Tailored Youth Drug Intervention in Primary Care

初级保健中量身定制的青少年药物干预

• 批准号: 6962150
• 负责人: Frederic C Blow
• 金额: $ 64.74万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-09-05 至 2010-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6962150
• 关键词: Cannabis; adolescence (12-20); age difference; alcoholism /alcohol abuse; behavior therapy; behavioral /social science research tag; child behavior; child mental disorders; clinical research; community health services; computer assisted patient care; drug abuse; drug abuse prevention; drug abuse therapy; gender difference; human subject; human therapy evaluation; longitudinal human study; marijuana abuse; medically underserved population; motivation; primary care physician; racial /ethnic difference; tobacco abuse

DESCRIPTION (provided by applicant): Preventing the initiation, and reducing the escalation of marijuana use among adolescents can have a major impact on the development of problem behaviors and health consequences in adulthood. The varying factors associated with initiation and escalation of marijuana use among adolescents (age 12-18) speaks to the importance of tailoring preventive approaches based on individual risk factors. Brief motivational interventions (BMI) have been demonstrated to be effective in reducing drug use (i.e., marijuana, alcohol, and tobacco) among adolescents and young adults. Typically, BMIs are delivered by a clinician; however, more recently, computers have been used successfully to deliver BMI in an interactive, graphically engaging format. The primary care setting represents an underutilized venue for prevention interventions addressing drug use/abuse among youth. This study will take place in three HRSA-funded Bureau of Primary Health Care community health clinics located in Flint, Michigan, a city with a diverse and medically under-served population. The purpose of this five-year study is to: (1) develop and refine promising, empirically-derived, BMI prevention/intervention modules delivered by a clinician or a computer to target marijuana use, and (2) test the effectiveness of BMI in preventing initiation/escalation of marijuana use among youth in community health clinics. The proposed BMI prevention/interventions are innovative because: a) they incorporate tailoring technology based on assessment of the adolescents' behaviors; and b) they incorporate prevention messages for those who have not initiated use, and intervention messages for those who are current users. This randomized controlled trial will screen 1,710 adolescents in primary care clinics over 30 months. A random sample of the approximately 70% who screen negative for past year marijuana use will be selected to participate in the study (n=450); all subjects who screen positive for past year use will be enrolled in the study (n=450). These 900 subjects will be stratified by gender, age, and past year marijuana use and randomized to one of three conditions: 1) computer-delivered brief motivational approach (BMI-C) (n=300; 150 non-users: prevention, 150 users: intervention); 2) therapist-delivered brief motivational approach (BMI-T) (n=300; 150 non-users, 150 users); or 3) a NIDA drug education booklet (DPB) (n=300; 150 non-users, 150 users). Primary outcomes will be evaluated at 3-, 6- and 12-months and include marijuana, alcohol, tobacco and other drug use. Key moderators of effectiveness will be examined, including behavioral intentions, self-efficacy, stage of change, school involvement, susceptibility to peer pressure, and potential health consequences (e.g., STD/HIV risk behaviors). This project will provide the critical first step toward the implementation of tailored marijuana prevention and intervention in primary care clinics.

描述（由申请人提供）： 防止青少年开始吸食大麻并减少吸食大麻的升级，可以对成年后问题行为的发展和健康后果产生重大影响。青少年（12-18 岁）吸食大麻的开始和增加的相关因素多种多样，这说明了根据个人风险因素制定预防方法的重要性。简短的动机干预（BMI）已被证明可以有效减少青少年和年轻人的药物使用（即大麻、酒精和烟草）。通常，BMI 由临床医生提供；然而，最近，计算机已成功用于以交互式、图形化的格式提供 BMI。初级保健机构是解决青少年吸毒/滥用问题的预防干预措施的未充分利用的场所。这项研究将在位于密歇根州弗林特市的三个由 HRSA 资助的初级卫生保健局社区卫生诊所进行，该城市人口多元化且医疗服务不足。这项为期五年的研究的目的是：(1) 开发和完善有前景的、基于经验的 BMI 预防/干预模块，由临床医生或计算机提供以针对大麻使用，以及 (2) 测试 BMI 在以下方面的有效性：防止青少年在社区卫生诊所吸食/升级大麻。拟议的 BMI 预防/干预措施具有创新性，因为： a) 它们结合了基于青少年行为评估的定制技术； b) 它们包含针对尚未开始使用的用户的预防信息以及针对当前用户的干预信息。这项随机对照试验将在 30 个月内对初级保健诊所的 1,710 名青少年进行筛查。大约 70% 的过去一年大麻使用筛查呈阴性的人将被随机抽取参加该研究 (n=450)；所有去年使用情况筛查呈阳性的受试者都将参加该研究（n=450）。这 900 名受试者将按性别、年龄和过去一年吸食大麻情况进行分层，并随机分配到以下三种情况之一：1) 计算机提供的简短激励方法 (BMI-C)（n=300；150 名非吸食者：预防，150 名非使用者：预防）用户：干预）； 2) 治疗师提供的简短激励方法 (BMI-T)（n=300；150 名非使用者，150 名使用者）；或 3) NIDA 药物教育手册 (DPB)（n=300；150 名非使用者，150 名使用者）。主要结果将在 3 个月、6 个月和 12 个月时进行评估，包括大麻、酒精、烟草和其他药物的使用。将审查有效性的关键调节因素，包括行为意图、自我效能、变化阶段、学校参与、对同伴压力的敏感性以及潜在的健康后果（例如性传播疾病/艾滋病毒危险行为）。该项目将为在初级保健诊所实施量身定制的大麻预防和干预措施迈出关键的第一步。