Pediatrician Office Drug Prevention

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DESCRIPTION (provided by applicant): The proposed Phase I SBIR project will demonstrate the feasibility of developing a drug prevention module that can be hosted through pediatrician offices. The intervention will assist parents of adolescents (ages 11-15) prevent the onset of gateway drugs, including alcohol, tobacco, marijuana, and inhalants. The program will be hosted via CHADIS, a subscription web portal available to pediatrician offices. This module will include: (1) pre-visit screening surveys for both parents and their adolescent children; (2) data-driven risk diagnoses; (3) clinician-focused instructions for selecting risk-appropriate educationa materials for parents; and (4) parental education components. During Phase I, a prototype version of the diagnosis algorithm and prototypical parent education materials will be developed and pilot tested. The program will focus on 11 elements common to previously evaluated parenting programs for the prevention of drug use. These include helping parents provide appropriate discipline for misbehavior, establish boundaries for acceptable behavior and define restrictions for unacceptable behavior, attend to and reinforce positive behavior, effectively communicate prosocial norms, values and expectations, provide supervision, monitor friends, activities, and whereabouts, show warmth, give social support, build emotional attachments, share quality time together, and successfully resolve conflicts. The Phase I project will focus on completing five tasks. (1) We will develop a pre-visit assessment. A set of surveys will assess the risk-status of adolescents and understand the parenting strengths and weakness of parents. The survey will exclude from consideration those youth who have the need for clinical treatment for substance use disorders. Among those not excluded, the survey will then assess validated markers of a teen's risk for using gateway drugs. (2) We will use existing datasets to develop an actuarial risk algorithm to estimate an individual adolescent's risk for using each gateway drug using actuarial methods. The objective of these analyses is to accurately estimate the probability of future 30-day gateway drug use. (3) We will complete prototype intervention development. We will develop a new series of key activities that address each of the 11 common elements of family-based drug prevention. These will help parents improve their parenting attitudes and skills related to preventing drug use among their adolescents. (4) We will develop a prototype physician office protocol. This will allow pediatricians and support staff to be intermediaries in the delivery of the parenting intervention. (5) We will complete a feasibility study. The objective of this study will be to demonstrate that all elements function as designed, are capable of fulfilling their intended roles and are deemed acceptable. Participants will be 20 families whose adolescents are cared for by a pediatric practice. Adolescents and parents will be screened. Actuarial estimates of future drug use will be provided to the pediatric office. Pediatricians will prescribe the prevention program to parents who will collectively test al instructional components. Post intervention assessments gathered from parents, adolescents, physicians, and other staff will assess intervention functioning, usability, and acceptability.