Patients, Clincs, and Systems: Screening for Alcohol Use

这一修订后的竞争性更新的中期职业生涯研究者奖在以患者为导向的研究是 提交的目的是为了巩固和扩大第一个奖项所取得的成就。作为 应审查委员会的要求，有关我的指导理念和学员的更多信息， 包括.续约将支持我的目标，为以病人为导向的酒精做出重大贡献 研究，特别侧重于妇女的健康，并继续作为下一代的教师， 临床研究者在指导方面，我想继续我的个人指导， 活动，同时还领导了医院范围内的跨学科指导计划的发展， 临床研究中心（CCI）的核心组成部分，我是那里的教育主任。在病人- 导向的研究，我提出的项目，“识别和修改酒精和物质的使用， 怀孕的青少年，”不仅将综合以前的临床研究中的几个富有成效的路线， 查明和减少怀孕期间饮酒的风险，以及采取动机干预措施， 这不仅涉及青少年吸毒问题，而且还涉及特别弱势群体的需要。发展 试点研究和最终的临床试验将为初级研究者提供充足的机会， 参加美国的青少年怀孕率是发达国家中最高的， 每年约有100万青少年怀孕。大多数青少年怀孕是 计划外的，往往比成年怀孕晚被发现。青少年健康风险行为，如 由于药物使用和性活动聚集在一起，构成了年轻人固有的生物风险， 产妇年龄和少女怀孕的不良社会后果。这项研究的目的是 双重：1）评估CRAFFT酒精和药物使用筛查工具在怀孕的青少年， 2)为了检验接受动机干预的受试者将表现出更大的 酒精和物质使用的减少比那些随机分配到注意力控制条件，包括 产前营养教育。拟议的研究地点是青年生殖健康服务中心， 在过去的二十年里，布里格姆妇女医院与儿童医院合作， 每年为200名新患者提供服务。

This revised Competitive Renewal for the Midcareer Investigator Award in Patient-Oriented Research is being submitted to allow me to consolidate and extend the achievements realized with the first award. As requested by the Review Committee, more information about my mentoring philosophy and mentees is included. A renewal would support my goals to make a significant contribution to patient-oriented alcohol research with a particular focus on women's health, and to continue as a teacher of the next generation of clinical researchers. In mentoring, I would like to continue my otherwise unfunded individual mentoring activities, while also leading the development of a hospital-wide, interdisciplinary mentoring program as a core component of the Center for Clinical Investigation (CCI), where I am Director of Education. In patient- oriented research, my proposed project, "Identification and Modification of Alcohol and Substance Use by Pregnant Adolescents," will not only synthesize several fruitful lines of previous clinical research in the identification and reduction of risk drinking in pregnancy, and motivational interventions in reducing adolescent substance use, but also address the needs of a particularly vulnerable group. The development of a pilot study and eventual clinical trial will provide ample opportunities for junior investigators to participate. The rate of adolescent pregnancy in America is the highest among developed nations, with approximately 1 million teenagers becoming pregnant every year. Most of these adolescent pregnancies are unplanned, and tend to be recognized later than adult pregnancies. Adolescent health risk behaviors such as substance use and sexual activity cluster together, componding the biologic risk inherent in young maternal age and the adverse social consequences of adolescent pregnancy. The study's purpose is twofold: 1) to evaluate the CRAFFT alcohol and drug use screening instrument in pregnant adolescents, and 2) to test the hypothesis that those subjects receiving the motivational intervention will demonstrate greater reductions in alcohol and substance use than those randomized to the attention control condition, consisting of prenatal nutrition education. The proposed study site is the Young Adult Reproductive Health Service, run by the Brigham and Women's Hospital in conjunction with Children's Hospital for the past two decades, and serves 200 new patients annually.