# Improving Outcomes for Emergency Department Patients with Alcohol Problems

> **NIH VA I01** · VETERANS HEALTH ADMINISTRATION · 2022 · —

## Abstract

Anticipated Impacts on Veteran's Health: The availability of VHA ED care has expanded rapidly over the past
decade. VHA Emergency Department (ED) often serves as a first stop for Veterans who are experiencing
acute problems related to hazardous alcohol use and mental health problems. Many Veterans seen in VHA
EDs report hazardous drinking that is either tied directly to their presenting problem or complicates the care of
medical and/or psychiatric symptoms. Hazardous drinking is directly related to high volume and high morbidity
problems in Veterans, including PTSD, suicidality and homelessness. Providing alcohol brief interventions in
this fast-paced environment can be difficult due to competing staff time demands. Expanding the role of peer
mentors used in the VHA to providing brief alcohol advice in the ED combined with post-ED continuing support
designed to reduce hazardous drinking and help Veterans engage in care has the potential to fill this gap in ED
care and improve outcomes for a vulnerable population. Project Background: Research indicates that a high
proportion of patients seen in EDs have hazardous or harmful alcohol use. Due to limited provider time to
screen for alcohol and deliver alcohol-related services in EDs, few individuals currently receive the needed
assistance to cut-back, stop drinking, and/or link to needed services following an ED visit. Single-session
alcohol brief interventions (BIs) alone are only modestly effective in the ED and thus more intensive, but
sustainable, interventions are needed to facilitate engagement to the most appropriate VHA resource (e.g.,
substance abuse treatment, homeless program case management, embedded mental health in primary care,
etc.). The VHA nationally has implemented the use of trained peer specialists in a number of areas. VHA EDs
have the opportunity to use peer specialists to conduct standardized alcohol brief interventions, provide
continuing support, and link Veterans to needed services. The widespread availability of peers within health
care teams provides a potential method to overcome barriers for connecting Veterans with hazardous/harmful
alcohol use to needed VHA services. Project Objectives: The objective of this proposed study is to conduct a
hybrid randomized controlled trial to determine the efficacy of an intervention starting in the ED with peer-
delivered brief alcohol advice (including a 6-session program of post-ED strengths-based peer mentorship)
compared to clinician-delivered brief advice in the ED only to facilitate reductions in hazardous drinking, and
linkage and engagement in primary and/or specialty care. Aim 1: Determine the efficacy of the ED Alcohol
Peer Mentor (APM) intervention compared to Clinical Brief Advice (CBA) on subsequent AUDIT scores,
including quantity/frequency of alcohol use, binge drinking, and alcohol consequences at 3-, 6-, and 12-months
post-baseline. Aim 2: Determine the impact of the APM intervention on linkage to primary and special...

## Key facts

- **NIH application ID:** 10271303
- **Project number:** 5I01HX002326-04
- **Recipient organization:** VETERANS HEALTH ADMINISTRATION
- **Principal Investigator:** Frederic C Blow
- **Activity code:** I01 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2022
- **Award amount:** —
- **Award type:** 5
- **Project period:** 2018-06-01 → 2023-09-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10271303

## Citation

> US National Institutes of Health, RePORTER application 10271303, Improving Outcomes for Emergency Department Patients with Alcohol Problems (5I01HX002326-04). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10271303. Licensed CC0.

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