Screening and brief intervention with adolescents with risky alcohol use in school-based health centers: A randomized clinical trial of the tool.

This study aimed to compare care delivery and alcohol and marijuana use for adolescents with risky alcohol use who received a school-based health center (SBHC) visit with and without the tool, an electronic tool that gives motivational feedback on substance use and summarizes results for providers. We conducted a randomized controlled trial with 148 adolescents aged 13-18 who met criteria for moderate- to high- risk alcohol use, recruited from urban SBHCs. Participants were randomized to receive their SBHC visit with ( = 73) or without ( = 75) the screening and feedback tool. All SBHC providers received a brief training on motivational interviewing. Adolescents who received the tool + SBHC visit reported higher levels of alcohol (67%) and marijuana (73%) counseling from the provider during their visit, compared with those who received a SBHC visit without the tool (40% and 45%, respectively, s < .005), and had higher motivation to decrease marijuana use relative to those who did not ( = .02). Relative to baseline, adolescents in both groups reduced their typical number of drinks of alcohol, maximum number of drinks of alcohol, and hours high on marijuana over time (s < .02) at 2-month follow-up. When adolescent patients are given an electronic screening and feedback tool, it can prompt providers to increase counseling of adolescents with substance use risk. Overall, participants who had a visit with a trained provider reported high satisfaction with care and decreased the amount of alcohol use over 2 months, suggesting that SBHCs are an excellent venue for delivery of brief substance use interventions.