Screening and Brief Advice to Reduce Teen Substance Use

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ClinicalTrials.gov Identifier: NCT00227877

Recruitment Status : Completed

First Posted : September 28, 2005

Results First Posted : September 21, 2018

Last Update Posted : August 14, 2019

View this study on Beta.ClinicalTrials.gov

Sponsor:

Collaborators:

Cambridge Health Alliance

Concord Hospital

Fallon Clinic

Tufts Medical Center

University of Vermont

Information provided by (Responsible Party):

John R Knight, MD, Boston Children's Hospital

Study Description

Brief Summary:

The purpose of this study is to test the effectiveness of a brief intervention for alcohol and drug use in adolescents that a primary care doctor can give in his/her office. The study will be conducted in nine primary care offices in three New England states, and in ten pediatric offices in Prague, Czech Republic (CZR).

We hypothesize that:

Among 12-18 year old well care patients who screen positive for drug/alcohol use, the experimental intervention administered by trained primary care providers will be more effective than standard care in decreasing drug and alcohol use;
Among 12-18 year old well care patients who screen negative for drug/alcohol use, the experimental intervention administered by trained primary care providers will be more effective than standard care in decreasing initiation of drug and alcohol use as measured by self-reports of substance use;
Among 12-18 year old well care patients who are at risk for riding with an impaired driver or driving while impaired, the experimental intervention administered by trained primary care providers will be more effective than standard care in decreasing Riding/Driving risk behavior as measured by a standardized scale.

Condition or disease	Intervention/treatment	Phase
Substance Related Disorders	Behavioral: cSBA - New England, USA Behavioral: cSBA - Prague, CZR	Not Applicable

Detailed Description:

We are trying to find out the best way for doctors to talk with their adolescent patients about alcohol and drug use. Adolescents 12-18 who are coming to their doctor's office for a routine well-care or follow-up visit will be invited to participate in the study. Participants do not have to have ever used alcohol or drugs. All participants will answer a computerized questionnaire about alcohol and drug use three times. The first one will be at the time of a doctor's visit. The second time will be three months later and the third time a year later. Adolescents who agree to be in the study during the first year will be in the 'control' group. Their doctor will talk to them about drugs and alcohol the same as he/she usually does for all his/her patients. Those who agree to be in the study during the second year will be in the 'intervention' group. Everyone in the 'intervention' group will receive some advice on the computer about their alcohol and drug use. Their doctor will also give them some specific advice about drug and alcohol use. The researchers have chosen what that advice will be, and all doctors involved in the study will give advice according to the study protocol. Participants and their parents will also be given educational information about alcohol and drugs. We will test the effectiveness of the intervention by comparing drug and alcohol use between those who are in the 'control' group, and those who are in the 'intervention' group.

We we will also validate the Czech version of the CRAFFT screen before conducting the effectiveness trial outlined above in the Czech Republic.

Study Design

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Study Type :	Interventional (Clinical Trial)
Actual Enrollment :	2695 participants
Allocation:	Non-Randomized
Intervention Model:	Parallel Assignment
Intervention Model Description:	In this before-/after- quasi-experimental trial, all sites first completed a treatment-as-usual phase with assessments only, followed by all sites undergoing training and completing a subsequent intervention phase.
Masking:	None (Open Label)
Primary Purpose:	Prevention
Official Title:	Screening and Brief Advice to Reduce Teen Substance Use
Actual Study Start Date :	December 2005
Actual Primary Completion Date :	December 2008
Actual Study Completion Date :	February 2010

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Drug Use and Addiction

U.S. FDA Resources

Arms and Interventions

Arm	Intervention/treatment
No Intervention: Control - New England, USA Control participants will receive "care as usual" from their provider
Experimental: cSBA - New England, USA Participants who are in the experimental arm will complete the CRAFFT screen on the computer and receive information on the computer regarding the health effects of substance use. Their provider will be given the results of their CRAFFT screen and a list of suggested "talking points" which they will use to guide a discussion with the patient about drug and alcohol use. Participants and their families will also receive educational brochures about substance use.	Behavioral: cSBA - New England, USA Participants who are in the experimental arm will complete the CRAFFT screen on the computer and receive information on the computer regarding the health effects of substance use. Their provider will be given the results of their CRAFFT screen and a list of suggested "talking point" which they will use to guide a discussion with the patient about drug and alcohol use. Participants and their families will also receive educational brochures about substance use. Other Name: SBIRT
No Intervention: Control - Prague, CZR Control participants will receive "care as usual" from their provider
Experimental: cSBA - Prague, CZR Participants who are in the experimental arm will complete the CRAFFT screen on the computer and receive information on the computer regarding the health effects of substance use. Their provider will be given the results of their CRAFFT screen and a list of suggested "talking points" which they will use to guide a discussion with the patient about drug and alcohol use. Participants and their families will also receive educational brochures about substance use.	Behavioral: cSBA - Prague, CZR Participants who are in the experimental arm will complete the CRAFFT screen on the computer and receive information on the computer regarding the health effects of substance use. Their provider will be given the results of their CRAFFT screen and a list of suggested "talking point" which they will use to guide a discussion with the patient about drug and alcohol use. Participants and their families will also receive educational brochures about substance use. Other Name: SBIRT

Outcome Measures

Primary Outcome Measures :

Past-90-day Substance Use at 3 Months Among Baseline Substance Users - New England, USA [ Time Frame: Past-90-days at 3 months post-baseline ]
Among the 12-18 year old primary care patients who reported past-12-month drug or alcohol use at baseline in New England, USA, this analysis reports the number who subsequently reported past-90-day drug or alcohol use at the 3 months post-baseline assessment.
Past-90-day Substance Use at 3 Months Among Baseline Substance Non-Users, New England, USA [ Time Frame: Past-90-days at 3 months post-baseline ]
Among the 12-18 year old primary care patients who did NOT report past-12-month drug or alcohol use at baseline in New England, USA, this analysis reports the number who subsequently reported past-90-day drug or alcohol use at the 3 months post-baseline assessment.
Past-12-month Substance Use at 12 Months Among Baseline Substance Users, New England, USA [ Time Frame: Past-12-months at 12 months post-baseline ]
Of those participants who reported past-12-month drug or alcohol use at baseline,the number reporting past-90-day drug or alcohol use at 12 months post-baseline assessment in New England, USA
Past-12-month Substance Use at 12 Months, Baseline Substance Non-Users, New England, USA [ Time Frame: Past-12-months at 12 months post-baseline ]
Of those participants who reported NO past-12-month drug or alcohol use at baseline,the number reporting past-90-day drug or alcohol use at 12 months post-baseline assessment in New England, USA
Past-90-day Substance Use at 3 Months Among Baseline Substance Users - Prague, CZR [ Time Frame: Past-90-days at 3 months post-baseline ]
Of those participants who reported past-12-month drug or alcohol use at baseline,the number reporting past-90-day drug or alcohol use at 3 months post-baseline assessment in Prague, Czech Republic
Past-90-day Substance Use at 3 Months Among Baseline Substance Non-Users - Prague, CZR [ Time Frame: Past-90-days at 3 months post-baseline ]
Of those participants who reported NO past-12-month drug or alcohol use at baseline,the number reporting past-90-day drug or alcohol use at 3 months post-baseline assessment in Prague, Czech Republic
Past-12-Month Substance Use at 12 Months Among Baseline Substance Users - Prague, CZR [ Time Frame: Past-12-months at 12 months post-baseline ]
Of those participants who reported past-12-month drug or alcohol use at baseline,the number reporting past-12-month drug or alcohol use at 12 months post-baseline assessment in Prague, Czech Republic
Past-12-Month Substance Use at 12 Months Among Baseline Substance Non-Users - Prague, CZR [ Time Frame: Past-12-months at 12 months post-baseline ]
Of those participants who reported past-12-month drug or alcohol use at baseline,the number reporting past-12-month drug or alcohol use at 12 months post-baseline assessment in Prague, Czech Republic

Secondary Outcome Measures :

Any Risky Riding or Driving at 3 Months - New England, USA [ Time Frame: Past-90-days at 3 months post-baseline ]
Any past-90-day self-reported Riding with a driver who had used alcohol or other drugs or Driving after having used alcohol or other drugs at 3 months post-baseline assessment - New England
Any Risky Riding or Driving at 12 Months - New England, USA [ Time Frame: Past-90-days at 12 months post-baseline ]
Any past-90-day self-reported Riding with a driver who had used alcohol or other drugs or Driving after having used alcohol or other drugs at 12 months post-baseline assessment - New England
Any Risky Riding or Driving at 3 Months - Prague, CZR [ Time Frame: Past-90-days at 3 months post-baseline ]
Any past-90-day self-reported Riding with a driver who had used alcohol or other drugs or Driving after having used alcohol or other drugs at 3 months post-baseline assessment - Prague, Czech Republic
Any Risky Riding or Driving at 12 Months - Prague, CZR [ Time Frame: Past-90-days at 12 months post-baseline ]
Any past-90-day self-reported Riding with a driver who had used alcohol or other drugs or Driving after having used alcohol or other drugs at 12 months post-baseline assessment - Prague, Czech Republic

Eligibility Criteria

Information from the National Library of Medicine

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.

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Ages Eligible for Study:	12 Years to 18 Years (Child, Adult)
Sexes Eligible for Study:	All
Accepts Healthy Volunteers:	No

Criteria

Inclusion Criteria:

12-18 year old patients coming for well care or follow-up visits to one of the study sites, All levels of substance use, Able to read and understand English

Exclusion Criteria:

Will not be available for 12 month follow-up period, Medically unstable at the time of the visit

Contacts and Locations

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT00227877

Locations

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United States, Massachusetts
Tufts-New England Medical Center
Boston, Massachusetts, United States, 02111
Cambridge Pediatrics
Cambridge, Massachusetts, United States, 02139
Fallon Clinic
Worcester, Massachusetts, United States, 01605
United States, New Hampshire
Capital Region Family Health Center
Concord, New Hampshire, United States, 03301
United States, Vermont
Milton Family Practice
Milton, Vermont, United States, 05468
Czechia
Center for the Evaluation, Prevention, and Research of Substance Abuse
Prague, Czechia

Sponsors and Collaborators

Boston Children's Hospital

Cambridge Health Alliance

Concord Hospital

Fallon Clinic

Tufts Medical Center

University of Vermont

Investigators

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Principal Investigator:	John R Knight, M.D.	Boston Children's Hospital

More Information

Additional Information:

This is the web site of the Center for Adolescent Substance Use and Addiction Research (CeASAR) at Children's Hospital Boston. CeASAR is the research center funded to direct this project. This link exits the ClinicalTrials.gov site

This link exits the ClinicalTrials.gov site

Publications of Results:

Knight JR, Csemy L, Sherritt L, Starostova O, Van Hook S, Bacic J, Finlay C, Tauber J, Brooks T, Kossack R, Kulig JW, Shaw J, Harris SK. Screening and Brief Advice to Reduce Adolescents' Risk of Riding With Substance-Using Drivers. J Stud Alcohol Drugs. 2018 Jul;79(4):611-616. doi: 10.15288/jsad.2018.79.611.

Knight JR, Kuzubova K, Csemy L, Sherritt L, Copelas S, Harris SK. Computer-Facilitated Screening and Brief Advice to Reduce Adolescents' Heavy Episodic Drinking: A Study in Two Countries. J Adolesc Health. 2018 Jan;62(1):118-120. doi: 10.1016/j.jadohealth.2017.08.013. Epub 2017 Oct 17.

Hadland SE, Copelas SH, Harris SK. Trajectories of Substance Use Frequency among Adolescents Seen in Primary Care: Implications for Screening. J Pediatr. 2017 May;184:178-185. doi: 10.1016/j.jpeds.2017.01.033. Epub 2017 Feb 10.

Harris SK, Johnson JK, Sherritt L, Copelas S, Rappo MA, Wilson CR. Putting Adolescents at Risk: Riding With Drinking Drivers Who Are Adults in the Home. J Stud Alcohol Drugs. 2017 Jan;78(1):146-151. doi: 10.15288/jsad.2017.78.146.

Louis-Jacques J, Knight JR, Sherritt L, Van Hook S, Harris SK. Do risky friends change the efficacy of a primary care brief intervention for adolescent alcohol use? J Adolesc Health. 2014 Apr;54(4):449-53. doi: 10.1016/j.jadohealth.2013.09.012. Epub 2013 Nov 8.

Harris SK, Csemy L, Sherritt L, Starostova O, Van Hook S, Johnson J, Boulter S, Brooks T, Carey P, Kossack R, Kulig JW, Van Vranken N, Knight JR. Computer-facilitated substance use screening and brief advice for teens in primary care: an international trial. Pediatrics. 2012 Jun;129(6):1072-82. doi: 10.1542/peds.2011-1624. Epub 2012 May 7.

Other Publications:

Knight JR, Shrier LA, Bravender TD, Farrell M, Vander Bilt J, Shaffer HJ. A new brief screen for adolescent substance abuse. Arch Pediatr Adolesc Med. 1999 Jun;153(6):591-6. doi: 10.1001/archpedi.153.6.591.

Knight JR, Sherritt L, Shrier LA, Harris SK, Chang G. Validity of the CRAFFT substance abuse screening test among adolescent clinic patients. Arch Pediatr Adolesc Med. 2002 Jun;156(6):607-14. doi: 10.1001/archpedi.156.6.607.

Van Hook S, Harris SK, Brooks T, Carey P, Kossack R, Kulig J, Knight JR; New England Partnership for Substance Abuse Research. The "Six T's": barriers to screening teens for substance abuse in primary care. J Adolesc Health. 2007 May;40(5):456-61. doi: 10.1016/j.jadohealth.2006.12.007. Epub 2007 Feb 15.

Knight JR, Harris SK, Sherritt L, Van Hook S, Lawrence N, Brooks T, Carey P, Kossack R, Kulig J. Prevalence of positive substance abuse screen results among adolescent primary care patients. Arch Pediatr Adolesc Med. 2007 Nov;161(11):1035-41. doi: 10.1001/archpedi.161.11.1035.

Knight JR, Harris SK, Sherritt L, Van Hook S, Lawrence N, Brooks T, Carey P, Kossack R, Kulig J. Adolescents' preference for substance abuse screening in primary care practice. Subst Abus. 2007;28(4):107-17. doi: 10.1300/J465v28n04_03.

Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):

Byregowda H, Flynn AL, Knight JR, Harris SK. Perceived Risk of Harm Mediates the Effects of Primary Care Alcohol Use Screening and Brief Advice in Adolescents. J Adolesc Health. 2022 Mar;70(3):442-449. doi: 10.1016/j.jadohealth.2021.09.029. Epub 2021 Dec 31.

Knight JR, Sherritt L, Gibson EB, Levinson JA, Grubb LK, Samuels RC, Silva T, Vernacchio L, Wornham W, Harris SK. Effect of Computer-Based Substance Use Screening and Brief Behavioral Counseling vs Usual Care for Youths in Pediatric Primary Care: A Pilot Randomized Clinical Trial. JAMA Netw Open. 2019 Jun 5;2(6):e196258. doi: 10.1001/jamanetworkopen.2019.6258.

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Responsible Party:	John R Knight, MD, Associate Professor of Pediatrics, Harvard Medical School, Boston Children's Hospital
ClinicalTrials.gov Identifier:	NCT00227877
Obsolete Identifiers:	NCT00592878, NCT00592956
Other Study ID Numbers:	NIDA-R01DA0118848
First Posted:	September 28, 2005 Key Record Dates
Results First Posted:	September 21, 2018
Last Update Posted:	August 14, 2019
Last Verified:	August 2019
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD:	No

Keywords provided by John R Knight, MD, Boston Children's Hospital:


alcohol abuse substance abuse substance related disorders

Additional relevant MeSH terms:

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Substance-Related Disorders Chemically-Induced Disorders Mental Disorders

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