Alcohol Screening in an Ethnically Diverse Sample of Adolescents in Primary Care

Screening youth in the primary care setting is one way to identify adolescents who may be at-risk for future alcohol problems. The current study tests the new NIAAA screening guide questions, which ask about friend and adolescent drinking, to see how well these questions work to predict subsequent alcohol use, problems, and involvement in other risk behaviors, such as sexual risk-taking and delinquency. In addition, the investigators plan to provide a brief motivational intervention for some at-risk teens and see whether alcohol use differs for those teens who receive the intervention and those teens who receive enhanced usual care. The results of this study have the potential to significantly impact the standard of care for identifying and intervening with at- risk youth in primary care settings.

Study Overview

• Status: Completed
• Conditions: Alcohol Use; Drug Use
• Intervention / Treatment: Behavioral: usual care; Behavioral: CHAT brief MI intervention

• Study Type: Interventional
• Enrollment (Actual): 294
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • California
    • North Hollywood, California, United States, 91605
      • Valley Community Clinic
  • Pennsylvania
    • Pittsburgh, Pennsylvania, United States, 15215
      • UPMC St. Margaret

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 12 years to 18 years (Child, Adult)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

Description

Inclusion Criteria: 1

• 12-18
• speak English

Exclusion Criteria:

• cognitive impairment

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Prevention
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Placebo Comparator: Usual Care; Youth in usual care will receive screening for alcohol and drug use. Those youth who are at risk will have a chance to talk to their provider about their use. They will also receive an informational brochure.	Behavioral: usual care; Youth receive a brochure with information on AOD use.
Experimental: CHAT brief MI intervention; Youth in CHAT will receive screening for alcohol and drug use. Those youth who are at risk will have a chance to talk to their provider about their use. In addition, these youth will CHAT. CHAT is a brief motivational intervention that takes places in the primary care setting. It is a 15-20 minute intervention for adolescents age 12-18 focused on discussing alcohol and drug use. They will also receive a booster call one month later to check in on how they are doing.	Behavioral: CHAT brief MI intervention; CHAT is one 15-20 minute session delivered in a single PC visit and utilizes motivational interviewing with youth to target alcohol and drug use in primary care.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Number of Times Used Alcohol	in the past three months: Number of times used alcohol; The 6-point frequency response scale (0= "Never" to 5= "More than 20 times") was rescaled to a pseudo-continuous variable ranging from 0 to 20 using the mid-point of any range as the new value (e.g. 3-10 times was recoded as 6.5 times).	Past 3 months

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Number of Times Used Marijuana	number of times used marijuana in the past 3 months; The 6-point frequency response scale (0= "Never" to 5= "More than 20 times") was rescaled to a pseudo-continuous variable ranging from 0 to 20 using the mid-point of any range as the new value (e.g. 3-10 times was recoded as 6.5 times).	Past 3 months

Collaborators and Investigators

• Sponsor: RAND
• Collaborators: University of Pittsburgh; Valley Community Clinic
• Investigators: Principal Investigator: Elizabeth J D'Amico, PhD, RAND

Publications and helpful links

General Publications

• D'Amico EJ, Parast L, Osilla KC, Seelam R, Meredith LS, Shadel WG, Stein BD. Understanding Which Teenagers Benefit Most From a Brief Primary Care Substance Use Intervention. Pediatrics. 2019 Aug;144(2):e20183014. doi: 10.1542/peds.2018-3014. Epub 2019 Jul 11.
• Meredith LS, Seelam R, Stein BD, Parast L, Shadel WG, D'Amico EJ. Adolescents with better mental health have less problem alcohol use six months later. Addict Behav. 2019 Aug;95:77-81. doi: 10.1016/j.addbeh.2019.03.006. Epub 2019 Mar 7.
• D'Amico EJ, Parast L, Shadel WG, Meredith LS, Seelam R, Stein BD. Brief motivational interviewing intervention to reduce alcohol and marijuana use for at-risk adolescents in primary care. J Consult Clin Psychol. 2018 Sep;86(9):775-786. doi: 10.1037/ccp0000332.
• Meredith LS, Ewing BA, Stein BD, Shadel WG, Brooks Holliday S, Parast L, D'Amico EJ. Influence of mental health and alcohol or other drug use risk on adolescent reported care received in primary care settings. BMC Fam Pract. 2018 Jan 9;19(1):10. doi: 10.1186/s12875-017-0689-y.
• D'Amico EJ, Parast L, Meredith LS, Ewing BA, Shadel WG, Stein BD. Screening in Primary Care: What Is the Best Way to Identify At-Risk Youth for Substance Use? Pediatrics. 2016 Dec;138(6):e20161717. doi: 10.1542/peds.2016-1717. Epub 2016 Nov 18.

Study record dates

Study Major Dates

• Study Start: March 1, 2013
• Primary Completion (Actual): November 1, 2015
• Study Completion (Actual): August 1, 2018

Study Registration Dates

• First Submitted: February 21, 2013
• First Submitted That Met QC Criteria: February 22, 2013
• First Posted (Estimate): February 25, 2013

Study Record Updates

• Last Update Posted (Actual): July 17, 2019
• Last Update Submitted That Met QC Criteria: July 3, 2019
• Last Verified: July 1, 2019

More Information

Terms related to this study

• Keywords: intervention; adolescents; motivational interviewing; alcohol and drug use
• Additional Relevant MeSH Terms: Drinking Behavior; Alcohol Drinking
• Other Study ID Numbers: 1R01AA021786 (U.S. NIH Grant/Contract)