Addressing Substance Use with the Adolescent in Primary Care

Kowalchuk, Alicia; Grubb, Maria Mejia de; González, Sandra; Zoorob, Roger

doi:10.1016/b978-0-323-66130-0.00013-2

Cited by 3 publications

(11 citation statements)

References 46 publications

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“…NIAAA, SAMHSA, and AAP recommend that care providers screen all adolescents and young adults ages 12 to 21 for alcohol and substance use behaviors using validated screening instruments on a yearly basis and, as needed, during acute care visits. 33 There are currently three prescreen options that are applicable to adolescents: the two age-specific questions found in NIAAA’s Alcohol Screening and Brief Intervention for Youth: A Practitioner’s Guide ; 29 the first three questions of the Screening to Brief Intervention (S2BI); and the three-item Alcohol Use Disorders Identification Test–Concise (AUDIT-C). 33 The two age-specific questions found within NIAAA’s guide ask about an adolescent’s personal alcohol use as well as that of their friends and is appropriate for children and adolescents between the ages of 9 and 18.…”

Section: Screeningmentioning

confidence: 99%

“… 33 There are currently three prescreen options that are applicable to adolescents: the two age-specific questions found in NIAAA’s Alcohol Screening and Brief Intervention for Youth: A Practitioner’s Guide ; 29 the first three questions of the Screening to Brief Intervention (S2BI); and the three-item Alcohol Use Disorders Identification Test–Concise (AUDIT-C). 33 The two age-specific questions found within NIAAA’s guide ask about an adolescent’s personal alcohol use as well as that of their friends and is appropriate for children and adolescents between the ages of 9 and 18. This AAP-endorsed guide includes elementary, middle, and high school age-appropriate variations of these two questions, which allow for accurate correlation of patient responses to current or potential risky alcohol consumption.…”

Section: Screeningmentioning

confidence: 99%

“… 18 , 39 Interestingly, the CRAFFT was able to detect preconception substance use in a small cohort of pregnant adolescents and young women between ages 17 and 25. 33 , 40 The CRAFFT has many advantages, including a short administration time and high sensitivity and specificity. 33 It also shows no evidence of gender bias.…”

Section: Screeningmentioning

confidence: 99%

“… 33 , 40 The CRAFFT has many advantages, including a short administration time and high sensitivity and specificity. 33 It also shows no evidence of gender bias. 36 …”

Section: Screeningmentioning

confidence: 99%

“…For example, the home environment, education and employment, eating, peer-related activities, drugs, sexuality, suicide/depression, and safety from injury and violence (HEEADSSS) and the strengths, school, home, activities, drugs/substance use, emotions/depression, sexuality, safety (SSHADESS) tools are interview frameworks specifically designed for use with adolescents in health care settings. 23 , 33 The HEEADSSS interview is a practical, complementary strategy that establishes rapport by asking less threatening questions at the beginning of the encounter before transitioning to more personal or potentially intrusive topics such as substance use. 33 The SSHADESS interview covers the same life areas as the HEEADSSS, but it also underscores adolescents’ resiliency by identifying their perceived and realized strengths before asking questions related to environmental context or risky behaviors.…”

Section: Screeningmentioning

confidence: 99%

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Alcohol Screening, Brief Intervention, and Referral to Treatment (SBIRT) for Girls and Women

Hammock¹,

Velasquez²,

Alwan³

et al. 2020

ARCR

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Females ages 12 and older are the fastest growing segment of alcohol consumers in the United States, with the past decade showing a 16% increase in alcohol use per 12-month period and a 58% increase in high-risk drinking (i.e., > 3 drinks in a day and/or > 7 drinks in a week) per 12-month period. The increase in alcohol use and risk drinking poses unique and serious consequences for women. Women have a more rapid progression to alcohol-related problems and alcohol use disorders (AUD) than men, and if pregnant, women can potentially expose the fetus to alcohol. Screening, brief intervention, and referral to treatment (SBIRT) is an evidence-based, integrated public health approach used to identify and address risky alcohol use among women in a variety of health and social service settings. This article presents the current status of SBIRT among girls ages 12 and older, women of childbearing age, and older women. Screening instruments, brief interventions, and implementation issues specific to women of all ages are described. Through this review of the current literature, care providers can determine best practices for the prevention and treatment of risk drinking in women of all ages presenting in health care settings.

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Section: Screeningmentioning

confidence: 99%

Section: Screeningmentioning

confidence: 99%

Section: Screeningmentioning

confidence: 99%

“… 33 , 40 The CRAFFT has many advantages, including a short administration time and high sensitivity and specificity. 33 It also shows no evidence of gender bias. 36 …”

Section: Screeningmentioning

confidence: 99%

Section: Screeningmentioning

confidence: 99%

See 3 more Smart Citations

Alcohol Screening, Brief Intervention, and Referral to Treatment (SBIRT) for Girls and Women

Hammock¹,

Velasquez²,

Alwan³

et al. 2020

ARCR

View full text Add to dashboard Cite

show abstract

Standard Versus Family-Based Screening, Brief Intervention, and Referral to Treatment for Adolescent Substance Use in Primary Care: Protocol for a Multisite Randomized Effectiveness Trial

Hogue,

Porter,

Ozechowski

et al. 2024

JMIR Res Protoc

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Background Screening, brief intervention, and referral to treatment for adolescents (SBIRT-A) is widely recommended to promote detection and early intervention for alcohol and other drug (AOD) use in pediatric primary care. Existing SBIRT-A procedures rely almost exclusively on adolescents alone, despite the recognition of caregivers as critical protective factors in adolescent development and AOD use. Moreover, controlled SBIRT-A studies conducted in primary care have yielded inconsistent findings about implementation feasibility and effects on AOD outcomes and overall developmental functioning. There is urgent need to investigate the value of systematically incorporating caregivers in SBIRT-A procedures. Objective This randomized effectiveness trial will advance research and scope on SBIRT-A in primary care by conducting a head-to-head test of 2 conceptually grounded, evidence-informed approaches: a standard adolescent-only approach (SBIRT-A-Standard) versus a more expansive family-based approach (SBIRT-A-Family). The SBIRT-A-Family approach enhances the procedures of the SBIRT-A-Standard approach by screening for AOD risk with both adolescents and caregivers; leveraging multidomain, multireporter AOD risk and protection data to inform case identification and risk categorization; and directly involving caregivers in brief intervention and referral to treatment activities. Methods The study will include 2300 adolescents (aged 12-17 y) and their caregivers attending 1 of 3 hospital-affiliated pediatric settings serving diverse patient populations in major urban areas. Study recruitment, screening, randomization, and all SBIRT-A activities will occur during a single pediatric visit. SBIRT-A procedures will be delivered digitally on handheld tablets using patient-facing and provider-facing programming. Primary outcomes (AOD use, co-occurring behavior problems, and parent-adolescent communication about AOD use) and secondary outcomes (adolescent quality of life, adolescent risk factors, and therapy attendance) will be assessed at screening and initial assessment and 3-, 6-, 9-, and 12-month follow-ups. The study is well powered to conduct all planned main and moderator (age, sex, race, ethnicity, and youth AOD risk status) analyses. Results This study will be conducted over a 5-year period. Provider training was initiated in year 1 (December 2023). Participant recruitment and follow-up data collection began in year 2 (March 2024). We expect the results from this study to be published in early 2027. Conclusions SBIRT-A is widely endorsed but currently underused in pediatric primary care settings, and questions remain about optimal approaches and overall effectiveness. In particular, referral to treatment procedures in primary care remains virtually untested among youth. In addition, whereas research strongly supports involving families in interventions for adolescent AOD, SBIRT-A effectiveness trial testing approaches that actively engage family members in primary care are absent. This trial is designed to help fill these research gaps to inform the critical health decision of whether and how to include caregivers in SBIRT-A activities conducted in pediatric primary care. Trial Registration ClinicalTrials.gov NCT05964010; https://www.clinicaltrials.gov/study/NCT05964010 International Registered Report Identifier (IRRID) PRR1-10.2196/54486

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Standard Versus Family-Based Screening, Brief Intervention, and Referral to Treatment for Adolescent Substance Use in Primary Care: Protocol for a Multisite Randomized Effectiveness Trial (Preprint)

Hogue,

Porter,

Ozechowski

et al. 2023

Preprint

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UNSTRUCTURED Screening, brief intervention, and referral to treatment for adolescents (SBIRT-A) is widely recommended to promote detection and early intervention for alcohol and other drug (AOD) use in pediatric primary care. Existing SBIRT-A procedures rely almost exclusively on adolescents alone, despite recognition of caregivers as critical protective factors in adolescent development and AOD use. Moreover, controlled SBIRT-A studies conducted in primary care have yielded inconsistent findings about implementation feasibility and effects on AOD outcomes and overall developmental functioning. There is urgent need to investigate the value of systematically incorporating caregivers in SBIRT-A procedures. This randomized effectiveness trial compares a standard adolescent-only approach (SBIRT-A-Standard) versus a family-based approach (SBIRT-A-Family) in which caregivers are systematically included in SBIRT-A activities. The study includes N = 2,300 adolescents (age 12 – 17) and their caregivers attending one of three hospital-affiliated pediatric settings serving diverse patient populations in major urban areas. Study recruitment, screening, randomization, and all SBIRT-A activities occur during a single pediatric visit. SBIRT-A procedures are delivered digitally on hand-held tablets using patient-facing and provider-facing programming. Primary outcomes (AOD use, co-occurring behavior problems, parent-youth communication about AOD use) and secondary outcomes (adolescent quality of life, therapy attendance) are assessed at screen/initial and 3, 6, 9, and 12 months follow-up. The study is well powered to conduct all planned main and moderator (age, sex, race/ethnicity, youth AOD risk status) analyses. Trial results will inform the critical health decision of whether and how to include caregivers in SBIRT-A activities conducted in pediatric primary care.

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Addressing Substance Use with the Adolescent in Primary Care

Cited by 3 publications

References 46 publications

Alcohol Screening, Brief Intervention, and Referral to Treatment (SBIRT) for Girls and Women

Alcohol Screening, Brief Intervention, and Referral to Treatment (SBIRT) for Girls and Women

Standard Versus Family-Based Screening, Brief Intervention, and Referral to Treatment for Adolescent Substance Use in Primary Care: Protocol for a Multisite Randomized Effectiveness Trial

Standard Versus Family-Based Screening, Brief Intervention, and Referral to Treatment for Adolescent Substance Use in Primary Care: Protocol for a Multisite Randomized Effectiveness Trial (Preprint)

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