Computerized alcohol screening for children and adolescents (cASCA) in primary ca

描述(由申请人提供)：该项目的目标是根据NIAAA的儿童和青少年酒精筛查指南，为初级保健办公室开发一个计算机化的筛查程序，并评估其在9至18岁的初级保健患者中的心理测量特性。有大量证据支持在成人初级保健患者中进行筛查和短暂干预的有效性，主要是在减少有害饮酒方面。然而，在接受初级医疗护理的青少年中进行酒精筛查和短暂干预的研究很少。该项目将根据NIAAA指南的两个具体年龄段的筛查问题，开发和验证新的儿童和青少年计算机化酒精筛查系统(CASCA)，并将CRAFFT和AUDIT作为二级风险和问题评估。我们将增加烟草筛查，因为烟草使用是美国癌症相关死亡的主要原因。该系统将生成一份提供者报告，其中包含筛查结果、风险级别以及推荐的简短建议、咨询或推荐策略。这个项目的具体目标是：1.评估任何一种疾病的敏感性、特异性、阳性预测值和阴性预测值 饮酒/饮酒天数“和”朋友“问题在确定时间线后续日历(TLFB)确定的过去一年的使用方面，以及在基线(标准效度)时，用于确定审计、CRAFFT和结构化精神诊断面谈(计算机化光盘IV，青年版)确定的任何问题使用、滥用或依赖。2.评估CASCA在测量饮酒频率类别和将患者划分为低、中、高风险类别方面的重测可靠性。3.评估“任何饮酒/饮酒天数”和“朋友”问题在预测饮酒、“狂欢”饮酒以及在12个月的随访中是否有任何问题的使用、滥用或依赖方面的预测有效性。4.评估CASCA的“任何饮酒/饮酒天数”项目在多大程度上预测了TLFB(任何使用和频率)衡量的药物使用风险，通过尼古丁成瘾清单(潜在尼古丁依赖筛查)衡量的烟草使用，通过青少年药物滥用筛查测试衡量的药物使用障碍，以及在基线和12个月的后续行动中通过青年盘预测量表衡量的预测其他精神健康问题的程度。5.比较不同亚组的CASCA的心理测量学特性，包括：年龄、性别、种族/民族、执业类型、提供者类型和患者风险(例如，有/没有朋友饮酒的人)；并在3个月、6个月、9个月和12个月的随访中探索CASCA系统对饮酒的可能影响。

DESCRIPTION (provided by applicant): The goal of this project is to develop a computerized screening program for primary care offices that is based on the NIAAA's Alcohol Screening Guide for Children and Adolescents and assess its psychometric properties among nine- to 18-yr-old primary care patients. There is substantial evidence supporting the effectiveness of screening and brief intervention among adult primary care patients, primarily in the reduction of harmful drinking. However, there have been few studies of alcohol screening and brief intervention conducted among adolescents receiving primary medical care. This project will develop and validate a new computerized Alcohol Screening for Children and Adolescents (cASCA) system based on the two age-specific screening questions of the NIAAA Guide and includes the CRAFFT and AUDIT as secondary risk and problem assessments. We will add tobacco screening, because tobacco use is the leading cause of cancer-related mortality in the US. The system will yield a provider report with the screening results, level of risk, and recommended brief advice, counseling, or referral strategies. The Specific Aims of this project are to: 1. Assess the sensitivity, specificity, positive and negative predictive values of the 'any drinking/number of drinking days' and 'friends' questions of the cASCA in identifying past-year use as determined by the Timeline Follow-Back Calendar (TLFB), and for identifying any problem use, abuse or dependence as determined by the AUDIT, CRAFFT and a structured psychiatric diagnostic interview (computerized DISC- IV, Youth Version) at baseline (criterion validity). 2. Assess the test-retest reliability of the cASCA in measuring drinking frequency categories and in classifying patients into Low, Medium and High risk categories. 3. Assess the predictive validity of the 'any drinking/number of drinking days' and 'friends' questions in predicting drinking, "binge" drinking, and any problem use, abuse or dependence at 12-mos follow-up. 4. Assess the degree to which the 'any drinking/number of drinking days' item of the cASCA predicts drug use risk as measured by the TLFB (any use and frequency), tobacco use as measured by the Hooked on Nicotine Checklist (screen for potential nicotine dependence), drug use disorders as measured by the Drug Abuse Screening Test for Adolescents, and the degree to which it predicts other mental health problems as measured by the Youth DISC Predictive Scales at baseline and 12-month follow-up. 5. Compare the psychometric properties of the cASCA across subgroups, including: age, gender, race/ethnicity, practice type, provider type, and patient risks (e.g., those with/without friends who drink); and explore the possible effects of the cASCA system on drinking at 3-, 6-, 9-, and 12-month follow-ups.