Screening and Brief Advice to Reduce Teen Substance Use
Condition: Substance Related Disorders
MeSH terms: Substance-Related Disorders
Study type: Interventional

Summary: 
      The purpose of this study is to test the effectiveness of a brief intervention for alcohol
      and drug use in adolescents that a primary care doctor can give in his/her office. The study
      will be conducted in nine primary care offices in three New England states, and in ten
      pediatric offices in Prague, Czech Republic (CZR).

      We hypothesize that:

        1. Among 12-18 year old well care patients who screen positive for drug/alcohol use, the
           experimental intervention administered by trained primary care providers will be more
           effective than standard care in decreasing drug and alcohol use;

        2. Among 12-18 year old well care patients who screen negative for drug/alcohol use, the
           experimental intervention administered by trained primary care providers will be more
           effective than standard care in decreasing initiation of drug and alcohol use as
           measured by self-reports of substance use;

        3. Among 12-18 year old well care patients who are at risk for riding with an impaired
           driver or driving while impaired, the experimental intervention administered by trained
           primary care providers will be more effective than standard care in decreasing
           Riding/Driving risk behavior as measured by a standardized scale.
    

Detailed description: 
      We are trying to find out the best way for doctors to talk with their adolescent patients
      about alcohol and drug use. Adolescents 12-18 who are coming to their doctor's office for a
      routine well-care or follow-up visit will be invited to participate in the study.
      Participants do not have to have ever used alcohol or drugs. All participants will answer a
      computerized questionnaire about alcohol and drug use three times. The first one will be at
      the time of a doctor's visit. The second time will be three months later and the third time a
      year later. Adolescents who agree to be in the study during the first year will be in the
      'control' group. Their doctor will talk to them about drugs and alcohol the same as he/she
      usually does for all his/her patients. Those who agree to be in the study during the second
      year will be in the 'intervention' group. Everyone in the 'intervention' group will receive
      some advice on the computer about their alcohol and drug use. Their doctor will also give
      them some specific advice about drug and alcohol use. The researchers have chosen what that
      advice will be, and all doctors involved in the study will give advice according to the study
      protocol. Participants and their parents will also be given educational information about
      alcohol and drugs. We will test the effectiveness of the intervention by comparing drug and
      alcohol use between those who are in the 'control' group, and those who are in the
      'intervention' group.

      We we will also validate the Czech version of the CRAFFT screen before conducting the
      effectiveness trial outlined above in the Czech Republic.
    

Intervention name(s): cSBA - New England, USA; cSBA - Prague, CZR
Intervention type(s): Behavioral; Behavioral
Intervention description(s): Participants who are in the experimental arm will complete the CRAFFT screen on the computer and receive information on the computer regarding the health effects of substance use. Their provider will be given the results of their CRAFFT screen and a list of suggested "talking point" which they will use to guide a discussion with the patient about drug and alcohol use. Participants and their families will also receive educational brochures about substance use.; Participants who are in the experimental arm will complete the CRAFFT screen on the computer and receive information on the computer regarding the health effects of substance use. Their provider will be given the results of their CRAFFT screen and a list of suggested "talking point" which they will use to guide a discussion with the patient about drug and alcohol use. Participants and their families will also receive educational brochures about substance use.
Other intervention name(s): SBIRT; SBIRT
Allocation: Non-Randomized
Intervention model: Parallel Assignment
Intervention model description: In this before-/after- quasi-experimental trial, all sites first completed a treatment-as-usual phase with assessments only, followed by all sites undergoing training and completing a subsequent intervention phase.
Masking: None (Open Label)
Primary purpose: Prevention
Keywords: alcohol abuse; substance abuse; substance related disorders