Computerized alcohol screening for children and adolescents (cASCA) in primary ca

小学儿童和青少年计算机化酒精筛查 (cASCA)

• 批准号: 8428437
• 负责人: JOHN R KNIGHT
• 金额: $ 68.65万
• 依托单位: BOSTON CHILDREN'S HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-09-15 至 2017-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8428437
• 关键词: Accidents; Address; Adolescent; Adult; Age; Alcohol consumption; Alcohol or Other Drugs use; Back; Calendar; Cancer Etiology; Caring; Categories; Cause of Death; Child; Computers; Counseling; Dependence; Diagnostic; Drug Use Disorder; Drug usage; Early Intervention; Effectiveness; Electronic Health Record; Ethnic Origin; Frequencies; Friends; Gender; Goals; Health; Home environment; Homicide; Human; Intervention; Interview; Libraries; Link; Measurement; Measures; Medical; Mental Health; National Institute on Alcohol Abuse and Alcoholism; New England; Nicotine; Nicotine Dependence; Patients; Predictive Value; Prevalence; Prevention; Primary Health Care; Property; Provider; Psychometrics; Race; Recruitment Activity; Reporting; Research; Risk; Risk Behaviors; Sampling; Schools; Screening Result; Sensitivity and Specificity; Structure; Subgroup; Substance Abuse Detection; Substance abuse problem; Suicide; System; Tablets; Telephone; Testing; Therapeutic Intervention; TimeLine; Tobacco use; Treatment Cost; Validation; Visit; Youth; adolescent alcohol; adolescent substance abuse; alcohol screening; alcohol screening and brief intervention; base; binge drinking; brief advice; brief screening; computerized; drinking; follow-up; high risk; improved; mortality; novel strategies; older patient; practice-based research network; preference; prevent; programs; public health relevance; research study; routine care; screening; screening and brief intervention; tobacco screening; tool; treatment as usual; underage drinking

DESCRIPTION (provided by applicant): The goal of this project is to develop a computerized screening program for primary care offices that is based on the NIAAA's Alcohol Screening Guide for Children and Adolescents and assess its psychometric properties among nine- to 18-yr-old primary care patients. There is substantial evidence supporting the effectiveness of screening and brief intervention among adult primary care patients, primarily in the reduction of harmful drinking. However, there have been few studies of alcohol screening and brief intervention conducted among adolescents receiving primary medical care. This project will develop and validate a new computerized Alcohol Screening for Children and Adolescents (cASCA) system based on the two age-specific screening questions of the NIAAA Guide and includes the CRAFFT and AUDIT as secondary risk and problem assessments. We will add tobacco screening, because tobacco use is the leading cause of cancer-related mortality in the US. The system will yield a provider report with the screening results, level of risk, and recommended brief advice, counseling, or referral strategies. The Specific Aims of this project are to: 1. Assess the sensitivity, specificity, positive and negative predictive values of the 'any drinking/number of drinking days' and 'friends' questions of the cASCA in identifying past-year use as determined by the Timeline Follow-Back Calendar (TLFB), and for identifying any problem use, abuse or dependence as determined by the AUDIT, CRAFFT and a structured psychiatric diagnostic interview (computerized DISC- IV, Youth Version) at baseline (criterion validity). 2. Assess the test-retest reliability of the cASCA in measuring drinking frequency categories and in classifying patients into Low, Medium and High risk categories. 3. Assess the predictive validity of the 'any drinking/number of drinking days' and 'friends' questions in predicting drinking, "binge" drinking, and any problem use, abuse or dependence at 12-mos follow-up. 4. Assess the degree to which the 'any drinking/number of drinking days' item of the cASCA predicts drug use risk as measured by the TLFB (any use and frequency), tobacco use as measured by the Hooked on Nicotine Checklist (screen for potential nicotine dependence), drug use disorders as measured by the Drug Abuse Screening Test for Adolescents, and the degree to which it predicts other mental health problems as measured by the Youth DISC Predictive Scales at baseline and 12-month follow-up. 5. Compare the psychometric properties of the cASCA across subgroups, including: age, gender, race/ethnicity, practice type, provider type, and patient risks (e.g., those with/without friends who drink); and explore the possible effects of the cASCA system on drinking at 3-, 6-, 9-, and 12-month follow-ups.

描述（由申请人提供）：该项目的目标是为初级保健办公室开发一个基于 NIAAA 儿童和青少年酒精筛查指南的计算机化筛查计划，并评估其在 9 至 18 岁人群中的心理测量特性初级保健患者。有大量证据支持对成年初级保健患者进行筛查和短暂干预的有效性，主要是在减少有害饮酒方面。然而，对接受初级医疗保健的青少年进行酒精筛查和短暂干预的研究很少。该项目将根据 NIAAA 指南的两个特定年龄筛查问题开发和验证新的计算机化儿童和青少年酒精筛查 (cASCA) 系统，并包括 CRAFFT 和 AUDIT 作为次要风险和问题评估。我们将增加烟草筛查，因为烟草使用是美国癌症相关死亡的主要原因。 该系统将生成一份提供者报告，其中包含筛查结果、风险级别以及推荐的简短建议、咨询或转诊策略。该项目的具体目标是： 1. 评估“任何”的敏感性、特异性、阳性和阴性预测值 饮酒/饮酒天数”和 cASCA 的“朋友”问题，用于确定时间线跟踪日历 (TLFB) 确定的过去一年的使用情况，以及确定审计确定的任何问题使用、滥用或依赖， CRAFFT 和基线（标准有效性）的结构化精神病诊断访谈（计算机化 DISC-IV，青年版）。 2. 评估 cASCA 在测量饮酒频率类别以及将患者分为低、中和高风险类别方面的重测可靠性。 3. 评估“任何饮酒/饮酒天数”和“朋友”问题在预测饮酒、“狂饮”饮酒以及 12 个月随访中任何问题使用、滥用或依赖方面的预测有效性。 4. 评估 cASCA 的“任何饮酒/饮酒天数”项目预测 TLFB（任何使用和频率）衡量的吸毒风险的程度，以及根据“成瘾尼古丁清单”（筛查尼古丁）衡量的烟草使用风险的程度。潜在的尼古丁依赖）、通过青少年药物滥用筛查测试测量的药物使用障碍，以及通过青少年 DISC 预测量表测量的基线和预测其他心理健康问题的程度12个月的随访。 5. 比较不同亚组的 cASCA 心理测量特性，包括：年龄、性别、种族/民族、执业类型、提供者类型和患者风险（例如，有/没有喝酒的朋友的患者）； 并在 3、6、9 和 12 个月的随访中探讨 cASCA 系统对饮酒的可能影响。