Date of Award

5-2017

Document Type

Dissertation

Degree Name

Doctor of Psychology (PsyD)

Department

Graduate Department of Clinical Psychology

First Advisor

Mary Peterson, Ph.D.

Second Advisor

Jeri Turgesen, Psy.D.

Third Advisor

Jory Smith, Psy.D.

Abstract

The negative impact of alcohol on an individual’s social, psychological, and physiological health is well known. Despite this knowledge, it remains a prevalent problem in our society. Residents of rural communities encounter a wide range of risk factors including poverty, unemployment, and limited access to healthcare. These factors can influence both the prevalence and treatment for alcohol use disorders. With limited access to medical resources, the Emergency Department (ED) can become the default provider for problems related to alcohol use. The reported prevalence of alcohol-related problems in the ED varies widely from an estimated 2% to 40% of all visits. Despite this, there is limited use of standardized populationhealth screeners, which highlights the need for an ED to determine the true prevalence of the problem before developing and implementing the continuum of care relative to substance use problems. The current study explored the prevalence of alcohol-related problems in a population of patients presenting to the ED of a rural general medical setting. It also explored variables differentiating a matched sample of patients presenting to the ED with and without identified alcohol use problems. The current study analyzed an archival data set of individuals (n = 5,450) admitted to an ED in rural Yamhill County, Oregon (population 100,725) during the year of 2015. The results of this study suggest that there was a statistically significant difference between average age, time spent in the emergency department, gender, and method of arrival. There was also found to be a significantly lower amount of people diagnosed with an alcoholrelated disorder in this particular rural emergency department setting compared to the national and regional average. Furthermore, despite no significant differences between groups in medical care utilization in 2015, there was a significant difference in utilization in 2016. With a proven need for alcohol interventions, the evident opportunity to reach and treat high-risk populations, and the empirically supported effectiveness of screening, brief interventions, and referrals to treatment suggest that rural emergency departments should take advantage of the unique opportunity to make a significant impact on a vulnerable and risky population.

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