Well-Child Screening and Referral to Prevent Alcohol Use Before High School

项目摘要 最近改进酒精使用(AU)和酒精的早期筛查和转诊以预防(SRP)的努力 在全科医生检查、急诊室就诊和其他医疗服务中使用障碍(AUD) 一直具有挑战性，因为它们并不有效；它们的传播和通过 从业者一直很少；他们未能增加干预登记人数，而不是像往常一样护理， 最多也就是15%。相反，本项目中提出的工具和协议是专门为 对9-13岁儿童进行非典风险筛查；旨在预防或限制高中前任何药物的使用； 与儿科医生合作开发，用于在他们执业的健康儿童检查预约期间使用； 创建它以便可以由其他医疗保健提供者实施，如行为专家或儿科 护士，而不仅仅是儿科医生；并使80%以上的高危青少年的父母来自低资源， 城市社区参加以家庭为基础的预防干预措施(超过90%的人完成了 干预)。在基础研究中开发的SRP协议解决了以下历史障碍 儿科医生使用针对AU的筛查工具，并在儿童、父母和 儿科医护人员。此阶段1提案和计划的阶段2活动将为以下SRP做准备 与儿科医生合作实现商业化(在克利夫兰、俄亥俄州、查佩尔的城市诊所工作 北卡罗来纳州希尔和佛罗里达州迈阿密)，他们代表了预期的早期采用者。第一个目标是编辑 并增强了IRT现有的本地儿科筛查应用程序，以包括家长报告、家长评估风险 青年风险指数(PERI)和青年自我报告、青年风险指数(YRI)等工具，以便 完成本机应用程序(离线移动设备，如没有互联网连接的平板电脑)，以及 被集成到电子健康记录(EHR)中。可用性研究，以及可行性和 验收研究，将导致基准评估，以通知第二阶段申请的提交。如果 可行，那么第二阶段的活动将包括创建将是 可扩展和可访问，可用于繁忙的儿科实践。

Project Abstract Recent attempts to improve early screening and referral for prevention (SRP) of alcohol use (AU) and alcohol use disorders (AUD) during general practitioner check-ups, emergency room visits, and other medical services have been challenging, because they have not been efficacious; their dissemination and adoption by practitioners have been minimal; and they have failed to increase intervention enrollment over care-as-usual, which is 15% at best. In contrast, the tools and protocol proposed in this project were specifically designed for screening of risk for AU by 9-13 year-olds; designed to prevent or curb any substance use before high school; developed collaboratively with pediatricians for use during well-child, check-up appointments at their practices; created so it can be implemented by other health care providers such as behavior specialists or pediatric nurses, and not just by pediatricians; and has led over 80% of parents of high-risk youth from low-resource, urban communities to enroll into family-based preventive interventions (over 90% of whom completed the intervention). This SRP protocol developed in basic research studies addresses historical barriers to pediatricians’ use of screening tools that target AU, and has high acceptability among children, parents, and pediatric health care staff. This Phase 1 proposal and the planned Phase 2 activities will prepare the SRP for commercialization in collaboration with pediatricians (working in urban practices in Cleveland, Ohio, Chapel Hill, North Carolina, and Miami, Florida) who represent the anticipated early adopters. The first aim is to edit and enhance iRT’s existing native pediatric screening app to include the parent-report, Parent Evaluation Risk Index (PERI), and the youth self-report, Youth Risk Index (YRI), tools, so that they are accessible for completion on a native app (offline mobile devices such as tablets that do not have internet connectivity), and are integrated into an electronic health record (EHR). Both Usability Studies, as well as a Feasibility and Acceptance Study, will result in benchmark evaluations to inform the submission of a Phase 2 application. If feasible, then Phase 2 activities will include the creation of “out-of-the-box” technological solution that will be scalable and accessible for use in busy pediatric practices.