Alcohol Screening & Brief Lntervention in Juvenile Justice: Filling the Gap
Condition: Evaluating NIAAA's Alcohol Screener; Evaluating a Brief Intervention
Study type: Interventional

Summary: 
      This proposal is in response to RFA-AA-12-008, Evaluation of NIAAA's Alcohol Screening Guide
      for Children and Adolescents. Of particular interest to the agency are evaluation of the
      Screener in clinical and/or other settings to predict alcohol-related consequences including
      use disorder; its use as an initial screen for drug use, cigarette smoking, conduct disorder,
      and unprotected sex; and its performance in making predictions concurrently and
      prospectively. This proposal targets these areas of interest. In addition, the investigators
      will study implementation of the Brief Intervention (BI) associated with the Screener. There
      is a great need for both screening and BI in juvenile probation settings as many of these
      youths have great need but are underserved.Many probation departments are turning to BI to
      work with probationers and parolees. Screening and BI has demonstrated efficacy in these
      settings, and yet no randomized control trials have been conducted to evaluate effectiveness
      in juvenile probation settings. Probation Officers (POs; n=40) are randomized to Screener
      (S), Screener+BI (SBI), or coaching (CSBI). Youths (N=1000) are randomized to 1 of these 3
      conditions, and all receive usual services (US). US consist of regular check-in with PO and
      access to referral services as needed (counseling, academic tutoring, etc.). Research
      staffers conduct in-depth assessment at baseline, 6- and 12- months. Sensitivity,
      specificity, and positive and negative predictive powers (SN, SP, PP, NP) are calculated to
      predict alcohol risk and consequences, as well as other risky behaviors concurrently and
      prospectively across age-groups. A 1-way design (S vs SBI vs CSBI) will be used to determine
      whether SBI and CSBI enhance youth services-use and reduce risks (e.g., alcohol use, risky
      sex). We examine moderators of outcomes (youth age, PO characteristics) and whether coaching
      (an important consideration in implementation science) in use of BI improves outcomes. This
      study will be the first randomized controlled trial evaluating the effectiveness of SBI in a
      juvenile probation setting.
    

Detailed description: 
      1. A) To evaluate SN, SP, PP and NP of the 2-question Alcohol Screener to detect: a)
           alcohol problems (academic, social, injuries, intoxicated driving, unprotected sex), b)
           abuse/dependence, c) past 4 week binge drinking. 1B) This will be repeated to predict
           risk prospectively over 12 months. Classification rates will be compared for race,
           ethnicity, gender, and age groups.

        2. A) To evaluate SN, SP, PP and NP of the 2-question Screener to detect a) 30-day drug
           use, b) 30-day cigarette use, c) conduct disorder, d) unprotected sex. 2B) This will be
           repeated to predict risk prospectively over 12 months. Classification rates will be
           compared for race, ethnicity, gender, and age groups. 3) To evaluate BI as compared to
           usual procedures. The investigators hypothesize those youths in BI will a) receive more
           services, b) be more satisfied with services, c) rate the relationship with the PO more
           highly, and d) have improved outcomes (alcohol, alcohol-related problems, problem
           recognition).
    

Intervention name(s): Brief Intervention; Brief Intervention with Coaching; Treatment as Usual
Intervention type(s): Behavioral; Behavioral; Behavioral
Allocation: Randomized
Intervention model: Single Group Assignment
Masking: Double (Participant, Outcomes Assessor)
Primary purpose: Treatment