Online System for Primary Care to Prevent and Address Teen Substance Use

Total Child Health, Inc., Baltimore MD

Investigators

Linked publications & trials

Abstract

Substance? ?Use? ?Project? ?Summary Substance? ?use? ?usually? ?(90%)? ?begins? ?during? ?adolescence,? ?causing? ?brain? ?and? ?liver? ?damage,? ?risky sexual? ?and? ?driving? ?behavior,? ?and? ?potentially? ?leading? ?to? ?addiction? ?therefore? ?prevention? ?and? ?early intervention? ?programs? ?targeting? ?teens? ?are? ?needed? ?to? ?prevent? ?this? ?morbidity,? ?gain? ?productive years? ?of? ?life? ?and? ?reduce? ?costs.? ?? ?This? ?proposal? ?presents? ?innovations? ?to? ?overcome? ?the? ?barriers? ?to effectively? ?addressing? ?teen? ?substance? ?use? ?during? ?primary? ?care? ?visits? ?through? ?further development? ?of? ?a? ?promising? ??c?omputerized? ?alcohol? ?and? ?substance? ?use? ?computerized? ??S?creening and? ?provider? ??B?rief? ??A?dvice? ?system? ?(cSBA)? ?and? ?integration? ?with? ?an? ?online? ??clinical? ?process support? ?system?? ?called? ?CHADIS.? ?? ?CHADIS? ?addresses? ?all? ?pediatric? ?screening? ?needs? ?and? ?is currently? ?widely? ?used? ?in? ?pediatric? ?practice? ?making? ?widespread? ?dissemination? ?of? ?a? ?CHADIS-cSBA module? ?immediately? ?feasible.? ?? ?? ?However,? ?because? ?of? ?limitations? ?related? ?to? ?time? ?and? ?training? ?the approach? ?of? ?motivational? ?interviewing? ?(MI),? ?with? ?strong? ?evidence? ?for? ?effecting? ?behavior? ?change in? ?substance? ?users,? ?was? ?not? ?a? ?part? ?of? ?cSBA.? ?? ?An? ?innovation? ?proposed? ?here? ?will? ?take? ?pre-visit? ?teen data? ?related? ?to? ?strengths? ?and? ?goals? ?and? ?acknowledged? ?reasons? ?for? ?usage? ?to? ?populate individualized? ??teleprompters?? ?accessible? ?at? ?the? ?moment? ?of? ?care? ?by? ?PCP?s? ?along? ?with? ?options? ?for sharing? ?graphical? ?representations? ?for? ?use? ?in? ?reinforcing? ?abstinence? ?or? ?motivate? ?discontinuing usage.? ?? ?In? ?addition,? ?the? ?prompts? ?for? ?discussion? ?of? ?teen? ?identified? ?strengths? ?and? ?goals? ?will? ?include wording? ?from? ?teen? ?studies? ?using? ??incremental? ?theory?(or? ?? ?the? ?belief? ?that? ?people? ?have? ?the potential? ?to? ?change),? ?which? ?has? ?shown? ?result? ?in? ?improvements? ?in? ?social? ?coping.? ?? ?CHADIS-cSBA will? ?also? ?provide? ?each? ?teen? ?a? ?confidential? ?individualized? ?portal? ?automatically? ?populated? ?with supports? ?for? ?their? ?endorsed? ?strengths? ?and? ?other? ?supports? ?as? ?well? ?as? ?substance-related? ?follow-up messaging.? ?? ?Post-visit? ?parent? ?education? ?will? ?include? ?access? ?to? ?a? ?Teen? ?Safe? ?course.? ?? ?Teens? ?found? ?to have? ?serious? ?substance? ?abuse? ?or? ?dual? ?diagnoses? ?will? ?have? ?referrals? ?facilitated? ?by? ?care coordination? ?functionality.? ?? ?PCP? ?participation? ?will? ?be? ?reinforced? ?by? ?a? ?American? ?Board? ?of Pediatrics? ?accredited? ?quality? ?improvement? ?program? ?for? ?their? ?required? ?re-certification? ?(MOC-4). In? ?Phase? ?1,? ?the? ?CHADIS-cSBA? ?module? ?will? ?be? ?created? ?with? ?both? ?professional? ?and? ?teen? ?feedback and? ?MOC-4? ?certification? ?obtained.? ?? ?In? ?Phase? ?2? ?the? ?resulting? ?system? ?will? ?be? ?piloted;? ?a? ?baseline? ?of substance? ?use? ?screening? ?conducted;? ?then? ?CHADIS-cSBA? ?module? ?will? ?be? ?randomly? ?assigned? ?to doctors? ?and? ?a? ?quality? ?improvement? ?intervention? ?will? ?be? ?conducted? ?to? ?measure? ?reduction? ?in? ?rates of? ?any? ?substance? ?use? ?at? ?3? ?and? ?12? ?month? ?follow-up? ?compared? ?to? ?treatment? ?as? ?usual.