Preventing Harmful Alcohol Use Among Trauma Patients in Cameroon

\*\*Brief Summary\*\* Alcohol use is a major contributor to injury burden in Cameroon, particularly among trauma patients presenting to emergency departments. Despite the strong association between alcohol use and injury, structured alcohol screening and intervention programs are not routinely integrated into trauma care in Cameroon. This study aims to evaluate a Cameroon-adapted Screening, Brief Intervention, and Referral to Treatment (SBIRT) program for trauma patients at the Limbe Regional Hospital. The study will be conducted in three phases: (1) training emergency department healthcare providers on a culturally adapted SBIRT program; (2) evaluating the feasibility, acceptability, and fidelity of SBIRT implementation in routine emergency care; and (3) assessing the effectiveness of SBIRT in reducing harmful alcohol use among trauma patients. Healthcare workers will be trained to deliver SBIRT, and eligible trauma patients screening positive for risky alcohol use will be enrolled in a randomized waitlist-controlled trial. Participants will undergo alcohol screening using validated tools and will be followed for six months. Outcomes will include alcohol use measured by the Alcohol Use Disorders Identification Test (AUDIT), phosphatidylethanol (PEth) biomarker levels, referral uptake, implementation outcomes, and patient well-being measures. The study is expected to generate evidence on the feasibility and effectiveness of integrating alcohol interventions into trauma care in a low-resource setting and inform future scale-up of SBIRT programs in Cameroon and similar settings.

Inclusion Criteria: * Adult trauma patients aged 18 years and older presenting to the Emergency Department of Limbe Regional Hospital. * Positive alcohol screening based on the Single Alcohol Screening Question (SASQ). * AUDIT-C score ≥4 for men or ≥3 for women. * Able to provide informed consent. * Resident within the study catchment area and available for follow-up. * Access to a telephone or another reliable means of contact for follow-up assessments. Exclusion Criteria: * Severe cognitive impairment preventing participation in study procedures or - provision of informed consent. * Severe traumatic brain injury or other medical condition requiring immediate life-saving intervention that precludes participation. * Current psychosis or severe psychiatric illness preventing meaningful participation in the intervention. * In police custody or other circumstances limiting ability to participate in follow-up. * Planned relocation outside the study catchment area during the study follow-up period. * Previously enrolled in the study.