This application responds to the National Institute on Alcohol Abuse and Alcoholism's Program Announcement PA-05-139 Health Services Research on the Prevention and Treatment of Drug and Alcohol Abuse, and its goal of understanding """"""""factors that affect the delivery of alcohol or drug abuse prevention, treatment, and related services: social factors, personal behaviors and attributes, financing, organization, management; and health technologies."""""""" In particular, we focus on expanding primary care's role in prevention and treatment of alcohol and other drug (AOD) problems. We address the gap in research on incentives and barriers for adolescent primary care providers to make AOD use a health care priority.
Our aim i s to identify the factors associated with screening practices and management of youth AOD use in order to integrate these activities more fully into primary care. We have the opportunity to study this in a large, heterogeneous managed care health plan. We use a model which examines the influence of provider, panel/patient and organizational characteristics on primary care screening and follow-up services. We propose an on-line survey of primary care providers with adolescent panels to investigate their AOD screening practices, and their perceptions of barriers and enabling factors to screening and follow-up interventions. The study makes use of both provider self-report and health plan electronic databases of screening behavior, and provider and panel characteristics. We also use the health plan's electronic medical record and other automated databases to examine reported and actual screening rates, as well as provider practices after the identification of AOD use. We collect data on organizational characteristics across the region's 48 facilities. Our multivariate analytic model examines facility differences in screening rates and accounts for the clustering of providers within facilities as appropriate. We also propose to conduct interviews with health plan administrators and chiefs, of pediatrics departments to explore policies and procedures as they impact development and dissemination of screening practices. Identifying barriers and incentives to screening and management of AOD problems can heighten integration of AOD identification and services within primary care. Early identification of AOD problems can prevent the development of medical, chemical dependency, and psychiatric problems. ? ? ?

Agency
National Institute of Health (NIH)
Institute
National Institute on Alcohol Abuse and Alcoholism (NIAAA)
Type
Research Project (R01)
Project #
5R01AA016204-02
Application #
7406830
Study Section
Health Services Research Review Subcommittee (AA)
Program Officer
Roach, Deidra
Project Start
2007-04-15
Project End
2010-03-31
Budget Start
2008-04-01
Budget End
2009-03-31
Support Year
2
Fiscal Year
2008
Total Cost
$308,800
Indirect Cost
Name
University of California San Francisco
Department
Psychiatry
Type
Schools of Medicine
DUNS #
094878337
City
San Francisco
State
CA
Country
United States
Zip Code
94143
Sterling, Stacy; Kline-Simon, Andrea H; Weisner, Constance et al. (2018) Pediatrician and Behavioral Clinician-Delivered Screening, Brief Intervention and Referral to Treatment: Substance Use and Depression Outcomes. J Adolesc Health 62:390-396
Kline-Simon, Andrea H; Litten, Raye Z; Weisner, Constance M et al. (2017) Posttreatment Low-Risk Drinking as a Predictor of Future Drinking and Problem Outcomes Among Individuals with Alcohol Use Disorders: A 9-Year Follow-Up. Alcohol Clin Exp Res 41:653-658
Sterling, Stacy; Kline-Simon, Andrea H; Jones, Ashley et al. (2017) Specialty addiction and psychiatry treatment initiation and engagement: Results from an SBIRT randomized trial in pediatrics. J Subst Abuse Treat 82:48-54
Sterling, Stacy; Kline-Simon, Andrea H; Satre, Derek D et al. (2015) Implementation of Screening, Brief Intervention, and Referral to Treatment for Adolescents in Pediatric Primary Care: A Cluster Randomized Trial. JAMA Pediatr 169:e153145
Satre, Derek D; Delucchi, Kevin; Lichtmacher, Jonathan et al. (2013) Motivational interviewing to reduce hazardous drinking and drug use among depression patients. J Subst Abuse Treat 44:323-9
Sterling, Stacy; Kline-Simon, Andrea H; Wibbelsman, Charles et al. (2012) Screening for adolescent alcohol and drug use in pediatric health-care settings: predictors and implications for practice and policy. Addict Sci Clin Pract 7:13
Sterling, Stacy; Valkanoff, Tina; Hinman, Agatha et al. (2012) Integrating substance use treatment into adolescent health care. Curr Psychiatry Rep 14:453-61
Sterling, Stacy; Weisner, Constance; Hinman, Agatha et al. (2010) Access to treatment for adolescents with substance use and co-occurring disorders: challenges and opportunities. J Am Acad Child Adolesc Psychiatry 49:637-46; quiz 725-6