MedPath

Computerized Alcohol Screening for Children and Adolescents (cASCA) in Primary Care

Not Applicable
Completed
Conditions
Prevention Harmful Effects
Interventions
Behavioral: computer-facilitated brief intervention
Registration Number
NCT02233946
Lead Sponsor
Boston Children's Hospital
Brief 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.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
871
Inclusion Criteria
  • access to computer and email address
  • available and willing to complete all follow ups by email or phone
  • medically and emotionally stable
  • can read and understand English
Exclusion Criteria
  • Patient has already participated in this study

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
screening w/ computer brief interventioncomputer-facilitated brief interventionscreening with computer-facilitated brief intervention
Primary Outcome Measures
NameTimeMethod
Time to First Post-visit Drinking Day12-months follow-up

Median (and interquartile range) for times to first use for the cSBI and Treatment As Usual (TAU) groups

Time to First Post-visit Heavy Episodic Drinking Day12-months follow-up

The number of days post-visit to first reported heavy episodic drinking day

Secondary Outcome Measures
NameTimeMethod
Time to First Post-visit Cannabis Use Day12-months follow-up

The number of days post-visit to first reported cannabis use day.

Past-3-month Riding Risk12 months follow-up

Self-reported riding in the past 3 months with a driver who had been drinking or using other drugs, stratified by reported riding risk in the past 3 months at baseline

Trial Locations

Locations (5)

Tufts Medical Center

🇺🇸

Boston, Massachusetts, United States

Boston Childrens Primary Care Center

🇺🇸

Boston, Massachusetts, United States

Longwood Pediatrics

🇺🇸

Boston, Massachusetts, United States

East Boston Neighborhood Health Center

🇺🇸

East Boston, Massachusetts, United States

Lexington Pediatrics

🇺🇸

Lexington, Massachusetts, United States

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