Department of Pediatrics, University of Washington, Seattle, Washington, USA.
Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, Washington, USA.
Subst Abus. 2019;40(4):510-518. doi: 10.1080/08897077.2019.1576090. Epub 2019 Mar 18.
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.
本研究旨在比较接受基于学校的健康中心（SBHC）就诊的具有风险性行为的青少年接受和未接受工具（一种提供有关物质使用的激励反馈并为提供者总结结果的电子工具）的护理提供和酒精和大麻使用情况。我们对 148 名年龄在 13-18 岁之间符合中度至高度风险饮酒标准的青少年进行了一项随机对照试验，这些青少年是从城市 SBHC 招募的。参与者被随机分配接受 SBHC 就诊，其中 73 名接受了工具筛查和反馈，75 名接受了 SBHC 就诊。所有 SBHC 提供者都接受了简短的动机访谈培训。与接受 SBHC 就诊但未使用工具的青少年相比，接受 工具+SBHC 就诊的青少年在就诊期间接受提供者提供的酒精（67%）和大麻（73%）咨询的比例更高（分别为 40%和 45%，s<.005），与未接受工具的青少年相比，他们减少大麻使用的动机更高（=.02）。与基线相比，两组青少年在 2 个月随访时都减少了他们的典型饮酒量、最大饮酒量和大麻使用时间（s<.02）。当给青少年患者提供电子筛查和反馈工具时，它可以促使提供者增加对有物质使用风险的青少年的咨询。总的来说，接受过有培训的提供者就诊的参与者对护理的满意度很高，并且在 2 个月内减少了饮酒量，这表明 SBHC 是提供简短物质使用干预的绝佳场所。
