Objective. To evaluate the effect of an Emergency Department (ED) based, educational intervention for at-risk health behaviors. Methods. A randomized trial over a one-year period. African American women, aged 21–55, presenting to the ED waiting room were eligible. Each participant took a computer-based survey on health risk behaviors. Participants who screened positive on any of four validated scales (for IPV, nicotine, alcohol, or drug dependence) were randomized to standard information about community resources (control) or to targeted educational handouts based upon their screening results (intervention). Participants were surveyed at 3 months regarding contacts with community resources and harm-reduction actions. Results. 610 women were initially surveyed; 326 screened positive (13.7% for IPV, 40.1% for nicotine addiction, 26.6% for alcohol abuse, and 14.4% for drug abuse). 157 women were randomized to intervention and 169 to control. Among women who completed follow-up ( ), women in the Intervention Group were significantly more likely to have contacted local resources (37% versus 9%, ) and were more likely to have taken risk-reducing action (97% versus 79%, ). Conclusion. Targeted, brief educational interventions may be an effective method for targeting risk behaviors among vulnerable ED populations. 1. Introduction Although African American women represent only 12.7% of women in the United States, they are disproportionately medically underserved [1]. For example, African American women are over 30% more likely than white women to die of cancer [2], and low-income African American women are more likely than higher income or nonminority women to report that they lack health insurance or a regular provider and were less likely to report that they had been given appropriate health risk counseling when seeing health care providers [3]. Over the past two decades the African American-Caucasian gap has not narrowed with respect to access to and use of health services [4]. Emergency departments (EDs) are used for medical treatment by those with limited access to care, including low-income people of color, and thus are an opportune place to focus on interventions and referrals for public health issues such as violence and substance use. African American women are at higher risk than women from other demographic groups for many health-related risk factors, including intimate partner violence (IPV) victimization [5], as well as alcohol, drug, and nicotine dependence. While IPV is of concern among all ethnic groups, research suggests that African American
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