Medical Office Intervention for Adolescent Drug Use

医务室对青少年吸毒的干预

基本信息

批准号：
7221284
负责人：
JOHN R KNIGHT
金额：
$ 47.37万
依托单位：
BOSTON CHILDREN'S HOSPITAL
依托单位国家：
美国
项目类别：
财政年份：
2004
资助国家：
美国
起止时间：
2004-06-01 至 2009-03-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7221284
关键词：
18 year old Accident and Emergency department Adolescent Adult Alcohol consumption Alcohol or Other Drugs use Alcohols Behavior Therapy Boston Calendar Caring Clinic Clinical Cognitive Therapy Counseling Drug abuse Drug usage Early Intervention Effectiveness of Interventions Feasibility Studies Goals Health Personnel Healthcare Intervention Laboratories Manuals Measurement Measures Mediating Medical Mental Health Methods National Institute of Drug Abuse Numbers Outcome Outpatients Patient Self-Report Patients Pattern Pediatric Hospitals Performance Pharmaceutical Preparations Preparation Primary Health Care Protocols documentation Public Health Randomized Randomized Controlled Clinical Trials Readiness Research Research Personnel Risk Risk Behaviors Schools Score Screening procedure Social Work Staging Standards of Weights and Measures Subgroup Substance abuse problem Testing TimeLine Training Work adolescent drug abuse adolescent drug use adolescent substance abuse base boys day design drug testing early /brief intervention /therapy efficacy trial experience girls improved interest motivational enhancement therapy older patient programs response size therapy development

项目摘要

This application is submitted to NIDA in response to PA-03-126, Behavioral Therapies Development Program, and proposes a Stage lb efficacy trial of a medical office brief intervention for adolescent drug abuse. Use of drugs is associated with a variety of health care problems, making settings where adolescents receive routine medical care ideal for implementation of routine screening and early intervention. However, medical settings are currently underutilized in this regard and new evidence-based strategies are needed to improve practice patterns, including standardized methods of screening, assessment, intervention, and referral to treatment. This investigative team has previously conducted studies aimed at assessing the reliability of substance abuse screening tests among adolescent medical patients. We then developed a new brief screen, the CRAFFT, which is both developmentally appropriate for adolescents and practical for use in busy clinic settings. We also completed a Stage 1a feasibility study of a medical office-based brief intervention based on motivational interviewing. Preliminary results from the Stage 1a study suggest that our approach will be effective in reducing use of drugs among 12-18 year old adolescent medical patients. We have developed a draft therapy manual, clinical encounter forms, a clinician training protocol, and a measurement battery. We are now prepared to conduct a Stage 1b study of the new intervention, which will use a randomized controlled design. The specific aims of the proposed plan are to: (1) Test the effect of the brief intervention on drug use, (2) Test the effect of the brief intervention on engagement in treatment, (3) Test the effect of the brief intervention on other substance-related outcomes, and (4) Identify factors that moderate and/or mediate the effect of the intervention on outcomes of interest and estimate their effect sizes. An effective brief intervention for drug abuse could be widely implemented in settings where adolescents receive routine healthcare, and would be of enormous public health significance across the U.S.

本申请是根据 PA-03-126（行为疗法开发计划）提交给 NIDA 的，并提议对青少年药物滥用的医疗办公室短暂干预进行 lb 阶段疗效试验。药物的使用与各种医疗保健问题相关，这使得青少年接受常规医疗保健的环境非常适合实施常规筛查和早期干预。然而，目前在这方面的医疗设施尚未得到充分利用，需要新的循证策略来改善实践模式，包括筛查、评估、干预和转诊治疗的标准化方法。该调查小组此前曾进行过旨在评估青少年患者药物滥用筛查测试可靠性的研究。然后，我们开发了一种新的简短屏幕 CRAFFT，它既适合青少年的发育，又适合在繁忙的诊所环境中使用。我们还完成了基于动机访谈的基于医疗办公室的简短干预的第一阶段可行性研究。 1a 阶段研究的初步结果表明，我们的方法将有效减少 12-18 岁青少年患者的药物使用。我们制定了治疗手册草稿、临床接触表、临床医生培训方案和测量电池。我们现在准备对新干预措施进行 1b 阶段研究，该研究将采用随机对照设计。拟议计划的具体目标是：(1) 测试简短干预对药物使用的影响，(2) 测试短期干预对参与治疗的影响，(3) 测试短期干预对其他与物质相关的结果，以及 (4) 确定调节和/或调节干预措施对感兴趣结果的影响的因素，并估计其影响大小。针对药物滥用的有效短暂干预措施可以在青少年接受常规医疗保健的环境中广泛实施，这将对美国各地的公共卫生产生巨大的意义。