Computerized Alcohol Screening for Children and Adolescents (cASCA) in Primary Care
Condition: Prevention Harmful Effects
Study type: Interventional

Summary: 
      The purpose of this study is to assess the psychometric properties of a brief screening
      questionnaire for alcohol problems among 9- to 18-year-old patients in pediatricians'
      offices, and to pilot test a personalized, computer-facilitated brief intervention delivered
      on a tablet computer and by the provider based on screening results.
    

Detailed description: 
      The primary goal of this project is to develop a computerized screening program for primary
      care offices that is based on the NIAAA's new 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 seen in busy primary care settings. This project will develop and
      validate a new computerized Alcohol Screening for Children and Adolescents (cASCA) program
      which incorporates the age-specific screening questions of the NIAAA Guide and includes the
      CRAFFT and AUDIT as secondary risk/problem assessments. We will add tobacco screening because
      tobacco use is the leading cause of cancer-related mortality in the US as well as screening
      for marijuana and other drug use so as to create a comprehensive screening instrument that
      includes all major substances that adolescents use.

      Additionally, the NIAAA guide recommends that providers deliver a brief intervention in
      response to the screening results. Therefore, a secondary aim of this project will be to
      pilot-test a computer-facilitated Brief Intervention component using a randomized design
      comparing three groups: 1) screening with treatment as usual [cASCA/TAU]; 2) screening with
      the computer-facilitated brief intervention [cASCA/BI]. The BI component consists of patients
      viewing on the computer, immediately after the screening, their score and level of risk for a
      substance use problem, as well as several interactive pages of science and true-life stories
      about the health risks of substance use. Clinicians are then given the screen results and
      suggested talking points for a few minutes of brief counseling during the visit.

      Hypothesis: Among 9- to 18-year-old primary care patients, those receiving cASCA/BI will have
      lower rates of any alcohol use, days of alcohol use, drinks per drinking day, and days of
      heavy episodic drinking, at 3, 6, 9 and 12-months follow-up than those receiving treatment as
      usual.
    

Intervention name(s): computer-facilitated brief intervention
Intervention type(s): Behavioral
Intervention description(s): Immediate feedback to patient of screening results and risk for substance use problem, followed by 11 pages of science and true-life stories about health risks of adolescent substance use. Screening results then go to provider who reviews them with patient and gives brief counseling, and refers to an online motivational enhancement therapy intervention for patients at moderate/high risk for substance use problems.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Prevention
Keywords: Substance Abuse; Prevention; Youth; Alcohol; Drugs