Pediatrician and behavioral clinician-delivered screening, brief intervention and referral to treatment: Substance use and depression outcomes
Open accessAbstract
Background Early intervention for adolescent substance use and mental health problems may mitigate potential harm. We examined patient outcomes from a pragmatic trial of two modalities of delivering Screening, Brief Intervention and Referral to Treatment (SBIRT) and Usual Care in pediatric primary care. Methods All clinic pediatricians (n=52) were randomized to three arms: 1) pediatrician-only, in which pediatricians were trained to deliver SBIRT; 2) embedded behavioral clinician (BC), in which pediatricians were trained to refer eligible adolescents to a BC who administered SBIRT; and 3) Usual Care (UC). Using electronic health record data, changes in past year substance use and depression symptoms between index visit and next screening visit were examined across treatment arms. Results Among patients who endorsed substance use and/or depression symptoms or were eligible for further assessments, brief interventions and referrals based on clinician assessment at index visit, 648 patients (mean age=15.2[SD=1.2]) were rescreened at a follow-up visit between 6 months and 2 years later. Among all patients, self-reported substance use rates did not differ over time or across arms, and depression symptoms increased over time. The embedded-BC arm had lower odds of having depression symptoms at follow-up than the physician-only arm, and lower odds than the UC arm though not significant; we found no differences between the pediatrician-only and UC arms. Conclusions The increase in depression symptoms over time highlights this population’s vulnerability and the importance of developing appropriate interventions. An embedded BC in pediatric primary care trained in SBIRT may benefit patients with depression symptoms.
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SBIRT are delivered to U.S. adolescents most frequently in pediatric primary care settings as a public health approach to preventing substance use and mental health symptoms.
“Screening, brief intervention, and referral to treatment (SBIRT) are delivered to U.S. adolescents most frequently in pediatric primary care settings as a public health approach to preventing substance use and mental health symptoms [15,16].”
From Young Adult Substance Use and Healthcare Use Associated With Screening, Brief Intervention and Referral to Treatment in Pediatric Primary Care. (2022) · cites this paper as [15]
The Introduction describes SBIRT as early intervention for adolescent substance use and discusses integrating substance use and mental health care into primary care. The Methods describe its delivery in a U.S. pediatric clinic. Neither passage establishes that pediatric primary care is where U.S. adolescents most frequently receive SBIRT. (LLM, conf=0.84)
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- Authors
- Sterling, S., Kline-Simon, A. H., Weisner, C., Jones, A., & Satre, D. D.
- Affiliations
- Kaiser Permanente (US)
- Corresponding author
- Sterling, Stacy
- Venue
- Journal of Adolescent Health
- Publisher
- Elsevier BV
- Published
- 2018-04
- Volume
- 62
- Issue
- 4
- Pages
- 390-396
- ISSN
- 1054-139X (ISSN-L)
- PMC
- PMC5866770
- OpenAlex
- W2787237529
- Semantic Scholar
- 9c8aa59763d71729188c65905e1fefc6535a87c5
- Cited by
- 24
- References
- 43
- Citations by year
- 2026: 1 · 2025: 5 · 2024: 3 · 2022: 3 · 2021: 4 · 2020: 4 · 2019: 3 · 2018: 1
- FWCI
- 2.34
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of Adolescent Health (acceptedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- National Institute on Alcohol Abuse and Alcoholism (R01 AA016204)
- Topics
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Health Sciences › Health Professions › Speech and Hearing › Adolescent and Pediatric Healthcare
- Keywords
- SBIRT, adolescent substance use, adolescent depression, depressive symptoms, pediatric primary care, early intervention, rescreening, usual care comparison
- MeSH terms
- Pediatricians, Adolescent, Delivery of Health Care, Depression, Female, Humans, Male, Mass Screening, Primary Health Care, Referral and Consultation, Cognitive Behavioral Therapy, Substance-Related Disorders
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