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

项目摘要/摘要 这是支持家长拨款(5R01AA027253)的行政补充，允许 将对研究材料和程序进行修改，以解决小型化的考虑因素 青少年健康差异和健康的社会决定因素对我们的研究目标的影响。的目标是 家长拨款是为了测试一种前景看好的计算机辅助青少年筛查的有效性，并简要介绍 儿科初级保健临床医生随机对照干预(CSBI)系统 对14-17岁的患者进行的试验，这些患者即将进行年度健康访问，报告不健康的饮酒或 在过去的12个月里和一名受损的司机一起骑车。多达40名儿科初级临床医生，分布在 正在招募10家诊所，并将其随机分配到常规CARE或cSBI分支机构，我们预计至少 他们的1300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 青少年间歇性大量饮酒的风险以及与受损的司机/驾驶一起骑车时的风险 过去12个月。这项试验是在#年美国儿科学会儿科研究中心进行的 办公室设置(PROS)全国实践为基础的研究网络。这项研究是世界上最大的儿科 到目前为止，在初级保健环境中进行药物使用筛查和短暂干预的试验。在本增刊中，我们 寻求加强对性行为青少年在物质使用相关风险方面的差异的了解 和性别少数群体(SGM)。SGM青少年更有可能出现不健康的物质使用行为 物质使用障碍与他们的非SGM同龄人相比。尽管如此，SGM青少年一直在 在以初级保健为基础的筛查和旨在早期干预的简短研究中代表性不足 物质使用的检测和预防。与具有SGM专业知识的研究人员和 作为一个社区咨询委员会，我们将开发面向SGM青少年的招募材料 儿科诊所设置，以及临床医生对SGM友好的语言和环境的指导，以加强 将SGM青少年纳入试验。我们将增加性取向和变性人状况的衡量标准 更准确地识别SGM青少年，以及考虑到健康的社会决定因素的几项措施 影响物质使用风险的因素(例如，欺凌、社会支持、学校环境)。添加这些内容的目标是 所采取的措施是阐明SGM地位的作用和与SGM相关的健康暴露的社会决定因素 在我们的研究中，青少年的物质使用风险。

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.