 at short-term follow-up. In these significant contrasts, Class 1 benefitted more from BA than bMI. There were no significant interactions involving Class 4 (more likely to be women; low severity; high levels of anxiety, depression, and reactance). Conclusions: This study identified the patient profiles that benefitted more from bMI than BA among nontreatment-seeking young adults who present intoxicated to the ED. The findings have implications for intervention design and argue for the importance of research aimed at developing intervention content tailored to patient profiles.

KW - alcohol intoxication

KW - brief motivational interviewing

KW - emergency department

KW - latent class analysis

KW - moderation analysis

UR - http://www.scopus.com/inward/record.url?scp=85166430752&partnerID=8YFLogxK

U2 - 10.1111/acer.15128

DO - 10.1111/acer.15128

M3 - Article

AN - SCOPUS:85166430752

SN - 0145-6008

VL - 47

SP - 1614

EP - 1623

JO - Alcoholism-Clinical and experimental research

JF - Alcoholism-Clinical and experimental research

IS - 8

ER -