Computer-facilitated Screening and Brief Intervention in pediatric primary care to reduce underage drinking: a large multi-site randomized trial (ADMIN SUPP: Special Interest)

儿科初级保健中计算机辅助筛查和简短干预以减少未成年人饮酒：一项大型多中心随机试验（ADMIN SUPP：特别兴趣）

• 批准号: 10675332
• 负责人: Sion Kim Harris
• 金额: $ 28.43万
• 依托单位: BOSTON CHILDREN'S HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-04-10 至 2025-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10675332
• 关键词: Academy; Accounting; Address; Administrative Supplement; Adolescent; Age; American; Behavior; Childhood; Clinic; Communities; Computers; Early Diagnosis; Enrollment; Environment; Goals; Impairment; Intervention; Language; Light; Measures; Modification; Outcome; Parents; Patients; Pediatric Research; Pediatrics; Primary Health Care; Procedures; Randomized; Randomized Controlled Trials; Reporting; Research; Research Personnel; Risk; Sex Orientation; Sexual and Gender Minorities; Site; Social support; Substance Use Disorder; System; Testing; Visit; adolescent health; alcohol misuse; base; binge drinking; bullying; design; driving safety; effectiveness testing; health disparity; impaired driving performance; improved; interest; minority children; parent grant; peer; practice-based research network; primary care setting; randomized trial; recruit; research study; school environment; screening and brief intervention; sexual role; social health determinants; social influence; substance use; substance use prevention; transgender; treatment arm; treatment as usual; underage drinking reduction

PROJECT SUMMARY/ABSTRACT This is an administrative supplement in support of the parent grant (5R01AA027253), which allows modifications to be made to the study materials and procedures to address considerations for minoritized adolescent health disparities and the influences of social determinants of health on our study aims. The goal of the parent grant is to test the effectiveness of a promising computer-facilitated adolescent Screening and Brief Intervention (cSBI) system for delivery by pediatric primary care clinicians in a cluster-randomized controlled trial of patients ages 14-17 years with an upcoming annual well-visit who report unhealthy alcohol use or having ridden with an impaired driver in the past 12 months. Up to 40 pediatric primary clinicians across up to 10 practices are being recruited and randomized into either a Usual care or cSBI arm, and we expect at least 1,300 of their eligible patients will be enrolled. The parent study primary aims are to test the effect of cSBI on adolescents’ risk of heavy episodic drinking and on riding with an impaired driver/driving while impaired in the past 12 months. This trial is being conducted in the American Academy of Pediatrics’ Pediatric Research in Office Settings (PROS) national practice-based research network. This study is one of the largest pediatric trials to date of substance use screening and brief intervention in primary care settings. In this supplement, we seek to enhance understanding of disparities in substance use-related risk among adolescents who are sexual and gender minority (SGM). SGM adolescents are at greater risk of unhealthy substance use behaviors and substance use disorders compared to their non-SGM peers. Nonetheless, SGM adolescents have been underrepresented in primary care-based screening and brief intervention research studies aimed at early detection and prevention of substance use. Collaborating with researchers who have SGM expertise and with a community advisory board, we will develop recruitment materials that appeal to SGM adolescents in general pediatric clinic settings, as well as clinician guidance on SGM-friendly language and environment to enhance inclusion of SGM adolescents in the trial. We will add measures of sexual orientation and transgender status to more accurately identify SGM adolescents, and several measures accounting for social determinants of health that influence substance use risk (e.g., bullying, social support, school environment). The goal of adding these measures is to shed light on the role of SGM status and SGM-relevant social determinants of health exposure on substance use risk among adolescents in our study.

项目概要/摘要 这是支持家长补助金 (5R01AA027253) 的行政补充，允许 对研究材料和程序进行修改，以解决少数群体的考虑 青少年健康差异以及健康的社会决定因素对我们研究目标的影响。目标是 家长补助金用于测试一项有前途的计算机辅助青少年筛查和简介的有效性 儿科初级保健临床医生在整群随机对照中实施的干预 (cSBI) 系统 对年龄为 14-17 岁且即将进行年度健康访问的患者进行的试验，这些患者报告了不健康的饮酒行为或 在过去 12 个月内曾与不清醒的驾驶员一起骑行。多达 40 名儿科初级临床医生 正在招募 10 家诊所并随机分配到常规护理或 cSBI 部门，我们预计至少 1,300 名符合条件的患者将被纳入其中。家长研究的主要目的是测试 cSBI 对 青少年偶尔酗酒以及与不清醒的驾驶员一起骑行/在不清醒的情况下驾驶的风险 过去 12 个月。该试验正在美国儿科学会儿科研究中心进行 办公室设置（PROS）国家基于实践的研究网络。这项研究是最大规模的儿科研究之一 迄今为止在初级保健机构中进行的物质使用筛查和简短干预的试验。在本补充中，我们 寻求加强对有性行为的青少年中物质使用相关风险差异的了解 和性别少数群体（SGM）。 SGM 青少年有更大的不健康物质使用行为风险 与非 SGM 同伴相比，物质使用障碍。尽管如此，SGM的青少年们还是 在基于初级保健的筛查和旨在早期诊断的简短干预研究中代表性不足 检测和预防物质使用。与拥有 SGM 专业知识的研究人员合作 一个社区咨询委员会，我们将开发对SGM青少年普遍有吸引力的招聘材料 儿科诊所设置，以及临床医生对 SGM 友好语言和环境的指导，以增强 将 SGM 青少年纳入试验。我们将添加性取向和变性身份的衡量标准 更准确地识别SGM青少年，以及考虑健康社会决定因素的多项措施 影响物质使用风险的因素（例如欺凌、社会支持、学校环境）。添加这些的目的 措施的目的是阐明 SGM 状态的作用以及与 SGM 相关的健康暴露社会决定因素 我们的研究中青少年物质使用风险。