Brief Youth Substance Use Intervention for Primary Care

Completed · Not applicable

Conditions studied: Alcohol Consumption, Drug Abuse

In brief

Over the past decade, many new programs intended to prevent substance use among adolescents have been developed and evaluated. There has been a recent shift towards brief interventions for youth in school (Brown, 2001; D'Amico and Fromme, 2002) and health care settings, such as emergency rooms and inpatient clinics (Barnett et al., 2001; Colby et al., 1998; Monti et al., 1999). Although the primary care setting presents a unique opportunity to intervene with youth concerning drug use, such as marijuana or inhalants, many youth are not screened for use (Friedman et al., 1990; Johnson and Millstein, 2003; Middleman et al., 1995) and preventive services in this setting are significantly below recommended levels (Halpern-Felsher et al., 2000; Klein et al., 2001; Ozer et al., 2001). The objectives of the proposed research are to: 1) explore the feasibility of adapting a brief intervention from our previous work for use in the primary care (PC) setting, and 2) assess the short-term efficacy of the intervention in the PC setting. During year 1, focus groups of high-risk youth (n=16), parents (n=8), and providers (n=8) will provide feedback on barriers to implementing a substance use brief intervention in a PC setting. We define high-risk youth as those who may have already developed regular patterns of use or have experienced some problems due to their use. In addition, the intervention will be pilot tested with 10 high-risk youth who will provide feedback on intervention content. Revisions will be made to the intervention curriculum based on this feedback and in year 2, the short-term efficacy of the intervention will be tested with a small sample of high-risk youth (n=30). This study will extend brief intervention research for youth, as it will be one of the first to examine the feasibility of implementing a brief substance use intervention to PC with high-risk youth and to determine the impact of this intervention on short-term outcomes.

Key facts

Study ID

NCT00292240

Run by

RAND

People needed

60

Starts

2004-10-01

Expected to finish

2007-04-01

Last updated by the study team

2024-04-25

Who can join

Age: 12 and older, up to 18. Sex: any. Healthy volunteers: accepted.

You may qualify if…

• 12-18 years old
• english speaker
• screen positive for alcohol and/or drug use
• We use a brief screener to identify youth at high-risk for drug or alcohol abuse. The CRAFFT was developed by Knight and colleagues to screen youth for alcohol and other drug use and is a mnemonic based on the six questions it asks. The CRAFFT is comprised from items from the RAFFT (Riggs and Alario, 1989), DAP (Drug and Alcohol Problems) (Klitzner et al., 1987) and POSIT (Problem Oriented Screening Instrument for Teenagers) (Rahdert, 1991). The CRAFFT is brief, highly correlated with the Personal Involvement with Chemicals Scale (PICS), a criterion standard (r = .84), and is practical for use in a primary care setting as it takes only a few minutes to administer (Knight et al., 1999). The measure includes the following Yes/No questions: 1) have you ever ridden in a car driven by someone (including yourself) who was high or had been using alcohol or drugs?, 2) do you ever use alcohol or drugs to relax, feel better about yourself, or fit in?, 3) do you ever use alcohol or drugs while you are by yourself (alone)?, 4) do you ever forget things you did while using alcohol or drugs?, 5) have you ever gotten into trouble while you were using alcohol or drugs?, and 6) do your family and friends ever tell you that you should cut down on your drinking or drug use?. The six items have a cut-off score of 2 or greater with a sensitivity of 92.3% and specificity of 82.5% for long-term treatment need (as identified by PICS scores) (Knight et al., 1999). We use a cut-off of 1 or greater, reflecting a less stringent criterion for "high-risk" that includes adolescents with potential problems who could benefit from a brief intervention in the primary care setting.

You may not qualify if…

• spanish speaker
• outside of age range
• does not qualify on screening questionnaire as using alcohol and/or drugs

Where it is running

• Los Angeles Free Clinic — Los Angeles, California, United States

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