This trial involved 726 American urban adolescents aged 14–18 years presenting to a level I emergency department (ED) between September 2006 and September 2009, who screened positive for both alcohol and violence and reported past-year alcohol use and aggression. Patients were randomised to a control group that received a brochure (n=235) or a 35-minute brief intervention delivered by either a computer (n=237) or therapist (n=254) in the ED. The brief intervention combined motivational interviewing with skills training, a review of goals, tailored feedback, decisional balance exercise, role plays, and referrals. At 3 months’ follow-up, compared with controls, participants in the therapist intervention showed self-reported reductions in the occurrence of peer aggression (therapist, –34.3%; control, –16.4%; relative risk [RR], 0.74), experience of peer violence (therapist, –10.4%; control, +4.7%; RR, 0.70), and violence consequences (therapist, –30.4%; control, –13.0%; RR, 0.76). At 6 months, participants in the therapist intervention showed self-reported reductions in alcohol consequences (therapist, –32.2%; control, –17.7%; OR, 0.56) compared with controls; participants in the computer intervention also showed self-reported reductions in alcohol consequences (computer, –29.1%; control, –17.7%; OR, 0.57).
