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Substance Use Screening and Prevention for Adolescents in Pediatric Primary Care

Not Applicable
Completed
Conditions
Substance Use
Interventions
Behavioral: Family Check-Up
Registration Number
NCT03074877
Lead Sponsor
RTI International
Brief Summary

This study is to test the effectiveness of integrating and adapting two National Institute on Drug Abuse (NIDA)-funded procedures for use in primary care pediatric clinics serving low-income youth: 1)the Youth Risk Index (YRI) and Transmissible Liability Index-Parent (TLI-P) nurse and/or research assistant-administered screening tools for high risk of substance use (SU) prior to high school and thus also for SUD and 2) the Family Check-Up (FCU) - a brief, family-based program to prevent SU/SUD with replicated efficacy.

Detailed Description

This study is to test the effectiveness of integrating and adapting two National Institute on Drug Abuse (NIDA)-funded procedures for use in primary care pediatric clinics serving low-income youth: 1) the Youth Risk Index (YRI) and Transmissible Liability Index (TLI-P) nurse and/or research assistant-administered screening tools for high risk of substance use (SU) prior to high school and thus also for SUD and 2) the Family Check-Up (FCU) - a brief, family-based program to prevent SU/SUD with replicated efficacy.

The following three aims focus on evaluating and refining the adaptation of the YRI \& TLI-P program for primary-care use: 1) to replicate the effectiveness of the YRI \& TLI-P screening tool in terms of concurrent and predictive validity and the engagement rate in the FCU; 2) to identify and address challenges in implementing and integrating the YRI \& TLI-P/FCU prevention strategy within a primary care clinic serving urban, low-income youth; and 3) to test the effectiveness of the YRI \& TLI-P/FCU on emerging SU, sexual activity, and conduct problems, as well as the putative mediators of these outcomes including parenting and parental well-being.

Based on prior FCU efficacy studies, 500 dyads of parents and their 9 years, 9 months to 13 years, 11 months old children from low-income, ethnically diverse families will be recruited from two large primary care clinics in an urban community. The FCU will be delivered for two or three years to test impact of dosage. Participants will be followed-up one year after completing FCU to evaluate longitudinal outcomes of the Integrated YRI \& TLI-P/FCU .

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
722
Inclusion Criteria
  • Child Aged 9 years, 9 months to 13 years, 11 months.
  • A biological or adoptive parents or legal guardian with appropriate documentation with custody of the child.
  • Either child or parent's score on screening assessment score must fall in elevated risk range.
  • Child must be recipient of needs based Medicaid or family income must be at or below 150% Health and Human Services (HHS) Poverty Guidelines.
Exclusion Criteria
  • Inability to read English,
  • Having moderate to severe mental disability (based on medical records),
  • Child not accompanied by a biological or adoptive parent with legal custody or legal guardian with appropriate documentation
  • Participant in the Early Steps Project

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Waitlist GroupFamily Check-UpFamilies recruited in Year 1 who are randomized to the wait-list group, and all families recruited in Year 2 will be assigned to the wait-list group. This group will receive the materials provided to all families, noted above, and the initial in-home assessment within 2 weeks of the screening to be conducted by a trained research assistant. At 1 year post-screening, the families in the wait-list group will be administered the follow-up assessment and will begin the Family Check-Up (FCU) intervention.
Family Check-Up (FCU)Family Check-UpFamilies recruited in Year 1 who are randomized to the FCU group will be provided with the Family Check-Up (FCU) after the initial in-home assessment and after 1 year follow-up assessment. The FCU is a brief (i.e., typically 3-5 sessions per year) family-centered intervention. The FCU intervention process consists of 3, and in some cases, 4 components: a) family assessment, b) a "Get to Know You" session, c) feedback, and d) follow-up treatment sessions.
Primary Outcome Measures
NameTimeMethod
Contextual Risk and Resources - 1twenty-four months

Administer Centers for Epidemiological Studies Depression Scale (CESD)

Contextual Risk and Resources - 3twenty-four months

Administer Dyadic Adjustment Scale (DYAD)

Contextual Risk and Resources - 2twenty-four months

Administer Demographic Questionnaire (DEMO)

Contextual Risk and Resources - 5twenty-four months

Administer Me and My Neighborhood Questionnaire (MMNQ)

Youth Outcomes - 1twenty-four months

Administer Child Behavior Checklist (CBCL)

Contextual Risk and Resources - 4twenty-four months

Administer Financial Stress Questionnaire (FINCE)

Contextual Risk and Resources - 6twenty-four months

Administer Parent Substance Use Questionnaire (SUBST-PC)

Youth Outcomes - 2twenty-four months

Assess Extracurricular Activities (ECA)

Assessment of Liability and EXposure to Substance use and Antisocial behavior (ALEXSA)twenty-four months

Administer Assessment of Liability and EXposure to Substance use and Antisocial behavior (ALEXSA)

Parenting and Family Socialization - 4twenty-four months

Assess using Parental Involvement Scale (PI)

Parenting and Family Socialization - Discussion Tasks - 4twenty-four months

Assessment using Recognition Discussion Task

Parenting and Family Socialization - Discussion Tasks - 5baseline

Assessment using Family Culture Discussion Task

Youth Outcomes - 3twenty-four months

Administer Recent Activities Interview (RAI)

Youth Outcomes - 4twenty-four months

Administer Screen for Child Anxiety-Related Emotional Disorders (SCR)

Parenting and Family Socialization - 1twenty-four months

Evaluate using Adult Child Relationship scale (ACRS)

Parenting and Family Socialization - Discussion Tasks - 3twenty-four months

Assessment using Monitoring \& Listening Discussion Task

Youth Outcomes - 5twenty-four months

Administer Self-Report of Delinquency (SHORT) (SRD)

Youth Outcomes - 7twenty-four months

Administer Youth Risk Behavior Survey (YRBS)

Parenting and Family Socialization - 3twenty-four months

Child Daily Face-to-Face Racial Discrimination (CDIS)

Parenting and Family Socialization - 6twenty-four months

Assess using Parenting Children and Adolescents measure (PARCA)

Parenting and Family Socialization - 7twenty-four months

Assessment using Parental Rating of Peers and Social Skills (PPRSK)

Parenting and Family Socialization - Discussion Tasks - 1twenty-four months

Assessment using Parent Child Hot topics Discussion Task

Youth Outcomes - 6twenty-four months

Target Child Substance Use (TC Subst)

Parenting and Family Socialization - 2twenty-four months

Distressing Experiences Microaggression Scale (MIC)

Parenting and Family Socialization - 5twenty-four months

Parental Monitoring Interview - Parent Response, - Child Response (PMI-PR, PMI-CR)

Parenting and Family Socialization - Discussion Tasks - 2twenty-four months

Assessment using Parent Child Hot Topics Questionnaire (PCHT)

Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (1)

University of Pittsburgh

🇺🇸

Pittsburgh, Pennsylvania, United States

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