Tailored Youth Drug Intervention in Primary Care

初级保健中量身定制的青少年药物干预

• 批准号: 6962150
• 负责人: Frederic C Blow
• 金额: $ 64.74万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-09-05 至 2010-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6962150
• 关键词: Cannabis; adolescence (12-20); age difference; alcoholism /alcohol abuse; behavior therapy; behavioral /social science research tag; child behavior; child mental disorders; clinical research; community health services; computer assisted patient care; drug abuse; drug abuse prevention; drug abuse therapy; gender difference; human subject; human therapy evaluation; longitudinal human study; marijuana abuse; medically underserved population; motivation; primary care physician; racial /ethnic difference; tobacco abuse

DESCRIPTION (provided by applicant): Preventing the initiation, and reducing the escalation of marijuana use among adolescents can have a major impact on the development of problem behaviors and health consequences in adulthood. The varying factors associated with initiation and escalation of marijuana use among adolescents (age 12-18) speaks to the importance of tailoring preventive approaches based on individual risk factors. Brief motivational interventions (BMI) have been demonstrated to be effective in reducing drug use (i.e., marijuana, alcohol, and tobacco) among adolescents and young adults. Typically, BMIs are delivered by a clinician; however, more recently, computers have been used successfully to deliver BMI in an interactive, graphically engaging format. The primary care setting represents an underutilized venue for prevention interventions addressing drug use/abuse among youth. This study will take place in three HRSA-funded Bureau of Primary Health Care community health clinics located in Flint, Michigan, a city with a diverse and medically under-served population. The purpose of this five-year study is to: (1) develop and refine promising, empirically-derived, BMI prevention/intervention modules delivered by a clinician or a computer to target marijuana use, and (2) test the effectiveness of BMI in preventing initiation/escalation of marijuana use among youth in community health clinics. The proposed BMI prevention/interventions are innovative because: a) they incorporate tailoring technology based on assessment of the adolescents' behaviors; and b) they incorporate prevention messages for those who have not initiated use, and intervention messages for those who are current users. This randomized controlled trial will screen 1,710 adolescents in primary care clinics over 30 months. A random sample of the approximately 70% who screen negative for past year marijuana use will be selected to participate in the study (n=450); all subjects who screen positive for past year use will be enrolled in the study (n=450). These 900 subjects will be stratified by gender, age, and past year marijuana use and randomized to one of three conditions: 1) computer-delivered brief motivational approach (BMI-C) (n=300; 150 non-users: prevention, 150 users: intervention); 2) therapist-delivered brief motivational approach (BMI-T) (n=300; 150 non-users, 150 users); or 3) a NIDA drug education booklet (DPB) (n=300; 150 non-users, 150 users). Primary outcomes will be evaluated at 3-, 6- and 12-months and include marijuana, alcohol, tobacco and other drug use. Key moderators of effectiveness will be examined, including behavioral intentions, self-efficacy, stage of change, school involvement, susceptibility to peer pressure, and potential health consequences (e.g., STD/HIV risk behaviors). This project will provide the critical first step toward the implementation of tailored marijuana prevention and intervention in primary care clinics.

描述（由申请人提供）： 防止启动，并减少青少年使用大麻使用的升级可能会对问题行为的发展和成年后的健康后果产生重大影响。与青少年使用大麻使用的起始和升级有关的因素（12-18岁）表明，基于个体危险因素调整预防方法的重要性。已证明简短的动机干预措施（BMI）可以有效地减少青少年和年轻人中的药物使用（即大麻，酒精和烟草）。通常，BMI由临床医生提供；但是，最近，计算机已成功地以一种交互式，图形引人入胜的格式传递BMI。初级保健环境代表了预防干预措施的未充分利用的场所，以解决青少年的药物使用/滥用。这项研究将在密歇根州弗林特市的三个HRSA资助的初级保健社区卫生诊所举行，该诊所位于密歇根州的弗林特，这是一个人口不足和医疗服务不足的城市。这项为期五年的研究的目的是：（1）开发和完善临床医生或计算机提供的有前途的，经验性的预防/干预模块以靶向大麻的使用，以及（2）测试BMI在社区健康临床中预防大麻中启动/升级大麻的有效性。拟议的BMI预防/干预措施具有创新性，因为：a）它们基于对青少年行为的评估而纳入裁缝技术； b）他们为尚未启动使用的人合并了预防消息，并为当前用户的人包含了干预消息。这项随机对照试验将在30个月内筛查初级保健诊所的1,710名青少年。将选择大约70％筛选过去一年大麻的筛查的随机样本将选择参加研究（n = 450）；筛选过去一年阳性的所有受试者将参加研究（n = 450）。这些900名受试者将按性别，年龄和过去一年的大麻使用进行分层，并随机分配到三个条件之一：1）计算机交付的简短动机方法（BMI-C）（n = 300; 150; 150个非用户：预防：150个用户：干预）； 2）治疗师提供简短的动机方法（BMI-T）（n = 300; 150个非用户，150位用户）；或3）NIDA药物教育手册（DPB）（n = 300; 150名非用户，150位用户）。主要结果将在3、6和12个月进行评估，包括大麻，酒精，烟草和其他药物使用。将检查有效性的关键主持人，包括行为意图，自我效能感，变革阶段，学校参与，对同伴压力的敏感性和潜在的健康后果（例如，性病/HIV风险行为）。该项目将为实施量身定制的大麻预防和初级保健诊所的干预提供至关重要的第一步。