Screening for Youth Alcohol and Drug Use: A Study of Primary Care Providers

描述（由申请人提供）：本申请响应国家酒精滥用和酒精中毒研究所的计划公告PA-05-139关于预防和治疗药物和酒精滥用的卫生服务研究，其目标是了解“影响酒精或药物滥用预防，治疗和相关服务的提供的因素：社会因素、个人行为和属性、融资、组织、管理;以及卫生技术。“特别是，我们专注于扩大初级保健在预防和治疗酒精和其他药物（AOD）问题方面的作用。我们解决差距的激励措施和障碍的研究，青少年初级保健提供者，使AOD使用卫生保健的优先事项。我们的目标是确定与筛查实践和管理青年AOD使用相关的因素，以便将这些活动更充分地融入初级保健。我们有机会在一个大型的、异构的管理式医疗保健计划中研究这一点。我们使用一个模型，探讨供应商，面板/病人和组织特征对初级保健筛查和后续服务的影响。我们提出了一个在线调查的初级保健提供者与青少年小组调查他们的AOD筛查的做法，和他们的看法的障碍和有利因素，筛选和后续干预。这项研究利用了提供者自我报告和健康计划电子数据库的筛查行为，提供者和面板的特点。我们还使用健康计划的电子病历和其他自动化数据库来检查报告和实际的筛查率，以及在确定使用AOD后的提供者做法。我们收集了该地区48家工厂的组织特征数据。我们的多变量分析模型检查设施的筛查率的差异，并考虑到设施内的提供者的集群。我们还建议与卫生计划管理人员和儿科部门负责人进行访谈，以探讨影响筛查实践发展和传播的政策和程序。识别障碍和激励措施，以筛选和管理的AOD问题，可以提高整合的AOD识别和服务的初级保健。早期识别AOD问题可以防止医疗，化学依赖和精神问题的发展。

DESCRIPTION (provided by applicant): This application responds to the National Institute on Alcohol Abuse and Alcoholism's Program Announcement PA-05-139 Health Services Research on the Prevention and Treatment of Drug and Alcohol Abuse, and its goal of understanding "factors that affect the delivery of alcohol or drug abuse prevention, treatment, and related services: social factors, personal behaviors and attributes, financing, organization, management; and health technologies." In particular, we focus on expanding primary care's role in prevention and treatment of alcohol and other drug (AOD) problems. We address the gap in research on incentives and barriers for adolescent primary care providers to make AOD use a health care priority. Our aim is to identify the factors associated with screening practices and management of youth AOD use in order to integrate these activities more fully into primary care. We have the opportunity to study this in a large, heterogeneous managed care health plan. We use a model which examines the influence of provider, panel/patient and organizational characteristics on primary care screening and follow-up services. We propose an on-line survey of primary care providers with adolescent panels to investigate their AOD screening practices, and their perceptions of barriers and enabling factors to screening and follow-up interventions. The study makes use of both provider self-report and health plan electronic databases of screening behavior, and provider and panel characteristics. We also use the health plan's electronic medical record and other automated databases to examine reported and actual screening rates, as well as provider practices after the identification of AOD use. We collect data on organizational characteristics across the region's 48 facilities. Our multivariate analytic model examines facility differences in screening rates and accounts for the clustering of providers within facilities as appropriate. We also propose to conduct interviews with health plan administrators and chiefs, of pediatrics departments to explore policies and procedures as they impact development and dissemination of screening practices. Identifying barriers and incentives to screening and management of AOD problems can heighten integration of AOD identification and services within primary care. Early identification of AOD problems can prevent the development of medical, chemical dependency, and psychiatric problems.