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: 7225793
• 负责人: JOHN R KNIGHT
• 金额: $ 29.95万
• 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/7225793
• 关键词: Czech Republic; 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）： 本申请是针对 RFA-DA-04-006“初级保健机构中青少年的筛查和干预”而提交给 NIDA 的，并提议对初级保健办公室针对青少年药物滥用的干预进行对照试验，其中包括计算机化筛选、简短的提供者建议以及家长和青少年教育。药物的使用与各种医疗保健问题相关，这使得青少年接受常规医疗保健的环境非常适合实施常规筛查和早期干预。然而，目前在这方面的医疗环境尚未得到充分利用，需要新的循证策略来改善实践模式，包括标准化的筛查、评估、简短干预和转诊治疗方法。我们之前进行过研究，旨在评估为青少年服务的初级保健机构中药物滥用筛查测试的可靠性。然后，我们开发了一种新的简短屏幕 CRAFFT，它既适合青少年的发育，又适合在繁忙的诊所环境中使用。我们目前正在新英格兰的初级保健中心网络中开展一项 CRAFFT 测试筛查实施情况的研究，其中包括青少年诊所、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，我们开发并试点测试了计算机化的 CRAFFT 筛查程序，该程序将根据青少年的物质使用参与水平提供青少年反馈和提供者提示。我们研究的下一个逻辑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对全面筛查和简短建议方法进行有效性试验。拟议研究的第一年将用于“淘汰”我们当前的筛选研究、制作适用于繁忙办公室的演示视频和提供者培训协议，以及与家长和青少年进行焦点小组讨论。在第 2-4 年期间，我们将使用预测后测控制实验设计来测试该方法的有效性。实验组和对照组将在所有参与地点按顺序招募。预测试将在年度健康护理访视时进行，后测试观察结果将在进入研究后 3 个月和 12 个月时获得。我们将通过测量使用者戒断物质使用率的组间差异以及非使用者开始物质使用的差异来评估结果。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。有效的简短干预措施可以在为青少年提供服务的初级保健实践中广泛实施，并将对美国各地的公共卫生产生巨大的意义。