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Computer-Facilitated Substance Use Screening and Brief Advice for Teens in Primary Care: An International Trial
Open accessAbstract
OBJECTIVE: Primary care providers need effective strategies for substance use screening and brief counseling of adolescents. We examined the effects of a new computer-facilitated screening and provider brief advice (cSBA) system. METHODS: We used a quasi-experimental, asynchronous study design in which each site served as its own control. From 2005 to 2008, 12- to 18-year-olds arriving for routine care at 9 medical offices in New England (n = 2096, 58% females) and 10 in Prague, Czech Republic (n = 589, 47% females) were recruited. Patients completed measurements only during the initial treatment-as-usual study phase. We then conducted 1-hour provider training, and initiated the cSBA phase. Before seeing the provider, all cSBA participants completed a computerized screen, and then viewed screening results, scientific information, and true-life stories illustrating substance use harms. Providers received screening results and “talking points” designed to prompt 2 to 3 minutes of brief advice. We examined alcohol and cannabis use, initiation, and cessation rates over the past 90 days at 3-month follow-up, and over the past 12 months at 12-month follow-up. RESULTS: Compared with treatment as usual, cSBA patients reported less alcohol use at follow-up in New England (3-month rates 15.5% vs 22.9%, adjusted relative risk ratio [aRRR] = 0.54, 95% confidence interval 0.38–0.77; 12-month rates 29.3% vs 37.5%, aRRR = 0.73, 0.57–0.92), and less cannabis use in Prague (3-month rates 5.5% vs 9.8%, aRRR = 0.37, 0.17–0.77; 12-month rates 17.0% vs 28.7%, aRRR = 0.47, 0.32–0.71). CONCLUSIONS: Computer-facilitated screening and provider brief advice appears promising for reducing substance use among adolescent primary care patients.
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“It has been found to be effective in reducing low, moderate, and high-risk substance use among youth in the US (Winters et al., 2014), Czech Republic (Harris et al., 2012) and South Africa (Carney et al., 2020).”
From Adapting a substance use screening and brief intervention for peer-delivery and for youth in Kenya (2023) · cites this paper as Harris et al., 2012
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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 [18]
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Metadata
- Authors
- Harris, S. K., Csémy, L., Sherritt, L., Starostova, O., Van Hook, S., Johnson, J., Boulter, S., Brooks, T., Carey, P., Kossack, R., Kulig, J. W., Van Vranken, N., & Knight, J. R.
- Affiliations
- Boston Children's Hospital (US)
- National Institute of Mental Health (CZ)
- Charles University (CZ)
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts;
- Concord Hospital (US)
- Cambridge Health Alliance (US)
- Family Practice Associates, Cambridge Health Center, Cambridge, Vermont;
- Reliant Medical Group (US)
- Tufts Medical Center (US)
- Dartmouth-Hitchcock Concord, Pediatrics, Concord, New Hampshire
- Corresponding author
- Harris, Sion Kim
- Venue
- Pediatrics
- Publisher
- American Academy of Pediatrics (AAP)
- Published
- 2012-06-01
- Volume
- 129
- Issue
- 6
- Pages
- 1072-1082
- ISSN
- 0031-4005 (ISSN-L)
- 1098-4275
- PMC
- PMC3362902
- OpenAlex
- W2125013925
- Semantic Scholar
- 842e38c17fdfec3628590eb154b10b2e7b656410
- Cited by
- 163
- References
- 70
- Citations by year
- 2026: 3 · 2025: 1 · 2024: 6 · 2023: 8 · 2022: 5 · 2021: 11 · 2020: 12 · 2019: 44 · 2018: 10 · 2017: 9 · 2016: 19 · 2015: 17 · 2014: 9 · 2013: 8
- FWCI
- 8.14
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- PEDIATRICS (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- J.F Maddox Foundation
- National Institutes of Health
- U.S. Public Health Service (T71NC0009, T20MC07462)
- National Institute on Alcohol Abuse and Alcoholism (K07AA013280)
- National Institute on Drug Abuse (R01DA018848)
- Maternal and Child Health Bureau (T20MC07462)
- Topics
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Smoking Behavior and Cessation
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
- Keywords
- brief advice, adolescent substance use, alcohol consumption, cannabis use, primary care, provider training, substance use prevention, substance use initiation, substance use cessation, harm reduction messaging
- MeSH terms
- Adolescent, Child, Diagnosis, Computer-Assisted, Female, Follow-Up Studies, Humans, Male, New England, Primary Health Care, Substance Abuse Detection, Czech Republic, Substance-Related Disorders, Internationality, Self Report
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