Cross-sectional online survey of clinicians’ knowledge, attitudes and challenges to screening and counselling adolescents and young adults for substance use

Abstract

ObjectiveTo examine adolescent healthcare clinicians’ self-reported screening practices as well as their knowledge, attitudes, comfort level and challenges with screening and counselling adolescents and young adults (AYA) for cigarette, e-cigarette, alcohol, marijuana, hookah and blunt use.DesignA 2016 cross-sectional survey.SettingAcademic departments and community-based internal medicine, family medicine and paediatrics practices.ParticipantsAdolescent healthcare clinicians (N=771) from 12 US medical schools and respondents to national surveys. Of the participants, 36% indicated male, 64% female, mean age was 44 years (SD=12.3); 12.3% of participants identified as Asian, 73.7% as white, 4.8% as black, 4.2% as Hispanic and 3.8% as other.Primary and secondary outcome measuresSurvey items queried clinicians about knowledge, attitudes, comfort level, self-efficacy and challenges with screening and counselling AYA patients about marijuana, blunts, cigarettes, e-cigarettes, hookah and alcohol.ResultsParticipants were asked what percentage of their 10–17 years old patients they screened for substance use. The median number of physicians reported screening 100% of their patients for cigarette (1st, 3rd quartiles; 80, 100) and alcohol use (75, 100) and 99.5% for marijuana use (50,100); for e-cigarettes, participants reported screening half of their patients and 0.0% (0, 50), (0, 75)) reported screening for hookah and blunts, respectively. On average (median), clinicians estimated that 15.0% of all 10–17 years old patients smoked cigarettes, 10.0% used e-cigarettes, 20.0% used marijuana, 25.0% drank alcohol and 5.0% used hookah or blunts, respectively; yet they estimated lower than national rates of use of each product for their own patients. Clinicians reported greater comfort discussing cigarettes and alcohol with patients and less comfort discussing e-cigarettes, hookah, marijuana and blunts.ConclusionsThis study identified low rates of screening and counselling AYA patients for use of e-cigarettes, hookahs and blunts by adolescent healthcare clinicians and points to potential missed opportunities to improve prevention efforts.

Factors associated with intention to implement SBI and SUD treatment: a survey of primary care clinicians in Texas enrolled in an online course

“…To the knowledge of this study’s authors, there are a limited number of studies that provide a comprehensive assessment of primary care clinicians’ knowledge, attitudes, subjective norms, and intentions to use evidence-based SBI and SUD treatment in the primary care setting. Of the studies available, most are either centered on specific patient populations (such as adolescents and young adults) [ 11 , 12 ], specific SUD types (i.e., opioid use disorder) [ 13 ], health professional students or trainees [ 14 ] or assess general perceptions, attitudes and self-efficacy related to screening practices or integration of AUD, nicotine use disorder, or opioid use disorder (OUD) in primary care [ 12 ]. Accordingly, more targeted investigations are needed to better understand clinician-level factors which may contribute to the implementation of evidence-based SUD prevention and treatment practices in primary care settings.…”