The goal of this SBIR is to develop an innovative adolescent primary health care delivery model for use in primary care that overcomes barriers of health care provider time, skill and teen engagement when providing effective tobacco use reduction counseling. This will be achieved by creating a web-based counseling module that will provide interactive, technology-driven tobacco reduction counseling to adolescents, individualized to their positive responses to tobacco use on the Rapid Assessment for Adolescent Preventive Services (c) (RAAPS) risk behavior screening tool. Significance: Nearly 75 percent of adolescent morbidity and mortality is a result of risky behaviors that cost hundreds of billions of healthcare dollars annually. Tobacco usage represents an especially crucial risk behavior to address as 90 percent of tobacco addiction begins during adolescence. Comprehensive autonomous web-based risk screening and counseling represents an excellent opportunity to overcome disparities in screening and cessation care for adolescents in an extremely efficient and cost-effective manner, reducing the burden on the health system as tobacco-using adolescents transition into chronic adult tobacco addicts. The Product: An innovative web-based adolescent tobacco cessation delivery model designed to work seamlessly with the existing RAAPS system will be developed for use in primary care. The web-based tobacco cessation counseling module will be marketed as an add-on to the current RAAPS system, giving health care providers a comprehensive all-in-one risk screening and counseling tool to deliver preventive care to adolescent patients. The new counseling module proposed for RAAPS will include interactive, tailored tobacco counseling module based on patient responses, an electronic record of the patient's tobacco reduction plan, and text messaging-based patient engagement that populates a record for health care providers of progress between appointments. Long Term Goal: The RAAPS system will be used for broad dissemination of an effective and cost-efficient web-based tobacco screening and counseling program, resulting in reductions in adolescent tobacco use and escalation and their associated health care costs. Phase I Hypothesis: A web-based tobacco use counseling module will meet the needs of health care providers to deliver and adolescents to receive evidence-based tobacco use counseling.
Specific Aim 1 : Create an online tobacco use counseling module that works seamlessly within the RAAPS system.
Specific Aim 2 : Assess the feasibility of the web-based tobacco use counseling module for health care providers and adolescents. Plans for Phase II: In Phase II, the tobacco counseling module will be tested in a randomized controlled trial with 200 adolescents within Michigan School Based Health Centers to determine adolescent perceptions following use of the counseling modules and subsequent reduction of tobacco use. Commercial Application: The overall market for the tobacco use module includes a variety of healthcare settings that provide care for adolescents, including hospitals, health systems, primary care and mental health offices, family planning centers, and military facilities. While forecasted percentages of market penetration vary by target, a conservative projections estimate recurring revenue at $2.0M by 2015, and $6.5M by 2018.

Public Health Relevance

In this SBIR, Possibilities for Change proposes to develop a web-based tobacco use counseling module for use by primary health care providers that will deliver interactive, technology driven risk reduction counseling to adolescents to improve the health outcomes of those adolescents that use tobacco. In real-world practice, the delivery of risk-reduction counseling for adolescents varies widely - and is highly dependent on the experience of the individual clinician, his or her knowledge of clinical guidelines, their subconscious bias', and personal comfort level across risk topics. This project seeks to reduce adolescent tobacco usage by adding an evidence-based tobacco use counseling module to an existing and proven adolescent risk screening software system, to effectively address this gap in care and improve the identification - and subsequent reduction - of adolescent risk behaviors.

National Institute of Health (NIH)
National Institute on Drug Abuse (NIDA)
Small Business Innovation Research Grants (SBIR) - Phase I (R43)
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Special Emphasis Panel (ZRG1)
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Grossman, Debra
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Possibilities for Change, LLC
Ann Arbor
United States
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