Screening and Brief Advice to Reduce Teen Substance Use

减少青少年药物使用的筛查和简短建议

• 批准号: 6860548
• 负责人: JOHN R KNIGHT
• 金额: $ 69.66万
• 依托单位: BOSTON CHILDREN'S HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-09-30 至 2009-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6860548
• 关键词: adolescence (12-20); behavioral /social science research tag; computer program /software; cost effectiveness; counseling; driving while intoxicated; drug abuse education; educational resource design /development; health services research tag; human subject; managed care; parent offspring interaction; primary care physician; questionnaires; substance abuse related disorder; training; videotape /videodisc

DESCRIPTION (provided by applicant): This application is submitted to NIDA in response to RFA-DA-04-006, Screening and Intervention for Youth in Primary Care Settings, and proposes a controlled trial of an primary care office intervention for adolescent substance abuse that includes computerized screening, brief provider advice, and parent and adolescent education. Use of drugs is associated with a variety of health care problems, making settings where adolescents receive routine medical care ideal for implementation of routine screening and early intervention. However, medical settings are currently underutilized in this regard and new evidence-based strategies are needed to improve practice patterns, including standardized methods of screening, assessment, brief intervention, and referral to treatment. We have previously conducted studies aimed at assessing the reliability of substance abuse screening tests in primary care settings that serve adolescents. We then developed a new brief screen, the CRAFFT, which is both developmentally appropriate for adolescents and practical for use in busy clinic settings. We are currently conducting a study of screening implementation with the CRAFFT test in a network of primary care sites in New England that includes an adolescent clinic, pediatric practices, family practices, and school-based health centers. As part of this study we have developed and pilot tested a computerized CRAFFT screening program, which will deliver adolescent feedback and provider prompts that are tailored to the adolescent's level of substance use involvement. The next logical steps in our research are to develop a demonstration video and provider training protocol, supplementary parent and adolescent education materials, and then to conduct an efficacy trial of the comprehensive screening and brief advice approach within our practice-based research network. Year one of the proposed study will be used for "wash out" of our current screening study, production of a demonstration video and provider training protocol that are practical for busy offices, and conducting focus groups with parents and adolescents. During years 2-4 we will test the efficacy of the approach using a pretest posttest controlled experimental design. The experimental and control cohorts will be recruited sequentially at all participating sites. Pretests will be given at the time of the annual well care visit, and posttest observations will be obtained at 3-months and 12-months following study entry. We will assess outcome by measuring between-groups differences in rates of substance use cessation among users, and differences in substance use initiation among non-users. We will also track primary care provider's management strategies and adolescents' adherence with follow-up appointments. An effective brief intervention could be widely implemented in primary care practices that serve adolescents, and would be of enormous public health significance across the U.S.

描述（由申请人提供）： 本申请提交给NIDA，以回应RFA-DA-04-006，初级保健环境中青少年的筛查和干预，并提出了一项初级保健办公室干预青少年药物滥用的对照试验，包括计算机化筛查，简短的提供者建议，以及父母和青少年教育。药物的使用与各种卫生保健问题有关，使青少年接受常规医疗护理的环境成为实施常规筛查和早期干预的理想场所。然而，目前在这方面，医疗环境利用不足，需要新的循证战略来改善实践模式，包括标准化的筛查、评估、简短干预和转诊治疗方法。我们以前进行的研究，旨在评估在初级保健机构，为青少年提供服务的药物滥用筛查测试的可靠性。然后，我们开发了一个新的简短的屏幕，CRAFFT，这是既适合青少年的发展和实用的忙碌诊所设置使用。我们目前正在新英格兰的一个初级保健中心网络中进行一项CRAFFT测试筛查实施研究，该网络包括青少年诊所、儿科诊所、家庭诊所和学校健康中心。作为这项研究的一部分，我们已经开发和试点测试的计算机CRAFFT筛选程序，这将提供青少年的反馈和供应商提示，是针对青少年的物质使用参与的水平。我们研究的下一个合乎逻辑的步骤是开发演示视频和提供者培训协议，补充家长和青少年教育材料，然后在我们基于实践的研究网络内进行全面筛查和简要建议方法的有效性试验。拟议研究的第一年将用于“清洗”我们目前的筛查研究，制作演示视频和提供者培训协议，这对忙碌的办公室是实用的，并与家长和青少年进行焦点小组。在第2-4年期间，我们将使用前测后测对照实验设计来测试该方法的有效性。将在所有参与研究中心按顺序招募实验和对照队列。将在年度良好护理访视时进行预测试，并在研究入组后3个月和12个月获得测试后观察结果。我们将通过测量使用者之间物质使用停止率的组间差异以及非使用者之间物质使用开始的差异来评估结果。我们还将跟踪初级保健提供者的管理策略和青少年对后续预约的遵守情况。有效的短暂干预可以在为青少年服务的初级保健实践中广泛实施，并将在美国各地具有巨大的公共卫生意义。