Sandelich Stephen, Coakes Cameron, Stuckey-Peyrot Heather L, Levy Sharon, Buresh Christopher, Chun Thomas H, Zgierska Aleksandra E
Departments of Pediatrics and Emergency Medicine, Penn State College of Medicine, Hershey, Pennsylvania, USA.
Penn State College of Medicine, Hershey, Pennsylvania, USA.
J Am Coll Emerg Physicians Open. 2025 Jun 7;6(4):100198. doi: 10.1016/j.acepjo.2025.100198. eCollection 2025 Aug.
Substance use among adolescents poses significant health risks; early identification is crucial. Understanding adolescents' and caregivers' perceptions toward substance use screening in emergency departments (EDs) is needed to develop acceptable and effective screening programs.
A national online survey recruited adolescents aged 13-17 years and caregivers of adolescents via a Qualtrics research panel. The survey included 34 questions for adolescents and 28 for caregivers, assessing attitudes, perceived barriers, and facilitators of ED-based substance use screening through Likert-scale, multiple-choice, and open-ended qualitative responses. Data were analyzed using descriptive statistics, chi-square tests for group comparisons, and thematic analysis for qualitative responses.
Among the 548 adolescent and 544 caregiver respondents, 43.8% of adolescents and 42.6% of caregivers supported universal substance use screening in the ED, whereas 50.4% of adolescents and 38.0% of caregivers rated screening as "very" or "extremely" important. Privacy concerns were identified as a barrier for the majority of adolescents (75.5%) and caregivers (67.8%). Supportive health care staff and clear communication were key facilitators for adolescents (70.0%) and caregivers (74.0%). Adolescents preferred follow-up in the form of digital tools. Thematic analysis of qualitative responses revealed shared concerns among adolescents and caregivers, including privacy, judgment, and test accuracy, whereas adolescents emphasized autonomy and comfort, and caregivers prioritizing transparency, involvement, and legal implications.
Most adolescents and caregivers did not definitely support substance use screening in EDs and identified distinct barriers and facilitators. Addressing concerns about privacy, legal consequences, and trust while leveraging digital tools and other follow-up resources may enhance screening acceptability and reach. Future clinical trials can leverage this information to design and evaluate interventions for optimal substance use screening among adolescents in EDs.
青少年物质使用会带来重大健康风险；早期识别至关重要。为制定可接受且有效的筛查项目，需要了解青少年及其照顾者对急诊科（ED）物质使用筛查的看法。
一项全国性在线调查通过Qualtrics研究小组招募了13 - 17岁的青少年及其照顾者。该调查包括针对青少年的34个问题和针对照顾者的28个问题，通过李克特量表、多项选择和开放式定性回答来评估对基于急诊科的物质使用筛查的态度、感知障碍和促进因素。使用描述性统计、用于组间比较的卡方检验以及用于定性回答的主题分析对数据进行分析。
在548名青少年和544名照顾者受访者中，43.8%的青少年和42.6%的照顾者支持在急诊科进行普遍的物质使用筛查，而50.4%的青少年和38.0%的照顾者将筛查评为“非常”或“极其”重要。隐私问题被确定为大多数青少年（75.5%）和照顾者（67.8%）的障碍。支持性的医护人员和清晰的沟通是青少年（70.0%）和照顾者（74.0%）的关键促进因素。青少年更喜欢以数字工具的形式进行后续跟进。对定性回答的主题分析揭示了青少年和照顾者之间的共同担忧，包括隐私、判断和检测准确性，而青少年强调自主性和舒适度，照顾者则优先考虑透明度、参与度和法律影响。
大多数青少年和照顾者并未明确支持在急诊科进行物质使用筛查，并确定了不同的障碍和促进因素。在利用数字工具和其他后续资源的同时，解决对隐私、法律后果和信任的担忧，可能会提高筛查的可接受性和覆盖面。未来的临床试验可以利用这些信息来设计和评估针对急诊科青少年最佳物质使用筛查的干预措施。
