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Evaluation of a Level I trauma center provider training in patient-centered alcohol brief interventions using the Behavior Change Counseling Index rated by standardized patients
  1. Doyanne Darnell,
  2. Lea Parker,
  3. Allison Engstrom,
  4. Dylan Fisher,
  5. Kaylie Diteman,
  6. Christopher Dunn
  1. Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, USA
  1. Correspondence to Dr Doyanne Darnell; darnelld{at}


Background Traumatic injury requiring hospitalization is common in the USA and frequently related to alcohol consumption. The American College of Surgeons requires that Level I and II verified trauma centers implement universal alcohol screening and brief intervention for injured patients. We examined whether Level I trauma center provider skill in patient-centered alcohol brief interventions improved after training and whether professional role (eg, nursing, social work) and education were associated with these skills.

Methods We present evaluation data collected as part of training in alcohol brief interventions embedded within a larger clinical trial of a collaborative care intervention targeting posttraumatic stress disorder and related comorbidities. Sixty-five providers from 25 US Level I trauma centers engaged in a 1-day workshop, with 2 hours dedicated to training in patient-centered alcohol brief interventions followed by 6 months of weekly coaching in a collaborative care model. Providers completed standardized patient role-plays prior to and 6 months after the workshop training. The standardized patient actors rated provider quality of alcohol brief interventions immediately after each role-play using the Behavior Change Counseling Index (BECCI), a pragmatic measure designed to assess the quality of behavior change counseling, an adaptation of motivational interviewing suitable for brief healthcare consultations about behavior change.

Results Seventy-two percent of providers completed both standardized patient role-play assessments. A statistically significant improvement in overall BECCI scores (t(41)=−2.53, p=0.02, Cohen’s d=−0.39) was observed among those providers with available pre–post data. Provider professional role was associated with BECCI scores at pre-training (F(3, 58)=11.25, p<0.01) and post-training (F(3, 41)=8.10, p<0.01).

Discussion Findings underscore the need for training in patient-centered alcohol brief interventions and suggest that even a modest training helps providers engage in a more patient-centered way during a role-play assessment.

Level of evidence Level V, therapeutic/care management.

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  • Contributors DD designed the study, oversaw data collection, reviewed the literature, analyzed and interpreted the data, and drafted the article. LP engaged in data collection, data interpretation, and contributed to drafts of the article. AE engaged in data collection and provided critical reviews of the article. KD contributed to the literature review, data interpretation, and provided critical reviews of the article. DF contributed to data collection and provided critical reviews of the article. CD contributed to the design of the study, literature review, data interpretation, and provided critical reviews of the article.

  • Funding This study was supported in part by the National Institutes of Health (NIH) Common Fund and National Institute of Mental Health (NIMH), through cooperative agreements (U54 AT007748, 1UH2MH106338-01/4UH3MH106338-02) from the Office of Strategic Coordination within the Office of the NIH Director, and in part by NIMH UH3MH106338-03S1.

  • Disclaimer The content is solely the responsibility of the authors and does not necessarily represent the official views of NIH.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available on reasonable request.

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