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

项目摘要 最近尝试改善酒精使用（Au）和酒精的早期筛查和预防转诊（SRP） 全科医生检查、急诊室就诊和其他医疗服务期间的使用障碍（AUD） 一直是具有挑战性的，因为它们并不有效;它们的传播和采用 从业者一直很少;他们未能增加干预登记超过照顾照常， 最多也就15%相比之下，本项目中提出的工具和协议是专门为 筛查9-13岁儿童的Au风险;旨在预防或遏制高中前的任何物质使用; 与儿科医生合作开发，用于在他们的实践中进行健康儿童检查预约; 创建，以便它可以由其他医疗保健提供者，如行为专家或儿科 护士，而不仅仅是儿科医生;并导致超过80%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（其中90%以上的人完成了 干预）。在基础研究中开发的SRP协议解决了以下方面的历史障碍： 儿科医生使用针对Au的筛查工具，在儿童、家长和 儿科医护人员。本第1阶段提案和计划的第2阶段活动将为SRP做好准备， 与儿科医生合作实现商业化（在俄亥俄州克利夫兰市的城市实践中工作， 希尔，北卡罗来纳州，和迈阿密，佛罗里达）谁代表预期的早期采用者。第一个目标是编辑 并增强iRT现有的原生儿科筛查应用程序，以包括家长报告、家长评估风险 指数（PERI）和青年自我报告，青年风险指数（YRI），工具，使他们能够获得 在本机应用程序上完成（离线移动的设备，如没有互联网连接的平板电脑），以及 电子健康记录（EHR）。可用性研究以及可行性和 验收研究，将导致基准评估，以通知提交第二阶段的应用程序。如果 可行的，那么第二阶段的活动将包括创建“开箱即用”的技术解决方案， 可扩展和可访问，以用于忙碌的儿科实践。

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.