PMID- 38530346
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20240425
IS  - 1929-0748 (Print)
IS  - 1929-0748 (Electronic)
IS  - 1929-0748 (Linking)
VI  - 13
DP  - 2024 Mar 26
TI  - Computer-Facilitated Screening and Brief Intervention for Alcohol Use Risk in 
      Adolescent Patients of Pediatric Primary Care Offices: Protocol for a Cluster 
      Randomized Controlled Trial.
PG  - e55039
LID - 10.2196/55039 [doi]
LID - e55039
AB  - BACKGROUND: Alcohol and other substance use disorders usually begin with 
      substance use in adolescence. Pediatric primary care offices, where most 
      adolescents receive health care, are a promising venue for early identification 
      of substance use and for brief intervention to prevent associated problems and 
      the development of substance use disorder. OBJECTIVE: This study tests the 
      effects of a computer-facilitated screening and brief intervention (cSBI) system 
      (the CRAFFT [Car, Relax, Alone, Forget, Family/Friends, Trouble] Interactive 
      System [CRAFFT-IS]) on heavy episodic drinking, riding with a driver who is 
      substance impaired, or driving while substance impaired among adolescents aged 14 
      to 17 years presenting for a well visit at pediatric primary care practices. 
      METHODS: We are conducting a cluster randomized controlled trial of the CRAFFT-IS 
      versus usual care and recruiting up to 40 primary care clinicians at up to 20 
      pediatric primary care practices within the American Academy of Pediatrics (AAP) 
      Pediatric Research in Office Settings network. Clinicians are randomized 1:1 
      within each practice to implement the CRAFFT-IS or usual care with a target 
      sample size of 1300 adolescent patients aged 14 to 17 years. At study start, 
      intervention clinicians complete web-based modules, trainer-led live sessions, 
      and mock sessions to establish baseline competency with intervention counseling. 
      Adolescents receive mailed recruitment materials that invite adolescents to 
      complete an eligibility survey. Eligible and interested adolescents provide 
      informed assent (parental permission requirement has been waived). Before their 
      visit, enrolled adolescents seeing intervention clinicians complete a 
      self-administered web-based CRAFFT screening questionnaire and view brief 
      psychoeducational content illustrating substance use-associated health risks. 
      During the visit, intervention clinicians access a computerized summary of the 
      patient's screening results and a tailored counseling script to deliver a 
      motivational interviewing-based brief intervention. All participants complete 
      previsit, postvisit, and 12-month follow-up study assessments. Primary outcomes 
      include past 90-day heavy episodic drinking and riding with a driver who is 
      substance impaired at 3-, 6-, 9-, and 12-month follow-ups. Multiple logistic 
      regression modeling with generalized estimating equations and mixed effects 
      modeling will be used in outcomes analyses. Exploratory aims include examining 
      other substance use outcomes (eg, cannabis and nicotine vaping), potential 
      mediators of intervention effect (eg, self-efficacy not to drink), and effect 
      moderation by baseline risk level and sociodemographic characteristics. RESULTS: 
      The AAP Institutional Review Board approved this study. The first practice and 
      clinicians were enrolled in August 2022; as of July 2023, a total of 6 practices 
      (23 clinicians) had enrolled. Recruitment is expected to continue until late 2024 
      or early 2025. Data collection will be completed in 2025 or 2026. CONCLUSIONS: 
      Findings from this study will inform the promotion of high-quality screening and 
      brief intervention efforts in pediatric primary care with the aim of reducing 
      alcohol-related morbidity and mortality during adolescence and beyond. TRIAL 
      REGISTRATION: ClinicalTrials.gov NCT04450966; 
      https://www.clinicaltrials.gov/study/NCT04450966. INTERNATIONAL REGISTERED REPORT 
      IDENTIFIER (IRRID): DERR1-10.2196/55039.
CI  - (c)Lydia A Shrier, Madison M O'Connell, Alessandra Torres, Laura P Shone, Alexander 
      G Fiks, Julia A Plumb, Jessica L Maturo, Nicholas H McCaskill, Donna Harris, 
      Pamela J Burke, Thatcher Felt, Marie Lynd Murphy, Lon Sherritt, Sion Kim Harris. 
      Originally published in JMIR Research Protocols 
      (https://www.researchprotocols.org), 26.03.2024.
FAU - Shrier, Lydia A
AU  - Shrier LA
AUID- ORCID: 0000-0002-9648-9319
AD  - Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, 
      MA, United States.
AD  - Department of Pediatrics, Harvard Medical School, Boston, MA, United States.
FAU - O'Connell, Madison M
AU  - O'Connell MM
AUID- ORCID: 0000-0001-7326-8292
AD  - Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, 
      MA, United States.
FAU - Torres, Alessandra
AU  - Torres A
AUID- ORCID: 0009-0001-4479-9219
AD  - Primary Care Research, American Academy of Pediatrics, Itasca, IL, United States.
FAU - Shone, Laura P
AU  - Shone LP
AUID- ORCID: 0009-0004-8954-5724
AD  - Primary Care Research, American Academy of Pediatrics, Itasca, IL, United States.
FAU - Fiks, Alexander G
AU  - Fiks AG
AUID- ORCID: 0000-0001-6525-8764
AD  - Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA, 
      United States.
FAU - Plumb, Julia A
AU  - Plumb JA
AUID- ORCID: 0000-0002-1446-8769
AD  - Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, 
      MA, United States.
FAU - Maturo, Jessica L
AU  - Maturo JL
AUID- ORCID: 0000-0001-8555-2565
AD  - Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, 
      MA, United States.
FAU - McCaskill, Nicholas H
AU  - McCaskill NH
AUID- ORCID: 0000-0001-6270-5493
AD  - Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, 
      MA, United States.
FAU - Harris, Donna
AU  - Harris D
AUID- ORCID: 0009-0004-0412-9175
AD  - Primary Care Research, American Academy of Pediatrics, Itasca, IL, United States.
FAU - Burke, Pamela J
AU  - Burke PJ
AUID- ORCID: 0000-0001-7235-0956
AD  - Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, 
      MA, United States.
AD  - School of Nursing, Bouve College of Health Sciences, Northeastern University, 
      Boston, MA, United States.
FAU - Felt, Thatcher
AU  - Felt T
AUID- ORCID: 0009-0007-0167-4460
AD  - Yakima Valley Farm Workers Clinic, Grandview, WA, United States.
FAU - Murphy, Marie Lynd
AU  - Murphy ML
AUID- ORCID: 0009-0002-8126-3074
AD  - Elmwood Pediatric Group, Rochester, NY, United States.
FAU - Sherritt, Lon
AU  - Sherritt L
AUID- ORCID: 0000-0002-6469-8327
AD  - Cornerstone Systems Northwest, Lynden, WA, United States.
FAU - Harris, Sion Kim
AU  - Harris SK
AUID- ORCID: 0000-0002-4618-0348
AD  - Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, 
      MA, United States.
AD  - Department of Pediatrics, Harvard Medical School, Boston, MA, United States.
LA  - eng
SI  - ClinicalTrials.gov/NCT04450966
GR  - R01 AA027253/AA/NIAAA NIH HHS/United States
PT  - Journal Article
DEP - 20240326
PL  - Canada
TA  - JMIR Res Protoc
JT  - JMIR research protocols
JID - 101599504
PMC - PMC11005433
OTO - NOTNLM
OT  - adolescent
OT  - alcohol
OT  - brief intervention
OT  - cSBI
OT  - computer-facilitated screening and brief intervention
OT  - intervention
OT  - mobile phone
OT  - prevention
OT  - primary care
OT  - screening
OT  - substance use
COIS- Conflicts of Interest: None declared.
EDAT- 2024/03/26 12:48
MHDA- 2024/03/26 12:49
PMCR- 2024/03/26
CRDT- 2024/03/26 11:54
PHST- 2023/11/30 00:00 [received]
PHST- 2024/02/05 00:00 [accepted]
PHST- 2024/02/02 00:00 [revised]
PHST- 2024/03/26 12:49 [medline]
PHST- 2024/03/26 12:48 [pubmed]
PHST- 2024/03/26 11:54 [entrez]
PHST- 2024/03/26 00:00 [pmc-release]
AID - v13i1e55039 [pii]
AID - 10.2196/55039 [doi]
PST - epublish
SO  - JMIR Res Protoc. 2024 Mar 26;13:e55039. doi: 10.2196/55039.