Culturally Appropriate Brief Interventions in Routine Hospital Care for Facial Injury Patients at High-Risk of Alcohol Misuse

Introduction: The Northern Territory (NT) has the highest estimated rate of alcohol consumption per capita in Australia and high levels of hospitalisations related to drunken assault. Facial trauma is common in assault victims and the NT has the second highest rate of jawbone fractures in the world. Indigenous people are over represented in this patient group and it is therefore important to ensure brief interventions for alcohol use are culturally appropriate and offered as part of routine hospital care. Culturally adapted resources have been developed and tested (RCT) by the Aboriginal and Islander Mental health initiative (AIMhi) team at Menzies School of Health Research Building on the relationships and knowledge gained from a recent of an AOD intervention conducted with at risk-patients at the Royal Darwin Hospital, this study involves the implementation and direct transfer of research findings to clinical practice. 

Objective: This study aims to introduce screening, brief interventions and referrals for high-risk drinkers admitted to hospital with facial trauma using a collaborative approach to best practice pathway development, implementation and evaluation. It is predicted that a multifaceted approach to implementation of best practice will result in a marked change in clinical practice towards management of at risk drinkers. Secondary hypotheses will test the impact of the culturally adapted, strengths-based intervention on treatment outcomes for Indigenous clients and hospital recidivism. 

Methods: Study design is mixed methods; data collection involved a post workshop questionnaire, file audits of clinical records and key informant interviews. Key outcome measures include rates of screening, the provision of brief interventions and instances of internal/external referrals for patients identified to be at risk. Descriptive statistics and qualitative data will be grouped and analysed by theme and syinthathised using trangulation. 

Results: The study is currently in the data collection phase. Baseline file audits have been conducted and qualitative data is under perliminary analysis. 

Discussion: Providing evidence on the effectiveness of implementation strategies such as interactive staff workshops and pamphlet-based brief interventions for problem drinkers will inform future hospital-based injury prevention strategies.