Substance? ?use? ?usually? ?(90%)? ?begins? ?during? ?adolescence,? ?causing? ?brain? ?and? ?liver? ?damage,? ?risky sexual? ?and? ?driving? ?behavior,? ?and? ?potentially? ?leading? ?to? ?addiction? ?therefore? ?prevention? ?and? ?early intervention? ?programs? ?targeting? ?teens? ?are? ?needed? ?to? ?prevent? ?this? ?morbidity,? ?gain? ?productive years? ?of? ?life? ?and? ?reduce? ?costs.? ?? ?This? ?proposal? ?presents? ?innovations? ?to? ?overcome? ?the? ?barriers? ?to effectively? ?addressing? ?teen? ?substance? ?use? ?during? ?primary? ?care? ?visits? ?through? ?further development? ?of? ?a? ?promising? ??c?omputerized? ?alcohol? ?and? ?substance? ?use? ?computerized? ??S?creening and? ?provider? ??B?rief? ??A?dvice? ?system? ?(cSBA)? ?and? ?integration? ?with? ?an? ?online? ??clinical? ?process support? ?system?? ?called? ?CHADIS.? ?? ?CHADIS? ?addresses? ?all? ?pediatric? ?screening? ?needs? ?and? ?is currently? ?widely? ?used? ?in? ?pediatric? ?practice? ?making? ?widespread? ?dissemination? ?of? ?a? ?CHADIS-cSBA module? ?immediately? ?feasible.? ?? ?? ?However,? ?because? ?of? ?limitations? ?related? ?to? ?time? ?and? ?training? ?the approach? ?of? ?motivational? ?interviewing? ?(MI),? ?with? ?strong? ?evidence? ?for? ?effecting? ?behavior? ?change in? ?substance? ?users,? ?was? ?not? ?a? ?part? ?of? ?cSBA.? ?? ?An? ?innovation? ?proposed? ?here? ?will? ?take? ?pre-visit? ?teen data? ?related? ?to? ?strengths? ?and? ?goals? ?and? ?acknowledged? ?reasons? ?for? ?usage? ?to? ?populate individualized? ??teleprompters?? ?accessible? ?at? ?the? ?moment? ?of? ?care? ?by? ?PCP?s? ?along? ?with? ?options? ?for sharing? ?graphical? ?representations? ?for? ?use? ?in? ?reinforcing? ?abstinence? ?or? ?motivate? ?discontinuing usage.? ?? ?In? ?addition,? ?the? ?prompts? ?for? ?discussion? ?of? ?teen? ?identified? ?strengths? ?and? ?goals? ?will? ?include wording? ?from? ?teen? ?studies? ?using? ??incremental? ?theory?(or? ?? ?the? ?belief? ?that? ?people? ?have? ?the potential? ?to? ?change),? ?which? ?has? ?shown? ?result? ?in? ?improvements? ?in? ?social? ?coping.? ?? ?CHADIS-cSBA will? ?also? ?provide? ?each? ?teen? ?a? ?confidential? ?individualized? ?portal? ?automatically? ?populated? ?with supports? ?for? ?their? ?endorsed? ?strengths? ?and? ?other? ?supports? ?as? ?well? ?as? ?substance-related? ?follow-up messaging.? ?? ?Post-visit? ?parent? ?education? ?will? ?include? ?access? ?to? ?a? ?Teen? ?Safe? ?course.? ?? ?Teens? ?found? ?to have? ?serious? ?substance? ?abuse? ?or? ?dual? ?diagnoses? ?will? ?have? ?referrals? ?facilitated? ?by? ?care coordination? ?functionality.? ?? ?PCP? ?participation? ?will? ?be? ?reinforced? ?by? ?a? ?American? ?Board? ?of Pediatrics? ?accredited? ?quality? ?improvement? ?program? ?for? ?their? ?required? ?re-certification? ?(MOC-4). In? ?Phase? ?1,? ?the? ?CHADIS-cSBA? ?module? ?will? ?be? ?created? ?with? ?both? ?professional? ?and? ?teen? ?feedback and? ?MOC-4? ?certification? ?obtained.? ?? ?In? ?Phase? ?2? ?the? ?resulting? ?system? ?will? ?be? ?piloted;? ?a? ?baseline? ?of substance? ?use? ?screening? ?conducted;? ?then? ?CHADIS-cSBA? ?module? ?will? ?be? ?randomly? ?assigned? ?to doctors? ?and? ?a? ?quality? ?improvement? ?intervention? ?will? ?be? ?conducted? ?to? ?measure? ?reduction? ?in? ?rates of? ?any? ?substance? ?use? ?at? ?3? ?and? ?12? ?month? ?follow-up? ?compared? ?to? ?treatment? ?as? ?usual.
Substance? ?Use? ?Project? ?Narrative This? ?proposal? ?will? ?create? ?innovations? ?to? ?overcome? ?the? ?barriers? ?to? ?effectively? ?addressing? ?teen substance? ?use? ?(SU)? ?in? ?primary? ?care? ?visits? ?through? ?further? ?development? ?of? ?a? ?promising c?omputerized? ?alcohol? ?and? ?substance? ?use? ?computerized? ??S?creening? ?and? ?provider? ??B?rief? ??A?dvice system? ?(cSBA)? ?and? ?integration? ?with? ?an? ?online? ??clinical? ?process? ?support? ?system?? ?(CHADIS).? ?? ?The planned? ?enhancements? ?in? ?the? ?new? ?CHADIS-cSBA? ?module? ?will? ?address? ?barriers? ?of? ?time? ?and doctor? ?training? ?through:? ?collection? ?of? ?comprehensive? ?pre-visit? ?data? ?in? ?an? ?online? ?questionnaire that? ?has? ?interactive? ?education? ?about? ?SU;? ?individualized? ?? ??teleprompters?? ?for? ?the? ?doctor? ?to? ?use? ?for supporting? ?teen? ?strengths? ?and? ?conducting? ?a? ?motivational? ?interview? ?(MI)? ?to? ?quit? ?or? ?reduce? ?use pre-populated? ?by? ?questionnaire? ?results;? ?post-visit? ?education? ?and? ?resources? ?automatically provided? ?in? ?a? ?confidential? ?individual? ?portal;? ?parent? ?video? ?education? ?about? ?SU;? ?and? ?a? ?parent-teen Contract? ?for? ?Life.? ?? ?The? ?CHADIS-cSBA? ?system? ?will? ?be? ?developed? ?with? ?teen? ?and? ?professional interview? ?input? ?and? ?then? ?tested? ?for? ?effectiveness? ?through? ?a? ?randomized? ?control? ?quality improvement? ?trial? ?supplemented? ?by? ?Board? ?recertification? ?credits? ?for? ?doctors? ?with? ?the? ?outcome? ?to be? ?measured? ?of? ?reduced? ?rates? ?of? ?substance? ?use? ?at? ?3? ?and? ?12? ?month? ?follow-up? ?compared? ?to treatment? ?as? ?usual.
