The pandemic of problem drug use, abuse and related health problems among young persons aged 12-25 in the U.S. continues unabated, in part, because opportunities for early identification and monitoring are missed. In particular, improved recognition of, and ongoing contact for, problem drug use and abuse among pre-teens and early adolescents in primary care settings could provide important information to health care professionals and engage early intervention services. Unfortunately, many barriers exist to routine screening and monitoring in primary care settings. These include the expense of traditional paper and pencil screening, competing demands on primary care clinicians and office staff, complex scoring programs and the ability to track youth over time. Our goal is to improve services for problem drug use and abuse and other related health risking behaviors for youth in primary care settings through research on early identification and monitoring. We expand an innovative partnership among the Columbus Children's Hospital, the Close To Home Primary Care Centers and Flipsidemedia.com to test the efficacy and acceptability of an early identification and monitoring system for problem drug use and abuse, depression and related mental disorders among pre-teens and teenagers in a randomized trial. We propose to compare care in nine Close To Home Centers with Automated Risk Assessment for Adolescents/Telephone Support (RA/TS) compared to usual care plus mailed screening results (UC+). Each site will be randomly assigned to start with six months on RA/TS or six months on UC+ and follow with the alternative. RA/TS is a web-based screening and assessment tool completed by adolescents during primary care visits and a linked, structured telephone tracking intervention consisting of three follow-up telephone calls to youth and their families monitoring identified problems and barriers to services. Specifically, we aim to 1) compare frequency of problem drug use and abuse identification in RA/TS youth vs. youth in UC+; 2) examine frequency of counseling, referral, psychotropic medication or other interventions for youth screening positive for problem drug use and abuse on RA in RA/TS youth vs. UC+ youth; and 3) evaluate the effect of the TS program on return to primary care, likelihood of completing referrals, number of primary care visits, number of specialty visits, and satisfaction with services after four months.

Agency
National Institute of Health (NIH)
Institute
National Institute on Drug Abuse (NIDA)
Type
Research Project (R01)
Project #
1R01DA018943-01
Application #
6861453
Study Section
Special Emphasis Panel (ZDA1-MXG-S (03))
Program Officer
Flanzer, Jerry
Project Start
2004-09-25
Project End
2008-08-31
Budget Start
2004-09-25
Budget End
2005-08-31
Support Year
1
Fiscal Year
2004
Total Cost
$455,562
Indirect Cost
Name
Nationwide Children's Hospital
Department
Type
DUNS #
147212963
City
Columbus
State
OH
Country
United States
Zip Code
43205
Embi, Peter J; Hebert, Courtney; Gordillo, Gayle et al. (2013) Knowledge management and informatics considerations for comparative effectiveness research: a case-driven exploration. Med Care 51:S38-44
Kelleher, Kelly (2010) Organizational capacity to deliver effective treatments for children and adolescents. Adm Policy Ment Health 37:89-94
Stevens, Jack; McGeehan, Jennifer; Kelleher, Kelly J (2010) Readiness to change in adolescents screening positive for substance use in urban primary care clinics. J Child Adolesc Subst Abuse 19:99-107
Gardner, William; Klima, Jennifer; Chisolm, Deena et al. (2010) Screening, triage, and referral of patients who report suicidal thought during a primary care visit. Pediatrics 125:945-52
Kelleher, Kelly J; Gardner, William P (2009) Thinking systematically about early identification. J Adolesc Health 44:516-7
Stevens, Jack; Klima, Jennifer; Chisolm, Deena et al. (2009) A trial of telephone services to increase adolescent utilization of health care for psychosocial problems. J Adolesc Health 45:564-70
Chisolm, Deena J; Klima, Jennifer; Gardner, William et al. (2009) Adolescent behavioral risk screening and use of health services. Adm Policy Ment Health 36:374-80
Kelleher, Kelly J; Stevens, Jack (2009) Evolution of child mental health services in primary care. Acad Pediatr 9:7-14
Chisolm, Deena J; Gardner, William; Julian, Teresa et al. (2008) Adolescent Satisfaction with Computer-Assisted Behavioural Risk Screening in Primary Care. Child Adolesc Ment Health 13:163-168
Stevens, Jack; Kelleher, Kelly J; Gardner, William et al. (2008) Trial of computerized screening for adolescent behavioral concerns. Pediatrics 121:1099-105