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? ?PCPs? ?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.
Public Health Relevance Statement: Substance? ?Use? ?Project? ?Narrative This? ?proposal? ?will? ?create? ?innovations? ?to? ?overcome? ?the? ?barriers? ?to? ?effectively? ?addressing? ?teen substance? ?use? ?(SU)? ?in? ?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? ?(CHADIS).? ?? ?The planned? ?enhancements? ?in? ?the? ?new? ?CHADIS-cSBA? ?module? ?will? ?address? ?barriers? ?of? ?time? ?and doctor? ?training? ?through:? ?collection? ?of? ?comprehensive? ?pre-visit? ?data? ?in? ?an? ?online? ?questionnaire that? ?has? ?interactive? ?education? ?about? ?SU;? ?individualized? ?? ?teleprompters? ?for? ?the? ?doctor? ?to? ?use? ?for supporting? ?teen? ?strengths? ?and? ?conducting? ?a? ?motivational? ?interview? ?(MI)? ?to? ?quit? ?or? ?reduce? ?use pre-populated? ?by? ?questionnaire? ?results;? ?post-visit? ?education? ?and? ?resources? ?automatically provided? ?in? ?a? ?confidential? ?individual? ?portal;? ?parent? ?video? ?education? ?about? ?SU;? ?and? ?a? ?parent-teen Contract? ?for? ?Life.? ?? ?The? ?CHADIS-cSBA? ?system? ?will? ?be? ?developed? ?with? ?teen? ?and? ?professional interview? ?input? ?and? ?then? ?tested? ?for? ?effectiveness? ?through? ?a? ?randomized? ?control? ?quality improvement? ?trial? ?supplemented? ?by? ?Board? ?recertification? ?credits? ?for? ?doctors? ?with? ?the? ?outcome? ?to be? ?measured? ?of? ?reduced? ?rates? ?of? ?substance? ?use? ?at? ?3? ?and? ?12? ?month? ?follow-up? ?compared? ?to treatment? ?as? ?usual.
NIH Spending Category: Behavioral and Social Science; Brain Disorders; Clinical Research; Clinical Trials and Supportive Activities; Drug Abuse (NIDA only); Health Services; Pediatric; Prevention; Screening And Brief Intervention For Substance Abuse; Substance Abuse; Substance Abuse Prevention
Project Terms: Abstinence; Accidental Injury; Accreditation; addiction; Address; Adolescence; Adolescent Medicine; adolescent substance use; Alcohol consumption; Alcohol or Other Drugs use; American; behavior change; Belief; Brain Injuries; brief advice; care coordination; care providers; Certification; Cessation of life; Child health care; Childhood; Clinical; Collection; computerized; Consensus; Contracts; coping; cost; Data; Development; driving behavior; Drowning; dual diagnosis; Early Intervention; Education; education resources; Effectiveness; efficacy testing; Elements; emotion regulation; Ethanol toxicity; Evaluation; Event; evidence base; Family Practice; Feedback; follow-up; Goals; high risk sexual behavior; Impaired cognition; improved; Individual; innovation; Intervention; intervention program; Intervention Trial; Interview; Life; Liver; liver injury; lung injury; Measures; Morbidity - disease rate; motivational enhancement therapy; Online Systems; Outcome; Overdose; Parents; Patients; Pediatrics; Phase; prevent; Prevention education; Preventive Intervention; Primary Health Care; Privatization; Process; programs; Provider; Qi; Quality Control; Questionnaires; Randomized; recruit; Schedule; screening; screening and brief intervention; screening participation; Screening Result; social; Social support; Substance abuse problem; substance use prevention; Support System; System; Systems Integration; Teenagers; Testing; theories; Time; Training; Transcript; treatment as usual; Vehicle crash; Visit; web site
