Online System for Primary Care to Prevent and Address Teen Substance Use

预防和解决青少年药物滥用的初级保健在线系统

• 批准号: 10179532
• 负责人: Sion Kim Harris
• 金额: $ 42.65万
• 依托单位: TOTAL CHILD HEALTH, INC.
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-08-01 至 2023-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10179532
• 关键词: Abstinence; Accidental Injury; Accreditation; Address; Adolescence; Adolescent Medicine; Alcohol consumption; Alcohol or Other Drugs use; American; Belief; Brain Injuries; Certification; Cessation of life; Child health care; Childhood; Clinical; Collection; Consensus; Contracts; Data; Development; Drowning; Early Intervention; Education; Elements; Ethanol toxicity; Event; Family Practice; Feedback; Goals; Impaired cognition; Individual; Intervention; Intervention Trial; Interview; Life; Liver; Measures; Morbidity - disease rate; Online Systems; Outcome; Overdose; Parents; Patients; Pediatrics; Phase; Prevention education; Preventive Intervention; Primary Health Care; Privatization; Process; Provider; Qi; Quality Control; Questionnaires; Randomized; Schedule; Screening Result; Social support; Substance abuse problem; Support System; System; Systems Integration; Teenagers; Testing; Time; Training; Transcript; Vehicle crash; Visit; addiction; adolescent substance use; behavior change; brief advice; care coordination; care providers; computerized; coping; cost; driving behavior; dual diagnosis; education resources; effectiveness evaluation; effectiveness testing; efficacy testing; emotion regulation; evidence base; follow-up; high risk sexual behavior; improved; innovation; intervention program; liver injury; lung injury; motivational enhancement therapy; prevent; programs; recruit; screening; screening and brief intervention; screening participation; social; substance use prevention; theories; treatment as usual; web site

Substance use usually (90%) begins during adolescence, causing brain and liver damage, risky sexual and driving behavior, and potentially leading to addiction therefore prevention and early intervention programs targeting teens are needed to prevent this morbidity, gain productive years of life and reduce costs. This proposal presents innovations to overcome the barriers to effectively addressing teen substance use during primary care visits through further development of a promising computerized alcohol and substance use computerized Screening and provider Brief Advice system (cSBA) and integration with an online “clinical process support system” called CHADIS. CHADIS addresses all pediatric screening needs and is currently widely used in pediatric practice making widespread dissemination of a CHADIS-cSBA module immediately feasible. However, because of limitations related to time and training the approach of motivational interviewing (MI), with strong evidence for effecting behavior change in substance users, was not a part of cSBA. An innovation proposed here will take pre-visit teen data related to strengths and goals and acknowledged reasons for usage to populate individualized “teleprompters” accessible at the moment of care by PCP’s along with options for sharing graphical representations for use in reinforcing abstinence or motivate discontinuing usage. In addition, the prompts for discussion of teen identified strengths and goals will include wording from teen studies using “incremental theory”(or the belief that people have the potential to change), which has shown result in improvements in social coping. CHADIS-cSBA will also provide each teen a confidential individualized portal automatically populated with supports for their endorsed strengths and other supports as well as substance-related follow-up messaging. Post-visit parent education will include access to a Teen Safe course. Teens found to have serious substance abuse or dual diagnoses will have referrals facilitated by care coordination functionality. PCP participation will be reinforced by a American Board of Pediatrics accredited quality improvement program for their required re-certification (MOC-4). In Phase 1, the CHADIS-cSBA module will be created with both professional and teen feedback and MOC-4 certification obtained. In Phase 2 the resulting system will be piloted; a baseline of substance use screening conducted; then CHADIS-cSBA module will be randomly assigned to doctors and a quality improvement intervention will be conducted to measure reduction in rates of any substance use at 3 and 12 month follow-up compared to treatment as usual.

通常在青少年期间开始使用物质（90％），造成大脑和肝脏损害，有风险的性 和驾驶行为，并有可能导致成瘾，因此预防和早期 需要针对青少年的干预计划来防止这种发病率，增长生产力 生活并降低成本。该提案提出了创新，以克服 通过进一步开发在初级保健访问期间有效解决青少年用途 有希望的计算机酒精和药物使用计算机筛选和提供商简介 咨询系统（CSBA），并与在线“临床流程支持系统”集成 乍得。 Chadis满足了所有儿科筛查需求，目前已广泛用于小儿 练习立即对Chadis-CSBA模块进行广泛传播。然而， 由于与时间和培训有关动机访谈的方法（MI）的局限性， 有强有力的证据证明了药物使用者的行为改变，这并不是CSBA的一部分。一个 这里提出的创新将采用与优势和目标有关的青少年数据和 目前可以访问个性化的“远程编译器”的公认使用原因 PCP的护理以及共享图形表示的选项用于加固 禁欲或激励停止使用。此外，讨论青少年的提示 确定的优势和目标将包括使用“增量理论”的青少年研究措辞（或 人们认为人们有可能改变），这表明 社会应对。 Chadis-CSBA还将为每个青少年提供一个自信的个性化门户 自动填充了支持其认可的优势和其他支持的支持 与物质有关的后续消息传递。访问后的父母教育将包括访问青少年 安全课程。青少年发现有严重的药物滥用或双重诊断会引用 由护理协调功能促进。 PCP参与将由美国人加强 儿科委员会认可的质量改进计划，以重新认证 （MOC-4）。在第1阶段，Chadis-CSBA模块将与专业和青少年一起创建 获得反馈和MOC-4认证。在第2阶段中，将导致最终系统； 进行物质使用筛查的基线；然后，Chadis-CSBA模块将随机分配给 医生和质量改进的干预措施将衡量降低的比率 与往常一样，在3和12个月的随访中使用的任何物质使用。