Accident and Emergency Department (AED)
The Accident and Emergency Department (AED) study also employs a cluster randomised and nested factorial design to test the impact and cost effectiveness of implementing three models of screening and brief intervention piloted in 9 AEDs in the same 3 regions as the PHC study. The study will compare three conditions: a control group receiving a patient information leaflet (PIL); AED staff trained to provide brief advice with hazardous and harmful drinkers attending AED plus PIL; and AED staff trained to screen and refer to an alcohol health worker who will carry out brief lifestyle counselling plus BA and PIL. The AED study will also compare targeted and universal screening approaches. However, due to the limited number of AEDs in the North East and the anticipated difficulties in finding 18 sites needed to have the same design as in the PHC study, a slightly different study design has been planned. Six AEDs across the 3 regions will be randomly allocated to universally screen, collect information about whether a patient would be part of a linked (targeted) presentation group and subsequently use statistical simulations to analyse the interactions and devise the optimal targeted screening strategy using these tools. Three further AEDs will be randomly allocated to carry out targeted screening using the Paddington Alcohol Test (PAT) which is the purpose and method the PAT was designed for. Thus we will be able to compare the efficacy of targeted and universal screening. 1179 subjects will be recruited (131 per AED). Study outcome measures will be the same as in the PHC study yielding important information on the effectiveness and cost effectiveness of different implementation approaches to guide implementation in AEDs nationally (ISRCTN93681536).