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Galán CA, Shaw DS, O'Rourke F, Reynolds MD, Gill A, Bogen DL, Ridenour TA. Substance Use Screening and Prevention for Adolescents in Pediatric Primary Care: A Randomized Clinical Trial using the Family Check-Up. Res Child Adolesc Psychopathol 2023; 51:151-163. [PMID: 36208361 PMCID: PMC10146025 DOI: 10.1007/s10802-022-00978-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/14/2022] [Indexed: 11/07/2022]
Abstract
This study evaluated acceptability, engagement in prevention, and efficacy of a primary care screening-and-referral-to-prevention program to reduce substance use in early adolescence. Screening tools were the Youth Risk Index and Transmissible Liability Index and prevention consisted of the Family Check-Up (FCU). Three hundred sixty-one 10- to 13-year-olds from low resource neighborhoods (85.9% African American; 52.4% female) screened "at risk" during primary care visits and were randomized to the FCU (n = 123) or usual care (n = 238). Screening was acceptable to parents and youths: nearly 95% of each rated it as important, about 90% of each were happy with or did not mind it, and only 2.4% of parents did not want their child to be screened at their next check-up. Of parents who had a chance to receive the FCU (or waitlist-control), 87.5% followed through with researchers while 93.5% who were offered FCU engaged in it. FCU efficacy primarily involved interactions such that youth with greater risk at baseline experienced larger benefits. At 12-month follow-up, FCU was associated with 11% reduced risk of initiating a new substance per substance that had been initiated before baseline; greater reductions in tolerance of deviance among those with higher tolerance of deviance at baseline; and a main effect of reduced anxiety, but no effect for conduct problems. Pediatric well-child check-up screening can identify high-risk youth before, or in the initial stages of, problematic SU; engage families in a preventive intervention; and reduce rates of substance use and related risk factors.
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Affiliation(s)
| | | | | | | | - Anne Gill
- University of Pittsburgh, Pittsburgh, PA, USA
| | | | - Ty A Ridenour
- University of Pittsburgh, Pittsburgh, PA, USA. .,Research Triangle Institute, Research Triangle Park, NC, USA. .,University of North Carolina, Chapel Hill, NC, USA.
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Ranganath P, Hjetland GJ, Finserås TR, Brunborg GS, Hesse M, Skogen JC. Negative experiences, social exclusion and unwanted attention on social media: exploring the association with adolescent alcohol use. BMC Public Health 2022; 22:2361. [PMID: 36527010 PMCID: PMC9756586 DOI: 10.1186/s12889-022-14679-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 11/21/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Adolescents' presence on Social Media (SoMe) facilitates peer connections making them susceptible to peer-influences and approval. Negative experiences on SoMe can affect adolescent stress and wellbeing, impelling their use of alcohol. This paper provides a novel understanding of the relationship between negative experiences on SoMe and key indicators of alcohol use in adolescents. METHODS Data was collected from upper secondary school students (n = 3528, ages 16-19, 45% boys) in Bergen (Norway) using a web-based questionnaire during school-hours in 2020 and 2021. Dependent variables were alcohol consumption, binge drinking and scoring ≥ 2 points on the CRAFFT instrument screening for substance use problems in adolescents. Independent variables were two scales indicating "negative acts and exclusion" and "unwanted attention from others". Covariates included age, gender, country of birth and subjective socioeconomic status. Results are presented as relative risk ratios (RRR), odds ratios (OR) and incidence rate ratios (IRR) with 95% confidence intervals. RESULTS Using multinomial logistic regression models, "negative acts and exclusion" and "unwanted attention" were positively associated with trying alcohol (OR: 1.50 (95% CI 1.28-1.76) and 1.86 (95% CI 1.66-2.09) respectively, both p ≤ 0.001), with frequency and amount of alcohol consumed. Findings from logistic regression models indicated that "negative acts and exclusion" and "unwanted attention" were positively associated with i. CRAFFT-caseness (OR: 2.13 and 1.86) and ii. frequent binge drinking (OR: 1.55 and 1.89). CONCLUSION Both exclusion and unwanted attention on SoMe were associated with indicators of problematic drinking, including frequency, quantity, and consequences related to alcohol.
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Affiliation(s)
- Priya Ranganath
- grid.7048.b0000 0001 1956 2722Center for Alcohol and Drug Research, Aarhus University, Bartholins Allé 10, 8000 Aarhus, Denmark
| | - Gunnhild Johnsen Hjetland
- grid.418193.60000 0001 1541 4204Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway ,grid.418193.60000 0001 1541 4204Centre for Evaluation of Public Health Measures, Norwegian Institute of Public Health, Oslo, Norway
| | - Turi Reiten Finserås
- grid.418193.60000 0001 1541 4204Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway
| | - Geir Scott Brunborg
- grid.418193.60000 0001 1541 4204Department of Alcohol, Tobacco and Drugs, Norwegian Institute of Public Health, Oslo, Norway ,grid.4714.60000 0004 1937 0626 Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Morten Hesse
- grid.7048.b0000 0001 1956 2722Center for Alcohol and Drug Research, Aarhus University, Bartholins Allé 10, 8000 Aarhus, Denmark
| | - Jens Christoffer Skogen
- grid.418193.60000 0001 1541 4204Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway ,grid.418193.60000 0001 1541 4204Centre for Evaluation of Public Health Measures, Norwegian Institute of Public Health, Oslo, Norway ,grid.412835.90000 0004 0627 2891Alcohol and Drug Research Western Norway, Stavanger University Hospital, Stavanger, Norway
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Addressing Barriers to Primary Care Screening and Referral to Prevention for Youth Risky Health Behaviors: Evidence Regarding Potential Cost-Savings and Provider Concerns. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2021; 23:212-223. [PMID: 34714504 PMCID: PMC8554188 DOI: 10.1007/s11121-021-01321-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/04/2021] [Indexed: 11/27/2022]
Abstract
Despite growing evidence and support for co-locating behavioral services in primary care to prevent risky health behaviors, implementation of these services has been limited due to a lack of reimbursement for services and negative perceptions among providers. We investigated potential to overcome these barriers based on new developments in healthcare funding and screening and referral to prevention (SRP) in primary care based on the Consolidated Framework for Implementation Research (CFIR), which could guide future SRP implementation strategies. To investigate the economic need for healthcare-based SRP, we quantified hospital charges to healthcare payors for services arising from adolescent risky behaviors (e.g., substance use, risky sex). Annual North Carolina (NC) hospital charges for these services exceeded $327 M (2019 dollars), suggesting high potential for cost savings if SRP can curb hospital services associated with risky behaviors. To investigate provider barriers and facilitators, we surveyed 151 NC pediatricians and 230 NC family therapists about their attitudes regarding a recently developed well-child visit SRP with family-based prevention. Both sets of professionals reported widespread need for and interest in the SRP but cited barriers of lack of reimbursement, training, and referrals to/from each other. Physicians, but not family therapists, reported concerns with poor patient or parent compliance. Many barriers could be resolved by co-locating family therapists in pediatric clinics to conduct well-child SRP. Our results support further research to develop business models for payor-funded SRP and CFIR-guided research to develop implementation strategies for primary care SRP to prevent adolescent risky health behaviors.
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Abstract
PURPOSE Alcohol and cannabis are the most commonly used substances during adolescence and are typically initiated during this sensitive neurodevelopmental period. The aim of this review is to provide a comprehensive overview of the most recent literature focused on understanding how these substances affect the developing brain. SEARCH METHODS Articles included in this review were identified by entering 30 search terms focused on substance use, adolescence, and neurodevelopment into MEDLINE, Embase, PsycINFO, ProQuest Central, and Web of Science. Studies were eligible for inclusion if they longitudinally examined the effect of adolescent alcohol and/or cannabis use on structural or functional outcomes in 50 or more participants. SEARCH RESULTS More than 700 articles were captured by the search, and 43 longitudinal studies met inclusion criteria, including 18 studies focused on alcohol use, 13 on cannabis use, and 12 on alcohol and cannabis co-use. DISCUSSION AND CONCLUSIONS Existing studies suggest heavy alcohol and cannabis use during adolescence are related to small to moderate disruptions in brain structure and function, as well as neurocognitive impairment. The effects of alcohol use include widespread decreases in gray matter volume and cortical thickness across time; slowed white matter growth and poorer integrity; disrupted network efficiency; and poorer impulse and attentional control, learning, memory, visuospatial processing, and psychomotor speed. The severity of some effects is dependent on dose. Heavy to very heavy cannabis use is associated with decreased subcortical volume and increased frontoparietal cortical thickness, disrupted functional development, and decreased executive functioning and IQ compared to non-using controls. Overall, co-use findings suggest more pronounced effects related to alcohol use than to cannabis use. Several limitations exist in the literature. Sample sizes are relatively small and demographically homogenous, with significant heterogeneity in substance use patterns and methodologies across studies. More research is needed to clarify how substance dosing and interactions between substances, as well as sociodemographic and environmental factors, affect outcomes. Larger longitudinal studies, already underway, will help clarify the relationship between brain development and substance use.
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Affiliation(s)
- Briana Lees
- Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Camperdown, Australia
| | - Jennifer Debenham
- Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Camperdown, Australia
| | - Lindsay M Squeglia
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina
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Parizek RA. Health Literacy Does Not Protect Against Underage Alcohol Use During the COVID-19 Pandemic. J Psychosoc Nurs Ment Health Serv 2021; 59:13-21. [PMID: 34432596 DOI: 10.3928/02793695-20210819-06] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Limited health literacy (HL) and alcohol use increase teens' risk for preventable disease burden and adverse outcomes. In the current study, relationships between HL and alcohol use were explored in 39 secondary school students sheltering-at-home during the coronavirus disease 2019 pandemic. HL was assessed using the Newest Vital Sign. Alcohol use was assessed with questions from the Youth Risk Behavior Survey (YRBS). Most students (76.9%) had adequate HL. Males had higher HL than females. Many teens (42.9%) reported drinking and recent alcohol use (18.2%). Drunk driving and riding with someone under the influence were comparable to the YRBS. Lifetime and recent alcohol use and positive alcohol expectancies were comparable among teens with adequate and limited HL. More teens with adequate HL had negative expectancies. Only teens with adequate HL reported recent binge drinking (10.3%), drunk driving (10.5%), or riding with someone under the influence (17.9%). Adequate HL does not protect teens from alcohol use and misuse. [Journal of Psychosocial Nursing and Mental Health Services, 59(12), 13-21.].
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Liskola J, Haravuori H, Lindberg N, Kiviruusu O, Niemelä S, Karlsson L, Marttunen M. The predictive capacity of AUDIT and AUDIT-C among adolescents in a one-year follow-up study. Drug Alcohol Depend 2021; 218:108424. [PMID: 33257195 DOI: 10.1016/j.drugalcdep.2020.108424] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Revised: 11/06/2020] [Accepted: 11/11/2020] [Indexed: 10/22/2022]
Abstract
AIM The Alcohol Use Disorders Identification Test (AUDIT) has been validated for use with adolescents to screen their harmful alcohol consumption. How well AUDIT or its derivative consumption version AUDIT-C predicts the development of problematic alcohol use among adolescents remains unknown. The aim of our study was to examine the predictive capacity of AUDIT and AUDIT-C among adolescents in a one-year follow-up. METHODS Finnish adolescents (N = 337) were examined at baseline with AUDIT and one year later with the Schedule for Affective Disorders and Schizophrenia for School-Age Children - Present and Lifetime version (K-SADS-PL) interview to assess alcohol problem use. Test characteristics and regression models were analyzed in predicting alcohol problem use. RESULTS The sensitivity of AUDIT (cut-off ≥5) was 0.809 and specificity 0.621 in predicting alcohol problem use among adolescents one year later. The positive test posterior probability was 0.51. For those who screened negative at baseline, the positive test posterior probability was 0.13. With AUDIT-C (cut-off ≥3), the posterior probabilities were 0.47 and 0.12, respectively (sensitivity 0.855, specificity 0.529). The odds ratio was 6.95 for those screening positive with AUDIT and 6.59 with AUDIT-C at baseline to have alcohol problem use one year later. CONCLUSIONS AUDIT has utility in screening youth at risk for developing alcohol problem use. It has significant predictive capacity in detecting risk especially among adolescents with depression.
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Affiliation(s)
- Joni Liskola
- Forensic Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki and Tuusula, Finland.
| | - Henna Haravuori
- Mental Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland; Adolescent Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Nina Lindberg
- Forensic Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki and Tuusula, Finland
| | - Olli Kiviruusu
- Mental Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Solja Niemelä
- Department of Psychiatry, University of Turku and Turku University Hospital, Turku, Finland
| | - Linnea Karlsson
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Finland; Centre for Population Health Research, University of Turku and Turku University Hospital, Finland; Department of Child Psychiatry, Turku University Hospital and University of Turku, Finland
| | - Mauri Marttunen
- Mental Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland; Adolescent Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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Trucco EM. A review of psychosocial factors linked to adolescent substance use. Pharmacol Biochem Behav 2020; 196:172969. [PMID: 32565241 PMCID: PMC7415605 DOI: 10.1016/j.pbb.2020.172969] [Citation(s) in RCA: 63] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 05/23/2020] [Accepted: 06/14/2020] [Indexed: 12/21/2022]
Abstract
PURPOSE Informed by ecological theories and models of influence, this review discusses various psychosocial risk and protective factors that contribute to adolescent substance use behavior. Given typical patterns of substance use initiation during this developmental period, an emphasis is placed on alcohol, cigarette, and marijuana use. FINDINGS Consistent with bioecological theories, peers and parents tend to have the strongest effect on adolescent substance use behavior. Influences can be both direct, such as offers and availability to use substances, as well as indirect influences, such as the perception of substance use approval. Schools and neighborhoods also contribute to adolescent substance use behavior, but this effect is often less direct. Moreover, the effect of neighborhoods on adolescent behavior reflects both structural components (e.g., neighborhood racial composition, teacher-student ratios) in addition to social process (e.g., neighborhood social cohesion, school connectedness). A review of parallel studies conducted with animals is also provided. SUMMARY Adolescent substance use behavior does not occur in a vacuum. Investigations must encompass the relevant social ecologies that affect adolescent behavior, including family, peer, school, and neighborhood contexts to provide a more complete understanding of substance use etiology.
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Affiliation(s)
- Elisa M Trucco
- Florida International University, Psychology Department, Center for Children and Families, 11200 SW 8th Street, AHC-1, Miami, FL 33199, United States of America.
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Arasi O, Ajuwon A. Use of sachet alcohol and sexual behaviour among adolescents in Ibadan, Nigeria. Afr Health Sci 2020; 20:14-27. [PMID: 33402888 PMCID: PMC7750056 DOI: 10.4314/ahs.v20i1.5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background Availability and affordability of sachet liquor has significantly increased adolescents' access to alcohol in Nigeria. This study investigated use of sachet alcohol and sexual behavior among adolescents in Ibadan South-East Local Government Area(IBSE-LGA), Oyo state, Nigeria. Methods A descriptive cross-sectional study was conducted with three-stage random sampling technique to select 390 adolescents in IBSE-LGA, Oyo state; using quantitative and qualitative instruments(5 IDIs). Results There were more male adolescents (61.8%); with 14.7±2.6 as mean age; equal proportion of early (10–14years) and late(15–19years) adolescents. Findings show that about 16% of the respondents have not completed Primary School education; half(50%) of the respondents had ever taken alcohol, while 39.5% are current users of sachet alcohol (more males, older adolescents and working class). Many respondents are sexually active(30.5%), out of which 63% did not use any protection in their last sex episode, and 33.6% tok sachet alcohol before sex. There was an association between sachet alcohol use and risky sexual behaviours(p<0.05). Participants of IDI believe alcohol boosts sexual performance. Conclusion Sex, age and school/work status were related to alcohol use among adolescents. Higher proportion of the adolescents associated alcohol use with heightened sexual performance. Health education strategies (public enlightenment, peer education and life skills training) against adolescent alcohol use is recommended.
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Affiliation(s)
| | - Ademola Ajuwon
- Department of Health Promotion & Education, College of Medicine, University of Ibadan
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Levy S, Seale JP, Alford DP. Medicine, with a focus on physicians: Addressing substance use in the 21st century. Subst Abus 2019; 40:396-404. [DOI: 10.1080/08897077.2019.1691130] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- Sharon Levy
- Director, Adolescent Substance Use and Addiction Program, Boston Children’s Hospital, Boston, Masachussetts, USA
| | - J. Paul Seale
- School of Medicine, Navicent Health and Mercer University School of Medicine, Macon, Georgia, USA
| | - Daniel P. Alford
- Boston University School of Medicine, Boston Medical Center, Boston, Masachussetts, USA
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Abstract
OBJECTIVE The aim of this study was to determine the psychometric properties of the National Institute on Alcohol Abuse and Alcoholism (NIAAA) 2-question alcohol screen within 16 Pediatric Emergency Care Applied Research Network pediatric emergency departments. This article describes the study methodology, sample characteristics, and baseline outcomes of the NIAAA 2-question screen. METHODS Participants included 12- to 17-year-olds treated in one of the participating pediatric emergency departments across the United States. After enrollment, a criterion assessment battery including the NIAAA 2-question screen and other measures of alcohol, drug use, and risk behavior was self-administered by participants on a tablet computer. Two subsamples were derived from the sample. The first subsample was readministered the NIAAA 2-question screen 1 week after their initial visit to assess test-retest reliability. The second subsample is being reassessed at 12 and 24 months to examine predictive validity of the NIAAA 2-question screen. RESULTS There were 4834 participants enrolled into the study who completed baseline assessments. Participants were equally distributed across sex and age. Forty-six percent of the participants identified as white, and 26% identified as black. Approximately one quarter identified as Hispanic. Using the NIAAA 2-question screen algorithm, approximately 8% were classified as low risk, 12% were classified as moderate risk, and 4% were classified as highest risk. Alcohol use was less likely to be reported by black participants, non-Hispanic participants, and those younger than 16 years. DISCUSSION This study successfully recruited a large, demographically diverse sample to establish rates of the NIAAA screen risk categories across age, sex, ethnicity, and race within pediatric emergency departments.
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Osilla KC, Seelam R, Parast L, D’Amico EJ. Associations between driving under the influence or riding with an impaired driver and future substance use among adolescents. TRAFFIC INJURY PREVENTION 2019; 20:563-569. [PMID: 31356125 PMCID: PMC6728146 DOI: 10.1080/15389588.2019.1615620] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Revised: 04/29/2019] [Accepted: 05/01/2019] [Indexed: 06/10/2023]
Abstract
Objective: Risky driving behaviors among adolescents, such as riding with a drinking or impaired driver (RWID) or driving while under the influence (DUI) of alcohol or drugs, are significant public health concerns. Few studies have examined associations of RWID and DUI with future substance use and problems after controlling for baseline substance use. Given that the DUI/RWDD event may be a teachable moment to prevent future consequences (e.g., when injured or arrested), it is important to understand how this risk behavior relates to subsequent use and problems. This study therefore examined characteristics of adolescents who reported DUI and RWID and assessed their risk of future alcohol and marijuana use and consequences 6 months later. Methods: Participants were 668 adolescents aged 12 to 18 (inclusive) recruited at 1 of 4 primary care clinics in Pittsburgh and Los Angeles as part of a larger randomized controlled trial. They completed surveys about their health behaviors at baseline and 6 months after baseline. We examined baseline characteristics of adolescents who reported DUI and RWID and then assessed whether past-year DUI and RWID at baseline were associated with alcohol and marijuana use and consequences 6 months after baseline. Results: Fifty-eight percent of participants were female, 56% were Hispanic, 23% were Black, 14% were White, 7% were multiethnic or other, and the average age was 16 years (SD = 1.9). At baseline, participants who reported RWID or DUI were more likely to be older, report past-year use of alcohol and marijuana, and more likely to have an alcohol use disorder or cannabis use disorder versus those who did not report RWID or DUI, respectively. At 6-month follow-up and after controlling for baseline demographics and baseline alcohol use, RWID was associated with more frequent drinking episodes in the past 3 months and greater number of drinks in the past month when they drank heavily. DUI at baseline was associated with more frequent heavy drinking episodes and alcohol and marijuana consequences 6 months later. Conclusions: RWID and DUI are significantly associated with greater alcohol and marijuana use over time. This study highlights that teens may be at higher risk for problem substance use in the future even if they ride with someone who is impaired. Prevention and intervention efforts for adolescents need to address both driving under the influence and riding with an impaired driver to prevent downstream consequences.
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Affiliation(s)
| | - Rachana Seelam
- RAND Corporation, 1776 Main Street, Santa Monica, CA 90407-2138
| | - Layla Parast
- RAND Corporation, 1776 Main Street, Santa Monica, CA 90407-2138
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A Comparison of Screening Practices for Adolescents in Primary Care After Implementation of Screening, Brief Intervention, and Referral to Treatment. J Adolesc Health 2019; 65:46-50. [PMID: 30850312 PMCID: PMC6589381 DOI: 10.1016/j.jadohealth.2018.12.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Revised: 12/04/2018] [Accepted: 12/04/2018] [Indexed: 11/21/2022]
Abstract
PURPOSE The American Academy of Pediatrics recommends screening adolescents for substance use at all well-child and appropriate acute-care visits. However, many pediatric practices aim for such screenings annually at well-child visits. METHODS As part of a larger study, 7 urban Federally Qualified Health Center clinics implemented universal screening for risky alcohol and drug use using the Car, Relax, Alone, Forget, Friends, Trouble (CRAFFT) screening tool. The present study compared uptake of screening and screening results at well-child versus acute-care visits. RESULTS Over a period of 13 months for which encounter-level electronic medical records data were available, there were 6,346 clinic visits by 3,475 unique patients aged 12-17 years, at which 76.6% (n = 4,865) of visits had a screening for problematic substance use conducted. Rates of screening were 95.1% (2,750/2,891 involving 2,629 unique adolescents) for well-child visits and 61.2% (2,115/3,455 involving 1,535 unique adolescents) for acute-care visits. Rates of positive screening results were 9.0% (248/2,750 involving 245 unique adolescents) for well-child visits and 7.8% (164/2,115 involving 126 unique adolescents) for acute-care visits. Of the 469 unique adolescents screened only during an acute-care visit during that same period, 40 unique adolescents had positive screening results for a positive screening rate of 8.5%. CONCLUSIONS Nearly 10% of adolescent patients screened only at acute-care visits would not have been screened if screening was implemented solely at well-child visits, and 40 adolescents reporting substance use would have been missed. The findings highlight the benefits of screening adolescents at every primary care visit to better detect and intervene in adolescents' substance use.
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Lunstead J, Weitzman ER, Harstad E, Dedeoglu F, Gaffin JM, Garvey KC, MacGinnitie A, Rufo PA, Fishman LN, Wisk LE, Levy S. Screening and Counseling for Alcohol Use in Adolescents With Chronic Medical Conditions in the Ambulatory Setting. J Adolesc Health 2019; 64:804-806. [PMID: 31122509 PMCID: PMC6540811 DOI: 10.1016/j.jadohealth.2019.02.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Revised: 02/07/2019] [Accepted: 02/07/2019] [Indexed: 11/29/2022]
Abstract
PURPOSE We seek to determine how youth with chronic medical conditions experience alcohol screening and counseling. METHODS Adolescents with type I diabetes, juvenile idiopathic arthritis, moderate persistent asthma, cystic fibrosis, attention deficit hyperactivity disorder, or inflammatory bowel disease were surveyed. Descriptive statistics and regression analysis quantified rates of asking and counseling about alcohol. RESULTS Of 390 participants (75.1% white/non-Hispanic, 51.8% female, average age 16.4 years), 70% reported being asked about their alcohol use by a healthcare provider, and 76% reported receiving at least one message regarding alcohol and health. Of past year drinkers, 54% disclosed use to their provider. Only 2.0% of youth reported receiving the message "I should not drink." CONCLUSIONS Most youth with chronic medical conditions were asked and counseled about alcohol use although few heard unambiguous recommendations to avoid alcohol consumption.
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Affiliation(s)
- Julie Lunstead
- Adolescent Substance Use and Addiction Program, Boston Children's Hospital, Boston, Massachusetts; Division of Developmental Medicine, Boston Children's Hospital, Boston, Massachusetts
| | - Elissa R Weitzman
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts; Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts; Computational Health Informatics Program, Boston Children's Hospital, Boston, Massachusetts
| | - Elizabeth Harstad
- Division of Developmental Medicine, Boston Children's Hospital, Boston, Massachusetts; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
| | - Fatma Dedeoglu
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts; Division of Immunology, Rheumatology Program, Boston Children's Hospital, Boston, Massachusetts
| | - Jonathan M Gaffin
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts; Division of Respiratory Diseases, Boston Children's Hospital, Boston, Massachusetts
| | - Katharine C Garvey
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts; Division of Endocrinology, Boston Children's Hospital, Boston, Massachusetts
| | - Andrew MacGinnitie
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts; Division of Immunology, Boston Children's Hospital, Boston, Massachusetts
| | - Paul A Rufo
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts; Division of Gastroenterology, Boston Children's Hospital, Boston, Massachusetts
| | - Laurie Newman Fishman
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts; Division of Gastroenterology, Boston Children's Hospital, Boston, Massachusetts; Division of General Internal Medicine & Health Services Research, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California
| | - Lauren E Wisk
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts; Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts
| | - Sharon Levy
- Adolescent Substance Use and Addiction Program, Boston Children's Hospital, Boston, Massachusetts; Division of Developmental Medicine, Boston Children's Hospital, Boston, Massachusetts; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts.
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Sanders J. Resistance and Fitting In: A Qualitative Analysis of Young Women in Alcoholics Anonymous. ALCOHOLISM TREATMENT QUARTERLY 2019. [DOI: 10.1080/07347324.2019.1584019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Jolene Sanders
- Sociology & Social Work, Hood College, Frederick, Maryland USA
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Linakis JG, Bromberg JR, Casper TC, Chun TH, Mello MJ, Richards R, Mull CC, Shenoi RP, Vance C, Ahmad F, Bajaj L, Brown KM, Chernick LS, Cohen DM, Fein J, Horeczko T, Levas MN, McAninch B, Monuteaux MC, Grupp-Phelan J, Powell EC, Rogers A, Suffoletto B, Dean JM, Spirito A. Predictive Validity of a 2-Question Alcohol Screen at 1-, 2-, and 3-Year Follow-up. Pediatrics 2019; 143:e20182001. [PMID: 30783022 PMCID: PMC6398369 DOI: 10.1542/peds.2018-2001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/13/2018] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The National Institute on Alcohol Abuse and Alcoholism (NIAAA) 2-question screen is a valid adolescent alcohol screening tool. No studies have examined if this tool predicts future alcohol problems. We conducted a study at 16 pediatric emergency departments to determine the tool's predictive validity for alcohol misuse and alcohol use disorders (AUDs). METHODS Participants (N = 4834) completed a baseline assessment battery. A subsample of participants completed the battery at 1, 2, and 3 years follow up. RESULTS Of the 2209 participants assigned to follow-up, 1611 (73%) completed a 1-year follow-up, 1591 (72%) completed a 2-year follow-up, and 1377 (62%) completed a 3-year follow-up. The differences in AUDs between baseline NIAAA screen nondrinkers and lower-risk drinkers were statistically significant at 1 year (P = .0002), 2 years (P <.0001), and 3 years (P = .0005), as were the differences between moderate- and highest-risk drinkers at 1 and 2 years (P < .0001 and P = .0088, respectively) but not at 3 years (P = .0758). The best combined score for sensitivity (86.2% at 1 year, 75.6% at 2 years, and 60.0% at 3 years) and specificity (78.1% at 1 year, 79.2% at 2 years, and 80.0% at 3 years) was achieved by using "lower risk" and higher as a cutoff for the prediction of a Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition diagnosis. CONCLUSIONS The NIAAA 2-question screen can accurately characterize adolescent risk for future AUDs. Future studies are needed to determine optimaluse of the screen.
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Affiliation(s)
- James G. Linakis
- The Warren Alpert Medical School, Brown University, Providence, Rhode Island
- Rhode Island Hospital, Providence, Rhode Island
| | - Julie R. Bromberg
- The Warren Alpert Medical School, Brown University, Providence, Rhode Island
- Rhode Island Hospital, Providence, Rhode Island
| | | | - Thomas H. Chun
- The Warren Alpert Medical School, Brown University, Providence, Rhode Island
- Rhode Island Hospital, Providence, Rhode Island
| | - Michael J. Mello
- The Warren Alpert Medical School, Brown University, Providence, Rhode Island
- Rhode Island Hospital, Providence, Rhode Island
| | | | - Colette C. Mull
- Nemours/Alfred I. duPont Hospital for Children, Wilmington, Delaware
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Rohit P. Shenoi
- Texas Children’s Hospital and College of Medicine, Baylor University, Houston, Texas
| | - Cheryl Vance
- University of California, Davis, Davis, California
| | - Fahd Ahmad
- St Louis Children’s Hospital and School of Medicine, Washington University in St Louis, St Louis, Missouri
| | - Lalit Bajaj
- Children’s Hospital Colorado, Aurora, Colorado
| | - Kathleen M. Brown
- Children’s National Medical Center, Washington, District of Columbia
| | | | | | - Joel Fein
- Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
| | | | | | - Brett McAninch
- University of Pittsburg Medical Center Children’s Hospital of Pittsburgh and School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | | | | | - Elizabeth C. Powell
- Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois; and
| | | | - Brian Suffoletto
- University of Pittsburg Medical Center Children’s Hospital of Pittsburgh and School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | | | - Anthony Spirito
- The Warren Alpert Medical School, Brown University, Providence, Rhode Island
| | - for the Pediatric Emergency Care Applied Research Network
- The Warren Alpert Medical School, Brown University, Providence, Rhode Island
- Rhode Island Hospital, Providence, Rhode Island
- University of Utah, Salt Lake City, Utah
- Nemours/Alfred I. duPont Hospital for Children, Wilmington, Delaware
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
- Texas Children’s Hospital and College of Medicine, Baylor University, Houston, Texas
- University of California, Davis, Davis, California
- St Louis Children’s Hospital and School of Medicine, Washington University in St Louis, St Louis, Missouri
- Children’s Hospital Colorado, Aurora, Colorado
- Children’s National Medical Center, Washington, District of Columbia
- Columbia University Irving Medical Center, New York City, New York
- Nationwide Children’s Hospital, Columbus, Ohio
- Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
- Los Angeles Biomedical Research Institute, Torrance, California
- Medical College of Wisconsin, Milwaukee, Wisconsin
- University of Pittsburg Medical Center Children’s Hospital of Pittsburgh and School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
- Boston Children’s Hospital, Boston, Massachusetts
- Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
- Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois; and
- University of Michigan, Ann Arbor, Michigan
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Spirito A, Bromberg JR, Casper TC, Chun T, Mello MJ, Mull CC, Shenoi RP, Vance C, Ahmad F, Bajaj L, Brown KM, Chernick LS, Cohen DM, Fein J, Horeczko T, Levas MN, McAninch B, Monuteaux MC, Grupp-Phelan J, Powell EC, Rogers A, Suffoletto B, Linakis JG. Screening for Adolescent Alcohol Use in the Emergency Department: What Does It Tell Us About Cannabis, Tobacco, and Other Drug Use? Subst Use Misuse 2019; 54:1007-1016. [PMID: 30727811 PMCID: PMC6476662 DOI: 10.1080/10826084.2018.1558251] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND The pediatric emergency department (PED) represents an opportune time for alcohol and drug screening. The National Institute of Alcohol Abuse and Alcoholism (NIAAA) recommends a two-question alcohol screen for adolescents as a predictor of alcohol and drug misuse. OBJECTIVE A multi-site PED study was conducted to determine the association between the NIAAA two-question alcohol screen and adolescent cannabis use disorders (CUD), cigarette smoking, and lifetime use of other drugs. METHODS Participants included 12-17-year olds (n = 4834) treated in one of 16 participating PEDs. An assessment battery, including the NIAAA two-question screen and other measures of alcohol, tobacco and drug use, was self-administered on a tablet computer. RESULTS A diagnosis of CUD, lifetime tobacco use or lifetime drug use was predicted by any self-reported alcohol use in the past year, which indicates a classification of moderate risk for middle school ages and low risk for high school ages on the NIAAA two-question screen. Drinking was most strongly predictive of a CUD, somewhat weaker for lifetime tobacco use, and weakest for lifetime drug use. This same pattern held for high school and middle school students and was stronger for high school students over middle school students for all three categories. This association was also found across gender, ethnicity and race. The association was strongest for CUD for high school students, sensitivity 81.7% (95% CI, 77.0, 86.5) and specificity 70.4% (95% CI, 68.6, 72.1). Conclusions/Importance: A single question about past year alcohol use can provide valuable information about other substance use, particularly marijuana.
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Affiliation(s)
- Anthony Spirito
- a The Warren Alpert Medical School of Brown University, Departments of Psychiatry and Human Behavior, Pediatrics, Emergency Medicine, Providence, Rhode Island, USA
| | - Julie R Bromberg
- a The Warren Alpert Medical School of Brown University, Departments of Psychiatry and Human Behavior, Pediatrics, Emergency Medicine, Providence, Rhode Island, USA.,b Rhode Island Hospital, Department of Emergency Medicine, Providence, Rhode Island, USA
| | - T Charles Casper
- c University of Utah, Department of Pediatrics, Salt Lake City, Utah, USA
| | - Thomas Chun
- a The Warren Alpert Medical School of Brown University, Departments of Psychiatry and Human Behavior, Pediatrics, Emergency Medicine, Providence, Rhode Island, USA.,b Rhode Island Hospital, Department of Emergency Medicine, Providence, Rhode Island, USA
| | - Michael J Mello
- a The Warren Alpert Medical School of Brown University, Departments of Psychiatry and Human Behavior, Pediatrics, Emergency Medicine, Providence, Rhode Island, USA.,b Rhode Island Hospital, Department of Emergency Medicine, Providence, Rhode Island, USA
| | - Colette C Mull
- d Nemours/Alfred I. duPont Hospital for Children, Department of Pediatrics, Wilmington, Delaware, USA
| | - Rohit P Shenoi
- e Baylor College of Medicine/Texas Children's Hospital, Departments of Emergency Medicine and Pediatrics, Houston, Texas, USA
| | - Cheryl Vance
- f University of California , Davis, Department of Pediatrics, Davis , California, USA
| | - Fahd Ahmad
- g St. Louis Children's Hospital/Washington University, Department of Emergency Medicine, St. Louis, Washington, USA
| | - Lalit Bajaj
- h Children's Hospital - Colorado, Departments of Pediatric Emergency Medicine and Pediatrics, Aurora, Colorado, USA
| | - Kathleen M Brown
- i Children's National Medical Center, Department of Emergency Medicine and Trauma Services, Washington, DC, USA
| | - Lauren S Chernick
- j Columbia University Medical Center, Department of Pediatric Emergency Medicine, New York, New York, USA
| | - Daniel M Cohen
- k Nationwide Children's Hospital, Departments of Pediatrics and Emergency Medicine, Columbus, Ohio, USA
| | - Joel Fein
- l The Children's Hospital of Philadelphia, Departments of Pediatrics and Emergency Medicine, Philadelphia, Pennsylvania, USA
| | - Timothy Horeczko
- m Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Department of Emergency and Pediatric Emergency Medicine, Los Angeles, California, USA
| | - Michael N Levas
- n Medical College of Wisconsin, Department of Pediatric Emergency Medicine, Milwaukee, Wisconsin, USA
| | - B McAninch
- o University of Pittsburgh/Children's Hospital of Pittsburgh of UPMC, Division of Pediatric Emergency Medicine, Pittsburgh, Pennsylvania, USA
| | - Michael C Monuteaux
- p Boston Children's Hospital, Department of Pediatrics, Boston, Massachusetts, USA
| | - Jackie Grupp-Phelan
- q University of California , San Francisco, Department of Pediatric Emergency Medicine, San Francisco , California, USA
| | - Elizabeth C Powell
- r Lurie Children's Hospital of Chicago, Department of Pediatric Emergency Medicine, Chicago, Illinois, USA
| | - Alexander Rogers
- s University of Michigan, Department of Emergency Medicine, Ann Arbor, Michigan, USA
| | - Brian Suffoletto
- o University of Pittsburgh/Children's Hospital of Pittsburgh of UPMC, Division of Pediatric Emergency Medicine, Pittsburgh, Pennsylvania, USA
| | - James G Linakis
- a The Warren Alpert Medical School of Brown University, Departments of Psychiatry and Human Behavior, Pediatrics, Emergency Medicine, Providence, Rhode Island, USA.,b Rhode Island Hospital, Department of Emergency Medicine, Providence, Rhode Island, USA
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Brittner MR, Pugh B, Soren K, Richter L, Stockwell MS. Frequency of Parent-Adolescent Alcohol-Specific Communication and Adolescent Perceptions of Alcohol. Clin Pediatr (Phila) 2018; 57:1332-1339. [PMID: 29871501 DOI: 10.1177/0009922818779220] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
To better understand the optimal frequency of parent-adolescent alcohol-specific communication, we conducted a secondary analysis of the National Center on Addiction and Substance Abuse Culture of High School Survey, a 2010 nationally representative online survey of 1000 high school students. Logistic regression models assessed the relationship between alcohol-specific communication and adolescent perceptions ( binge drinking is very dangerous, drinking is cool, and getting drunk is very dangerous), adjusting for grade, sex, race, personal and peer alcohol use, and parental monitoring. Among adolescents reporting personal and peer alcohol use, a dose-response relationship existed between frequency of alcohol-specific communication and thinking binge drinking is very dangerous (often [adjusted odds ratio [AOR] = 7.98; 95% confidence interval [CI] = 2.98-21.36], sometimes (AOR = 6.08; 95% CI = 2.36-15.69), rarely (AOR = 5.27; 95% CI = 1.95-14.26) vs never), and was also associated with decreased perceptions that drinking is cool (often [AOR = 0.22; 95% CI = 0.08-0.66), rarely vs never [AOR = 0.17; 95% CI = 0.06-0.51]); the inverse was true for never-drinkers without peer use.
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Affiliation(s)
- Mindy R Brittner
- 1 NewYork-Presbyterian Hospital, New York, NY, USA.,2 College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Brandie Pugh
- 3 The National Center on Addiction and Substance Abuse, New York, NY, USA
| | - Karen Soren
- 1 NewYork-Presbyterian Hospital, New York, NY, USA.,2 College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Linda Richter
- 3 The National Center on Addiction and Substance Abuse, New York, NY, USA
| | - Melissa S Stockwell
- 1 NewYork-Presbyterian Hospital, New York, NY, USA.,2 College of Physicians and Surgeons, Columbia University, New York, NY, USA.,4 Mailman School of Public Health, Columbia University, New York, NY, USA
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18
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Mello MJ, Becker SJ, Bromberg J, Baird J, Zonfrillo MR, Spirito A. Implementing Alcohol Misuse SBIRT in a National Cohort of Pediatric Trauma Centers-a type III hybrid effectiveness-implementation trial. Implement Sci 2018; 13:35. [PMID: 29471849 PMCID: PMC5824578 DOI: 10.1186/s13012-018-0725-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Accepted: 02/05/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The American College of Surgeons mandates universal screening for alcohol misuse and delivery of an intervention for those screening positive as a requirement for certification as a level 1 trauma center. Though this requirement has been mandated for over a decade, its implementation has been challenging. Our research team completed an implementation study supporting seven pediatric trauma centers' compliance with the requirement by developing and implementing an institutional alcohol Screening, Brief Intervention and Referral to Treatment (SBIRT) policy for adolescent trauma patients. A mixed-methods approach indicated that SBIRT adoption rates increased at all sites; however, providers' fidelity to the SBIRT intervention was variable, and providers reported a number of barriers to SBIRT implementation. The goal of this study is to conduct a fully powered type III hybrid effectiveness-implementation trial to test the effectiveness of a comprehensive implementation strategy in increasing the implementation of SBIRT for alcohol and other drug use (AOD) in pediatric trauma centers. METHODS Our implementation strategy is based on the Science to Service Laboratory (SSL), an approach developed by the SAMHSA-funded Addiction Technology Transfer Centers that consists of three core elements (i.e., didactic training + performance feedback + leadership coaching). Utilizing a stepped wedge design, a national cohort of 10 pediatric trauma centers will receive the SSL implementation strategy. At six distinct time points, each of the 10 sites will provide data from 30 electronic medical records (n = 1800 in total). A subset of adolescents will also report on fidelity of intervention delivery and linkage to care (i.e., continued AOD discussion and/or treatment with a primary care provider) 1 month after hospital discharge. In addition, nurses, social workers, and leaders will report on organizational readiness for implementation at four distinct time points. DISCUSSION This protocol proposes a unique opportunity to examine whether a comprehensive implementation strategy can improve the fidelity of SBIRT delivery across a national cohort of pediatric trauma centers. With injured adolescents, this could optimize the detection and intervention of AOD use and improve adolescent health. TRIAL REGISTRATION Clinicaltrials.gov NCT03297060 .
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Affiliation(s)
- Michael J Mello
- Department of Emergency Medicine, Alpert Medical School of Brown University, Providence, RI, USA. .,Department of Health Services, Policy and Practice, Brown University School of Public Health, Providence, RI, USA. .,Injury Prevention Center of Rhode Island Hospital-Hasbro Children's Hospital, Providence, RI, USA.
| | - Sara J Becker
- Department of Behavorial and Social Sciences, Brown University School of Public Health, Providence, RI, USA
| | - Julie Bromberg
- Department of Emergency Medicine, Alpert Medical School of Brown University, Providence, RI, USA.,Injury Prevention Center of Rhode Island Hospital-Hasbro Children's Hospital, Providence, RI, USA
| | - Janette Baird
- Department of Emergency Medicine, Alpert Medical School of Brown University, Providence, RI, USA.,Injury Prevention Center of Rhode Island Hospital-Hasbro Children's Hospital, Providence, RI, USA
| | - Mark R Zonfrillo
- Department of Emergency Medicine, Alpert Medical School of Brown University, Providence, RI, USA.,Injury Prevention Center of Rhode Island Hospital-Hasbro Children's Hospital, Providence, RI, USA.,Department of Pediatrics, Alpert Medical School of Brown University, Providence, RI, USA
| | - Anthony Spirito
- Department of Psychiatry and Human Behavior, Albert Medical School of Brown University, Providence, RI, USA
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Sharrad S, de C, Aylward P, Wiechula R. An exploration of adolescents' decisions to abstain or refrain from alcohol consumption in Australian social settings: a qualitative systematic review. ACTA ACUST UNITED AC 2018; 13:156-79. [PMID: 26571291 DOI: 10.11124/jbisrir-2015-2359] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
BACKGROUND A significant number of Australian adolescents consume alcohol, with almost two thirds of them doing so at risky levels. This is continuing to increase despite recent National Health and Medical Research Council (NHMRC) guidelines stipulating that no alcohol is the safest option. Measures initiated to reduce and prevent alcohol consumption by adolescents have limited effectiveness. Consumption of alcohol by Australian adolescents is a national concern because of the deleterious effects of alcohol consumption on adolescents' social, physical and neurological development, as well as other short- and long-term health risks, and the negative impact of alcohol-related violence and injury on the community. Understanding adolescents' decisions to abstain or refrain from alcohol consumption may provide valuable insights to assist in dealing with this significant social and health issue, more particularly about the mechanisms used by adolescents or their ability to make decisions about resisting or abstaining from alcohol consumption when exposed to alcohol in their social setting(s). OBJECTIVES The review aimed to synthesize the best available qualitative evidence on the decisions made or mechanisms used by adolescents who abstain or refrain from consuming alcohol in any social setting where alcohol is available. INCLUSION CRITERIA Adolescents aged between 14 and 19 years who reside in Australia.The phenomenon of interest was abstinence from or resistance to alcohol consumption when exposed to alcohol in social situations.This review considered studies that focused on qualitative data, including, but not limited to,designs such as phenomenology, grounded theory, action research and exploratory studies. SEARCH STRATEGY A three-step search strategy was used. An initial search to identify keywords only was undertaken in Medline and CINAHL. This was followed by an expanded search using all identified keywords and index terms specific to each included database. The reference lists of included papers were then searched for any other relevant studies. METHODOLOGICAL QUALITY No studies met the inclusion criteria sufficiently to progress to critical appraisal. DATA EXTRACTION No studies progressed to data extraction. DATA SYNTHESIS Data synthesis was not undertaken as no study met the inclusion criteria. RESULTS Although a number of studies retrieved indicated they had qualitative elements to their studies, the qualitative data was not reported. CONCLUSIONS Although a number of studies met some aspects of the inclusion criteria there was insufficient reporting of the phenomenon of interest. Due to the lack of studies meeting the inclusion criteria, no conclusions can be drawn for clinical practice. A lack of qualitative data on this topic has been identified. Thus there is a great need for qualitative research to understand and know more about what enables an adolescent to abstain or refrain from consumption in order to inform or formulate effective interventions, policies or plans to prevent or reduce the volume of alcohol consumed by Australian adolescents.
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Affiliation(s)
- Sue Sharrad
- 1School of Nursing, University of Adelaide, Australia2Centre for Evidence-based Practice South Australia: an Affiliate Center of the Joanna Briggs Institute3Discipline of General Practice, University of Adelaide, Australia
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Meredith LS, Ewing BA, Stein BD, Shadel WG, Brooks Holliday S, Parast L, D'Amico EJ. Influence of mental health and alcohol or other drug use risk on adolescent reported care received in primary care settings. BMC FAMILY PRACTICE 2018; 19:10. [PMID: 29316897 PMCID: PMC5759885 DOI: 10.1186/s12875-017-0689-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Accepted: 12/08/2017] [Indexed: 12/01/2022]
Abstract
Background To describe patterns of alcohol and other drug (AOD) use risk and adolescent reported primary care (PC) screening and intervention, and examine associations of AOD risk and mental health with reported care received. Methods We analyzed data from cross-sectional surveys collected from April 3, 2013 to November 24, 2015 from 1279 diverse adolescents ages 12–18 who reported visiting a doctor at least once in the past year. Key measures were AOD risk using the Personal Experience Screening Questionnaire; mental health using the 5-item Mental Health Inventory; binary measures of adolescent-reported screening and intervention. Results Half (49.2%) of the adolescents reported past year AOD use. Of the 769 (60.1%) of adolescents that reported being asked by a medical provider in PC about AOD use, only 37.2% reported receiving screening/intervention. The odds of reported screening/intervention were significantly higher for adolescents with higher AOD risk and lower mental health scores. Conclusions Adolescents at risk for AOD use and poor mental health are most likely to benefit from brief intervention. These findings suggest that strategies are needed to facilitate medical providers identification of need for counseling of both AOD and mental health care for at risk youth. Trials registration clinicaltrials.gov, Identifier: NCT01797835, March 2013.
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Affiliation(s)
- Lisa S Meredith
- RAND Corporation, 1776 Main Street, Santa Monica, CA, 90407-2138, USA. .,VA HSR&D Center for the Study of Healthcare Innovation, Implementation, and Policy, California, Los Angeles, USA.
| | - Brett A Ewing
- RAND Corporation, 1776 Main Street, Santa Monica, CA, 90407-2138, USA
| | | | | | | | - Layla Parast
- RAND Corporation, 1776 Main Street, Santa Monica, CA, 90407-2138, USA
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21
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Boecker-Schlier R, Holz NE, Hohm E, Zohsel K, Blomeyer D, Buchmann AF, Baumeister S, Wolf I, Esser G, Schmidt MH, Meyer-Lindenberg A, Banaschewski T, Brandeis D, Laucht M. Association between pubertal stage at first drink and neural reward processing in early adulthood. Addict Biol 2017; 22:1402-1415. [PMID: 27345375 DOI: 10.1111/adb.12413] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Revised: 04/20/2016] [Accepted: 04/25/2016] [Indexed: 01/03/2023]
Abstract
Puberty is a critical time period during human development. It is characterized by high levels of risk-taking behavior, such as increased alcohol consumption, and is accompanied by various neurobiological changes. Recent studies in animals and humans have revealed that the pubertal stage at first drink (PSFD) significantly impacts drinking behavior in adulthood. Moreover, neuronal alterations of the dopaminergic reward system have been associated with alcohol abuse or addiction. This study aimed to clarify the impact of PSFD on neuronal characteristics of reward processing linked to alcohol-related problems. One hundred sixty-eight healthy young adults from a prospective study covering 25 years participated in a monetary incentive delay task measured with simultaneous EEG-fMRI. PSFD was determined according to the age at menarche or Tanner stage of pubertal development, respectively. Alcohol-related problems in early adulthood were assessed with the Alcohol Use Disorder Identification Test (AUDIT). During reward anticipation, decreased fMRI activation of the frontal cortex and increased preparatory EEG activity (contingent negative variation) occurred with pubertal compared to postpubertal first alcohol intake. Moreover, alcohol-related problems during early adulthood were increased in pubertal compared to postpubertal beginners, which was mediated by neuronal activation of the right medial frontal gyrus. At reward delivery, increased fMRI activation of the left caudate and higher feedback-related EEG negativity were detected in pubertal compared to postpubertal beginners. Together with animal findings, these results implicate PSFD as a potential modulator of psychopathology, involving altered reward anticipation. Both PSFD timing and reward processing might thus be potential targets for early prevention and intervention.
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Affiliation(s)
- Regina Boecker-Schlier
- Department of Child and Adolescent Psychiatry and Psychotherapy; Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University; Mannheim Germany
| | - Nathalie E. Holz
- Department of Child and Adolescent Psychiatry and Psychotherapy; Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University; Mannheim Germany
| | - Erika Hohm
- Department of Child and Adolescent Psychiatry and Psychotherapy; Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University; Mannheim Germany
| | - Katrin Zohsel
- Department of Child and Adolescent Psychiatry and Psychotherapy; Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University; Mannheim Germany
| | - Dorothea Blomeyer
- Department of Child and Adolescent Psychiatry and Psychotherapy; Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University; Mannheim Germany
| | - Arlette F. Buchmann
- Department of Child and Adolescent Psychiatry and Psychotherapy; Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University; Mannheim Germany
| | - Sarah Baumeister
- Department of Child and Adolescent Psychiatry and Psychotherapy; Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University; Mannheim Germany
| | - Isabella Wolf
- Department of Child and Adolescent Psychiatry and Psychotherapy; Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University; Mannheim Germany
- Department Neuroimaging, Central Institute of Mental Health; Medical Faculty Mannheim/Heidelberg University; Mannheim Germany
| | - Günter Esser
- Department of Psychology; University of Potsdam; Potsdam Germany
| | - Martin H. Schmidt
- Department of Child and Adolescent Psychiatry and Psychotherapy; Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University; Mannheim Germany
| | - Andreas Meyer-Lindenberg
- Department of Psychiatry and Psychotherapy; Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University; Mannheim Germany
| | - Tobias Banaschewski
- Department of Child and Adolescent Psychiatry and Psychotherapy; Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University; Mannheim Germany
| | - Daniel Brandeis
- Department of Child and Adolescent Psychiatry and Psychotherapy; Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University; Mannheim Germany
- Department of Child and Adolescent Psychiatry and Psychotherapy; Psychiatric Hospital, University of Zurich; Zurich Switzerland
- Center for Integrative Human Physiology; University of Zurich; Zurich Switzerland
- Neuroscience Center Zurich; University of Zurich and ETH Zurich; Zurich Switzerland
| | - Manfred Laucht
- Department of Child and Adolescent Psychiatry and Psychotherapy; Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University; Mannheim Germany
- Department of Psychology; University of Potsdam; Potsdam Germany
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22
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Moreno Padilla M, O’Halloran L, Bennett M, Cao Z, Whelan R. Impulsivity and Reward Processing Endophenotypes in Youth Alcohol Misuse. CURRENT ADDICTION REPORTS 2017. [DOI: 10.1007/s40429-017-0167-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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23
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Payne BK, Lee KM, Giletta M, Prinstein MJ. Implicit attitudes predict drinking onset in adolescents: Shaping by social norms. Health Psychol 2017; 35:829-36. [PMID: 27505203 DOI: 10.1037/hea0000353] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Implicit attitudes toward alcohol predict drinking among adults and adolescents. If implicit attitudes reflected associations learned through direct experience with drinking, then they would likely only predict drinking among individuals who have previously consumed alcohol. In contrast, if implicit attitudes reflected indirect experience through social messages, they might also then predict future drinking, even among individuals with no drinking experience. In this study, we tested whether implicit attitudes would predict initiation of drinking for the first time, and whether parents' and friends' norms toward alcohol would influence the development of implicit attitudes. METHOD For this study, we followed 868 adolescents between the ages of 12 and 15 years for 3 years. Implicit attitudes were measured using the affect misattribution procedure (Payne, Cheng, Govorun, & Stewart, 2005; Payne, Govorun, & Arbuckle, 2008). Explicit intentions to drink and the frequency of drinking and binge drinking were measured at each of 3 annual waves. RESULTS Implicit attitudes toward alcohol predicted future drinking behavior 1 year later, and effects were similar for adolescents who had previously tried alcohol and for those who had not. To understand what factors might shape implicit attitudes among participants without drinking experience, we examined the role of parental norms and friends' norms toward drinking. Parental approval of drinking predicted the development of more positive implicit attitudes, which in turn predicted later drinking. CONCLUSION Implicit attitudes toward alcohol can develop in advance of direct experience drinking alcohol. Results have implications for the implicit processes underpinning adolescent drinking, and the processes by which implicit associations are learned. (PsycINFO Database Record
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Affiliation(s)
| | - Kent M Lee
- Department of Psychology and Neuroscience
| | - Matteo Giletta
- Department of Developmental Psychology, Tilburg University
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24
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Earnshaw VA, Elliott MN, Reisner SL, Mrug S, Windle M, Emery ST, Peskin MF, Schuster MA. Peer Victimization, Depressive Symptoms, and Substance Use: A Longitudinal Analysis. Pediatrics 2017; 139:peds.2016-3426. [PMID: 28562268 PMCID: PMC8918284 DOI: 10.1542/peds.2016-3426] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/28/2017] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Peer victimization is common among youth and associated with substance use. Yet, few studies have examined these associations longitudinally or the psychological processes whereby peer victimization leads to substance use. The current study examined whether peer victimization in early adolescence is associated with alcohol, marijuana, and tobacco use in mid- to late adolescence, as well as the role of depressive symptoms in these associations. METHODS Longitudinal data were collected between 2004 and 2011 from 4297 youth in Birmingham, Alabama; Houston, Texas; and Los Angeles County, California. Data were analyzed by using structural equation modeling. RESULTS The hypothesized model fit the data well (Root Mean Square Error of Approximation [RMSEA] = 0.02; Comparative Fit Index [CFI] = 0.95). More frequent experiences of peer victimization in the fifth grade were associated with greater depressive symptoms in the seventh grade (B[SE] = 0.03[0.01]; P < .001), which, in turn, were associated with a greater likelihood of alcohol use (B[SE] = 0.03[0.01]; P = .003), marijuana use (B[SE] = 0.05[0.01]; P < .001), and tobacco use (B[SE] = 0.05[0.01]; P < .001) in the tenth grade. Moreover, fifth-grade peer victimization was indirectly associated with tenth-grade substance use via the mediator of seventh-grade depressive symptoms, including alcohol use (B[SE] = 0.01[0.01]; P = .006), marijuana use (B[SE] = 0.01[0.01]; P < .001), and tobacco use (B[SE] = 0.02[0.01]; P < .001). CONCLUSIONS Youth who experienced more frequent peer victimization in the fifth grade were more likely to use substances in the tenth grade, showing that experiences of peer victimization in early adolescence may have a lasting impact by affecting substance use behaviors during mid- to late adolescence. Interventions are needed to reduce peer victimization among youth and to support youth who have experienced victimization.
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Affiliation(s)
- Valerie A. Earnshaw
- Division of General Pediatrics, Boston Children’s Hospital, Boston, Massachusetts,Department of Pediatrics, Harvard Medical School, Boston, Massachusetts,Department of Human Development and Family Studies, University of Delaware, Newark, Delaware
| | | | - Sari L. Reisner
- Division of General Pediatrics, Boston Children’s Hospital, Boston, Massachusetts,Department of Pediatrics, Harvard Medical School, Boston, Massachusetts,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts,The Fenway Institute, Fenway Health, Boston, Massachusetts
| | - Sylvie Mrug
- Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabam
| | - Michael Windle
- Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Susan Tortolero Emery
- Center for Health Promotion and Prevention Research, The University of Texas Health Science Center at Houston School of Public Health, Houston, Texas
| | - Melissa F. Peskin
- Center for Health Promotion and Prevention Research, The University of Texas Health Science Center at Houston School of Public Health, Houston, Texas
| | - Mark A. Schuster
- Division of General Pediatrics, Boston Children’s Hospital, Boston, Massachusetts,Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
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MacArthur GJ, Jacob N, Pound P, Hickman M, Campbell R. Among friends: a qualitative exploration of the role of peers in young people's alcohol use using Bourdieu's concepts of habitus, field and capital. SOCIOLOGY OF HEALTH & ILLNESS 2017; 39:30-46. [PMID: 27573161 PMCID: PMC5244664 DOI: 10.1111/1467-9566.12467] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
Drinking is viewed by young people as a predominantly social activity which provides an opportunity for entertainment and bonding with friends. Using Bourdieu's concepts of habitus, field and capital, this article explores young people's attitudes and beliefs around alcohol use, influences on behaviour, and the role of peers, with a view to informing the development of preventive interventions. Semi-structured interviews were conducted with 28 young people aged 18-20 in the south west of England. We describe how friends were integral in drinking experiences, and drinking with friends was equated with fun and enjoyment. In this way, the desire for social and symbolic capital appeared to be a key motivator for adolescent drinking. Critically, however, wider cultural norms played the predominant role in shaping behaviour, via the internalisation of widely accepted practice and the subsequent externalisation of norms through the habitus. Applying Bourdieu's theory suggests that population-level interventions that regulate alcohol consumption, and thus disrupt the field, are likely to facilitate behaviour change among young people by driving a response in habitus.
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Affiliation(s)
| | - Nina Jacob
- Cardiff University School of Social SciencesCardiffUK
| | - Pandora Pound
- School of Social and Community MedicineUniversity of BristolUK
| | - Matthew Hickman
- School of Social and Community MedicineUniversity of BristolUK
| | - Rona Campbell
- School of Social and Community MedicineUniversity of BristolUK
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Spirito A, Bromberg JR, Casper TC, Chun TH, Mello MJ, Dean JM, Linakis JG. Reliability and Validity of a Two-Question Alcohol Screen in the Pediatric Emergency Department. Pediatrics 2016; 138:peds.2016-0691. [PMID: 27940674 PMCID: PMC5127060 DOI: 10.1542/peds.2016-0691] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/22/2016] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVE A multisite study was conducted to determine the psychometric properties of the National Institute of Alcohol Abuse and Alcoholism (NIAAA) 2-question alcohol screen within pediatric emergency departments (PEDs). METHODS Participants (N = 4838) included 12- to 17-year-old subjects treated in 1 of the 16 participating PEDs across the United States. A criterion assessment battery (including the NIAAA 2-question alcohol screen and other measures of alcohol, drug use, and risk behaviors) was self-administered on a tablet computer. A subsample (n = 186) was re-administered the NIAAA 2-question screen 1 week later to assess test-retest reliability. RESULTS Moderate to good test-retest reliability was demonstrated. A classification of moderate risk or higher on the screen had the best combined sensitivity and specificity for determining a diagnosis of alcohol use disorder (AUD) for all students. Any past year drinking among middle school students increased the odds of a diagnosis of an AUD according to Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition criteria, whereas the optimal cutoff for high school ages was ≥3 drinking days in the past year. The optimal cutoff for drinking days determining a positive Alcohol Use Disorders Identification Test score among middle school subjects was ≥1 drinking day, whereas the optimal cutoff for high school subjects was ≥2 drinking days. CONCLUSIONS The NIAAA 2-question screen is a brief, valid approach for alcohol screening in PEDs. A positive screen suggests that referral for further evaluation is indicated to determine if an adolescent has an AUD.
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Affiliation(s)
| | - Julie R. Bromberg
- Emergency Medicine, The Warren Alpert Medical School of Brown University, Providence, Rhode Island;,Department of Emergency Medicine, Rhode Island Hospital, Providence, Rhode Island; and
| | - T. Charles Casper
- Department of Pediatrics & PECARN Data Coordinating Center, University of Utah, Salt Lake City, Utah
| | - Thomas H. Chun
- Emergency Medicine, The Warren Alpert Medical School of Brown University, Providence, Rhode Island;,Department of Emergency Medicine, Rhode Island Hospital, Providence, Rhode Island; and
| | - Michael J. Mello
- Emergency Medicine, The Warren Alpert Medical School of Brown University, Providence, Rhode Island;,Department of Emergency Medicine, Rhode Island Hospital, Providence, Rhode Island; and
| | - J. Michael Dean
- Department of Pediatrics & PECARN Data Coordinating Center, University of Utah, Salt Lake City, Utah
| | - James G. Linakis
- Emergency Medicine, The Warren Alpert Medical School of Brown University, Providence, Rhode Island;,Department of Emergency Medicine, Rhode Island Hospital, Providence, Rhode Island; and
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D’Amico EJ, Parast L, Meredith LS, Ewing BA, Shadel WG, Stein BD. Screening in Primary Care: What Is the Best Way to Identify At-Risk Youth for Substance Use? Pediatrics 2016; 138:peds.2016-1717. [PMID: 27940696 PMCID: PMC5127067 DOI: 10.1542/peds.2016-1717] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/27/2016] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND It is important to improve primary care providers' capability to identify youth at risk for alcohol and other drug use. To our knowledge, this is the first study to use Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition criteria to compare screeners for youth for both alcohol and marijuana, given that these are the most frequently used substances by this age group. METHODS We compared the psychometric performance of 4 screeners: the National Institute on Alcohol Abuse and Alcoholism Screening Guide (NIAAA SG), the Alcohol Use Disorders Identification Test, the Car-Relax-Alone-Forget-Family and Friends-Trouble (CRAFFT) screener, and the Personal Experience Screening Questionnaire Problem Severity Scale (PESQ-PS) in identifying alcohol and marijuana use outcomes. Youth age 12 through 18 (N = 1573; 27% black, 51% Hispanic) were screened with the NIAAA SG, followed by a Web survey that included the other screeners and outcomes. RESULTS Sensitivity for alcohol outcomes indicated that the NIAAA SG (0.87) did not perform as well as the CRAFFT (0.97) or PESQ-PS (0.97) screeners but performed better than the Alcohol Use Disorders Identification Test (0.70). The pattern for sensitivity across screeners for marijuana outcomes was similar. CONCLUSIONS An important tradeoff in primary care settings is precision versus practicality. Because of brevity and focus on frequency of drinking, the NIAAA SG offers ease of administration and is good at identifying youth with probably problematic drinking levels. The PESQ-PS and the CRAFFT correctly identify more at-risk youth for alcohol and marijuana than the NIAAA SG. Future work is needed to elucidate how to efficiently and accurately identify at-risk youth in the primary care setting, including determining the best cutoff points to use to increase sensitivity.
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Marjerrison S, Hendershot E, Empringham B, Nathan PC. Smoking, Binge Drinking, and Drug Use Among Childhood Cancer Survivors: A Meta-Analysis. Pediatr Blood Cancer 2016; 63:1254-63. [PMID: 26999299 DOI: 10.1002/pbc.25943] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Revised: 12/20/2015] [Accepted: 01/15/2016] [Indexed: 01/22/2023]
Abstract
INTRODUCTION Childhood cancer survivors are at risk for late effects of therapy, some of which may be exacerbated by smoking, alcohol, or drug use. We undertook a meta-analysis of the literature to determine whether survivors engage in risk-taking behaviors at rates different from their peers/siblings. METHODS Studies comparing current engagement in risk-taking behaviors between cancer survivors and siblings or matched peers were identified in MEDLINE (1946-), EMBASE (1947-), PsychINFO (1806-), and the Cochrane Controlled Trials Register. Two reviewers assessed publications for inclusion and extracted data independently. Studies were combined using inverse variance weighting to determine odds ratios (OR) and prevalence rates of risk-taking behaviors in survivors compared to controls. RESULTS Fourteen of 1,713 studies satisfied inclusion criteria. Twelve assessed smoking, six binge drinking, and seven drug use. Among survivors, 22% (95% confidence interval 0.19, 0.26) smoked, 20% (0.08, 0.51) were binge drinkers, and 15% (0.10, 0.23) used drugs. Survivors were less likely than siblings to smoke (OR 0.68 [0.49, 0.96]) or binge drink (OR 0.77 [0.68, 0.88]), but similarly likely to use drugs (OR 0.33 [0.03, 3.28]). Survivors were less likely than matched peers to smoke (OR 0.54 [0.42, 0.70]) or use drugs (OR 0.57 [0.40, 0.82]), but equally likely to binge drink (OR 0.97 [0.38, 2.49]). CONCLUSIONS Childhood cancer survivors engage in similar or lower rates of risk taking than their siblings/peers. Future studies should identify survivors most likely to benefit from focused interventions, and determine the impact of risk-taking behaviors on the risk for late effects of cancer therapy.
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Affiliation(s)
- Stacey Marjerrison
- Division of Haematology/Oncology, McMaster Children's Hospital, Hamilton, Ontario, Canada
| | - Eleanor Hendershot
- Division of Haematology/Oncology, McMaster Children's Hospital, Hamilton, Ontario, Canada.,Division of Hematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada.,Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Brianna Empringham
- Division of Haematology/Oncology, McMaster Children's Hospital, Hamilton, Ontario, Canada
| | - Paul C Nathan
- Division of Hematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada
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Palm A, Olofsson N, Danielsson I, Skalkidou A, Wennberg P, Högberg U. Motivational interviewing does not affect risk drinking among young women: A randomised, controlled intervention study in Swedish youth health centres. Scand J Public Health 2016; 44:611-8. [PMID: 27289105 DOI: 10.1177/1403494816654047] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/14/2016] [Indexed: 11/16/2022]
Abstract
AIM The aim of this study was to analyse risk and binge drinking at 12-month follow-up in young women with risk drinking who received motivational interviewing compared with controls. METHODS Young women attending Swedish youth health centres were randomised into intervention or control groups. The intervention group members were asked about their alcohol consumption by a midwife/social worker using the Alcohol Use Disorders Identification Test Consumption. A score of ⩾5 was used as the cut-off value for risk drinking. Participants with risk drinking in the intervention group received motivational interviewing within the same visit. Participants in the control group had a regular visit with a midwife/social worker and answered the same questions about alcohol consumption in a questionnaire after their visit. A questionnaire with the same questions was administered to participants 12 months after baseline. RESULTS Of 1445 eligible young women, 1051 (73%) consented to randomisation and were enrolled in the study. The follow-up rate was 54%. There was a significant decrease in risk- and binge drinking, from baseline to follow-up, in both the intervention and the control groups. Generalised estimating equation analyses demonstrated no significant effect between groups. Of participants who did not have risk drinking at baseline, about 20% in both groups had developed high-risk drinking by the 12-month follow-up. CONCLUSIONS NO SIGNIFICANT DIFFERENCES IN RISK DRINKING BETWEEN YOUNG WOMEN WHO RECEIVED MOTIVATIONAL INTERVIEWING AND CONTROLS WERE FOUND THERE WAS A LARGE INTRA-INDIVIDUAL MOBILITY IN YOUNG WOMEN'S RISK DRINKING BEHAVIOUR THIS HIGHLIGHTS THE IMPORTANCE OF FINDING RELIABLE SCREENING TOOLS THAT CAN CAPTURE THE MOBILITY IN DRINKING BEHAVIOUR IN YOUTH MORE RESEARCH IS NEEDED BEFORE RECOMMENDATIONS CAN BE MADE.
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Affiliation(s)
- Anna Palm
- Department of Women's and Children's Health, Uppsala University, Sweden Department of Gynaecology and Obstetrics, Sundsvall Hospital, Sweden
| | - Niclas Olofsson
- Department of Health Sciences, Mid Sweden University, Sweden
| | - Ingela Danielsson
- Department of Clinical Sciences Obstetrics and Gynaecology, Umeå University, Sweden
| | | | - Peter Wennberg
- Centre for Social Research on Alcohol and Drugs (SoRAD), Stockholm University, Sweden
| | - Ulf Högberg
- Department of Women's and Children's Health, Uppsala University, Sweden
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Harris BR. Communicating about screening, brief intervention, and referral to treatment: Messaging strategies to raise awareness and promote voluntary adoption and implementation among New York school-based health center providers. Subst Abus 2016; 37:511-515. [DOI: 10.1080/08897077.2016.1175400] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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McClure AC, Tanski SE, Li Z, Jackson K, Morgenstern M, Li Z, Sargent JD. Internet Alcohol Marketing and Underage Alcohol Use. Pediatrics 2016; 137:e20152149. [PMID: 26738886 PMCID: PMC5011761 DOI: 10.1542/peds.2015-2149] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/16/2015] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Internet alcohol marketing is not well studied despite its prevalence and potential accessibility and attractiveness to youth. The objective was to examine longitudinal associations between self-reported engagement with Internet alcohol marketing and alcohol use transitions in youth. METHODS A US sample of 2012 youths aged 15 to 20 was surveyed in 2011. An Internet alcohol marketing receptivity score was developed, based on number of positive responses to seeing alcohol advertising on the Internet, visiting alcohol brand Web sites, being an online alcohol brand fan, and cued recall of alcohol brand home page images. We assessed the association between baseline marketing receptivity and both ever drinking and binge drinking (≥6 drinks per occasion) at 1-year follow-up with multiple logistic regression, controlling for baseline drinking status, Internet use, sociodemographics, personality characteristics, and peer or parent drinking. RESULTS At baseline, ever-drinking and binge-drinking prevalence was 55% and 27%, respectively. Many (59%) reported seeing Internet alcohol advertising, but few reported going to an alcohol Web site (6%) or being an online fan (3%). Higher Internet use, sensation seeking, having family or peers who drank, and past alcohol use were associated with Internet alcohol marketing receptivity, and a score of 1 or 2 was independently associated with greater adjusted odds of initiating binge drinking (odds ratio 1.77; 95% confidence interval, 1.13-2.78 and odds ratio 2.15; 95% confidence interval, 1.06-4.37 respectively) but not with initiation of ever drinking. CONCLUSIONS Although high levels of engagement with Internet alcohol marketing were uncommon, most underage youths reported seeing it, and we found a prospective association between receptivity to this type of alcohol marketing and future problem drinking, making additional research and ongoing surveillance important.
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Affiliation(s)
- Auden C. McClure
- Departments of Pediatrics, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire,Cancer Control Research Program, Norris Cotton Cancer Center, Lebanon, New Hampshire,Address correspondence to Auden C. McClure, MD, MPH, Department of Pediatrics, Dartmouth-Hitchcock Medical Center, One Medical Center Drive, Lebanon, NH 03756. E-mail:
| | - Susanne E. Tanski
- Departments of Pediatrics, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire,Cancer Control Research Program, Norris Cotton Cancer Center, Lebanon, New Hampshire
| | - Zhigang Li
- Cancer Epidemiology, Norris Cotton Cancer Center, Lebanon, New Hampshire
| | - Kristina Jackson
- Center for Alcohol and Addiction Studies, Brown University, Providence, Rhode Island; and
| | | | - Zhongze Li
- Biostatistics Shared Resources, Norris Cotton Cancer Center, Lebanon, New Hampshire
| | - James D. Sargent
- Departments of Pediatrics, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire,Cancer Control Research Program, Norris Cotton Cancer Center, Lebanon, New Hampshire
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Harris B, Shaw B, Lawson H, Sherman B. Barriers to Addressing Adolescent Substance Use: Perceptions of New York School-Based Health Center Providers. THE JOURNAL OF SCHOOL HEALTH 2016; 86:96-104. [PMID: 26762820 DOI: 10.1111/josh.12358] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2015] [Revised: 05/11/2015] [Accepted: 02/26/2015] [Indexed: 06/05/2023]
Abstract
BACKGROUND Adolescent substance use is associated with chronic health conditions, accidents, injury, and school-related problems, including dropping out. Schools have the potential to provide students with substance use prevention and intervention services, albeit with confidentiality challenges. School-based health centers (SBHCs) provide confidentiality, positioning them as ideal settings to provide substance use prevention and intervention. This study identified program directors' and clinicians' barriers to addressing adolescent substance use in SBHCs. METHODS Between May and June 2013, an electronic survey was distributed to all 162 New York State SBHC program directors and clinicians serving middle and high school students. RESULTS The most prevalent perceived barriers to discussing substance use with students were time constraints (43%), the belief that students are not honest about their use (43%), and clinicians' lack of training (28%). Both directors and clinicians identified challenges in getting students to return for additional sessions to address their use, and they also indicated that confidentiality was a treatment referral barrier. CONCLUSIONS This study identified timely opportunities that may be leveraged and unique challenges that may be overcome with targeted dissemination, training, and technical assistance efforts to enable directors and clinicians to routinely address substance use in SBHCs.
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Affiliation(s)
- Brett Harris
- Health Policy, Management, and Behavior, University at Albany School of Public Health, Rensselaer, NY 12144.
| | - Benjamin Shaw
- Health Policy, Management, and Behavior, University at Albany School of Public Health, Rensselaer, NY 12144.
| | - Hal Lawson
- University at Albany School of Social Welfare, Albany, NY.
| | - Barry Sherman
- Health Policy, Management, and Behavior, University at Albany School of Public Health, Rensselaer, NY 12144.
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Prevention trial in the Cherokee Nation: design of a randomized community trial. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2016; 16:291-300. [PMID: 24615546 PMCID: PMC4308639 DOI: 10.1007/s11121-014-0478-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Despite advances in prevention science and practice in recent decades, the U.S. continues to struggle with significant alcohol-related risks and consequences among youth, especially among vulnerable rural and Native American youth. The Prevention Trial in the Cherokee Nation is a partnership between prevention scientists and Cherokee Nation Behavioral Health to create, implement, and evaluate a new, integrated community-level intervention designed to prevent underage drinking and associated negative consequences among Native American and other youth living in rural high-risk underserved communities. The intervention builds directly on results of multiple previous trials of two conceptually distinct approaches. The first is an updated version of CMCA, an established community environmental change intervention, and the second is CONNECT, our newly developed population-wide intervention based on screening, brief intervention, and referral to treatment (SBIRT) research. CMCA direct-action community organizing is used to engage local citizens to address community norms and practices related to alcohol use and commercial and social access to alcohol among adolescents. The new CONNECT intervention expands traditional SBIRT to be implemented universally within schools. Six key research design elements optimize causal inference and experimental evaluation of intervention effects, including a controlled interrupted time-series design, purposive selection of towns, random assignment to study condition, nested cohorts as well as repeated cross-sectional observations, a factorial design crossing two conceptually distinct interventions, and multiple comparison groups. The purpose of this paper is to describe the strong partnership between prevention scientists and behavioral health leaders within the Cherokee Nation, and the intervention and research design of this new community trial.
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Mitchell SG, Kelly SM, Gryczynski J, Myers CP, O'Grady KE, Kirk AS, Schwartz RP. The CRAFFT cut-points and DSM-5 criteria for alcohol and other drugs: a reevaluation and reexamination. Subst Abus 2015; 35:376-80. [PMID: 25036144 DOI: 10.1080/08897077.2014.936992] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND The CRAFFT, previously validated against DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition) diagnostic criteria, is the most widely used screening instrument for alcohol and other substance misuse in adolescents. The present secondary analysis study sought to compare the CRAFFT with the new DSM-5 diagnostic criteria in order to assess the CRAFFT's psychometric properties and determine the optimal cut-point for identifying adolescents in need of further assessment. METHODS Participants were primary care patients aged 12-17 (N = 525) who were recruited while waiting for a medical appointment in an urban federally qualified health center in Baltimore, Maryland, USA. Participants were administered the CRAFFT and the Composite International Diagnostic Interview, second edition, modified to include the new DSM-5 craving item. The authors examined the performance of the CRAFFT in identifying any problem use (defined as 1 or more DSM-5 criteria) and any DSM-5 substance use disorder (2 or more DSM-5 criteria) for alcohol or drugs other than tobacco. The authors examined sensitivity, specificity, and receiver operating characteristic areas under the curve (AUC) to determine the optimal CRAFFT cut-point(s) for predicting any problem use and any DSM-5 substance use disorder (SUD). RESULTS Examining the CRAFFT as a continuous measure, AUC values were 0.93 for problem use or higher and 0.97 for DSM-5 SUD. Consistent with previously recommended cut-points for the CRAFFT, the cut-point of 2 performed optimally for identifying adolescents both exhibiting problem use of alcohol or drugs and meeting DSM-5 SUD criteria for alcohol or other drugs. CONCLUSIONS Despite changes in the DSM substance use diagnostic criteria, the CRAFFT continues to demonstrate excellent sensitivity and specificity at its established cut-point of 2. Additional studies examining the CRAFFT in light of the new DSM-5 diagnostic criteria with more diverse populations are warranted.
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Abstract
Prenatal exposure to alcohol can damage the developing fetus and is the leading preventable cause of birth defects and intellectual and neurodevelopmental disabilities. In 1973, fetal alcohol syndrome was first described as a specific cluster of birth defects resulting from alcohol exposure in utero. Subsequently, research unequivocally revealed that prenatal alcohol exposure causes a broad range of adverse developmental effects. Fetal alcohol spectrum disorder (FASD) is the general term that encompasses the range of adverse effects associated with prenatal alcohol exposure. The diagnostic criteria for fetal alcohol syndrome are specific, and comprehensive efforts are ongoing to establish definitive criteria for diagnosing the other FASDs. A large and growing body of research has led to evidence-based FASD education of professionals and the public, broader prevention initiatives, and recommended treatment approaches based on the following premises:▪ Alcohol-related birth defects and developmental disabilities are completely preventable when pregnant women abstain from alcohol use.▪ Neurocognitive and behavioral problems resulting from prenatal alcohol exposure are lifelong.▪ Early recognition, diagnosis, and therapy for any condition along the FASD continuum can result in improved outcomes.▪ During pregnancy:◦no amount of alcohol intake should be considered safe;◦there is no safe trimester to drink alcohol;◦all forms of alcohol, such as beer, wine, and liquor, pose similar risk; and◦binge drinking poses dose-related risk to the developing fetus.
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Gallimberti L, Buja A, Chindamo S, Lion C, Terraneo A, Marini E, Gomez Perez LJ, Baldo V. Prevalence of substance use and abuse in late childhood and early adolescence: What are the implications? Prev Med Rep 2015; 2:862-7. [PMID: 26844161 PMCID: PMC4721381 DOI: 10.1016/j.pmedr.2015.09.018] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
The aim of the present study was to assess the prevalence by gender of substance use and misuse in late childhood and early adolescence. A survey was conducted in 2013-2014 at primary and secondary schools of Padova, Veneto region, North-East Italy, on a sample of 171 pupils in 5th grade and 1325 in 6th to 8th grade. Among the 8th graders, more than one in three males and one in four females had experimented with smoking, and more than half the boys and nearly half the girls had experience of alcohol. In this same age group, almost two in three males and one in three females had used energy drinks, and nearly 5% of the boys had experience of marijuana and/or stimulant drugs. In addition, almost one in four of the male students in 8th grade had experimented with three of these substances. The middle school years should be identified as the first period at risk concerning the use of these drugs. Prevention programs should begin in early adolescence, focusing on delaying the use or abuse of any of the "gateway drugs."
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Affiliation(s)
- Luigi Gallimberti
- Novella Fronda Foundation, Foundation for Studies and Applied Clinical Research in the Field of Addiction Medicine, Padua, Italy
| | - Alessandra Buja
- Department of Molecular Medicine, Laboratory of Public Health and Population Studies, Institute of Hygiene, University of Padova, Padua, Via Loredan 18, 35128 Padova, Italy
| | - Sonia Chindamo
- Novella Fronda Foundation, Foundation for Studies and Applied Clinical Research in the Field of Addiction Medicine, Padua, Italy
| | - Camilla Lion
- 2nd School of Hygiene and Preventive Medicine Department of Molecular Medicine, Laboratory of Public Health and Population Studies, Institute of Hygiene, University of Padova, 35128 Padova, Italy
| | - Alberto Terraneo
- Novella Fronda Foundation, Foundation for Studies and Applied Clinical Research in the Field of Addiction Medicine, Padua, Italy
| | - Elena Marini
- Novella Fronda Foundation, Foundation for Studies and Applied Clinical Research in the Field of Addiction Medicine, Padua, Italy
| | - Luis Javier Gomez Perez
- Department of Molecular Medicine, Laboratory of Public Health and Population Studies, Institute of Hygiene, University of Padova, Padua, Via Loredan 18, 35128 Padova, Italy
| | - Vincenzo Baldo
- Department of Molecular Medicine, Laboratory of Public Health and Population Studies, Institute of Hygiene, University of Padua, Via Loredan 18, 35128 Padova Italy
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Huang R, Ho SY, Wang MP, Lo WS, Lam TH. Sociodemographic risk factors of alcohol drinking in Hong Kong adolescents. J Epidemiol Community Health 2015; 70:374-9. [DOI: 10.1136/jech-2015-206418] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Accepted: 10/02/2015] [Indexed: 12/18/2022]
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Abstract
BACKGROUND Adolescent use of alcohol and illicit substances is quite common among pediatric psychiatry inpatients; however, little data exist on substance use screening instruments that can be used to augment thorough psychiatric diagnostic interviews. CRAFFT is a screening tool for adolescent substance use that has been validated in outpatient general medical settings. This is the first study to examine its use in adolescent psychiatric inpatients. METHODS We performed a chart review of records from adolescents admitted to our inpatient psychiatric unit who completed a CRAFFT screen on admission. We compared CRAFFT scores with other measures of substance use, including urine drug screens and the diagnosis of a substance use disorder at discharge. We also examined measures of depression and suicidality in individuals with elevated CRAFFT scores (≥2 positive answers out of 6) and compared them with measures in those with normal CRAFFT scores. RESULTS Elevated CRAFFT scores were correlated with other measures of alcohol and substance use, including the diagnosis of a substance use disorder at discharge (P<0.0001), and laboratory screening for alcohol (P=0.0048) and marijuana (P<0.0001) on admission. Previous suicide attempts (P=0.005) and "psychiatric trauma" (P=0.0027) were also positively associated with elevated CRAFFT scores. CONCLUSIONS CRAFFT scores in adolescent inpatients were correlated with other measures of substance use, supporting its efficacy as a screening tool in this population. CRAFFT scores were also positively correlated with a history of psychiatric trauma and past suicide attempts, which is consistent with the results of previous studies associating pediatric substance use and traumatic life events with an increased risk of suicide.
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Mitchell SG, Schwartz RP, Kirk AS, Dusek K, Oros M, Hosler C, Gryczynski J, Barbosa C, Dunlap L, Lounsbury D, O'Grady KE, Brown BS. SBIRT Implementation for Adolescents in Urban Federally Qualified Health Centers. J Subst Abuse Treat 2015; 60:81-90. [PMID: 26297321 DOI: 10.1016/j.jsat.2015.06.011] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Revised: 05/11/2015] [Accepted: 06/17/2015] [Indexed: 11/16/2022]
Abstract
BACKGROUND Alcohol, tobacco, and other drug use remains highly prevalent among US adolescents and is a threat to their well-being and to the public health. Evidence from clinical trials and meta-analyses supports the effectiveness of Screening, Brief Intervention and Referral to Treatment (SBIRT) for adolescents with substance misuse but primary care providers have been slow to adopt this evidence-based approach. The purpose of this paper is to describe the theoretically informed methodology of an on-going implementation study. METHODS This study protocol is a multi-site, cluster randomized trial (N=7) guided by Proctor's conceptual model of implementation research and comparing two principal approaches to SBIRT delivery within adolescent medicine: Generalist vs. Specialist. In the Generalist Approach, the primary care provider delivers brief intervention (BI) for substance misuse. In the Specialist Approach, BIs are delivered by behavioral health counselors. The study will also examine the effectiveness of integrating HIV risk screening within an SBIRT model. Implementation Strategies employed include: integrated team development of the service delivery model, modifications to the electronic medical record, regular performance feedback and supervision. Implementation outcomes, include: Acceptability, Appropriateness, Adoption, Feasibility, Fidelity, Costs/Cost-Effectiveness, Penetration, and Sustainability. DISCUSSION The study will fill a major gap in scientific knowledge regarding the best SBIRT implementation strategy at a time when SBIRT is poised to be brought to scale under health care reform. It will also provide novel data to inform the expansion of the SBIRT model to address HIV risk behaviors among adolescents. Finally, the study will generate important cost data that offer guidance to policymakers and clinic directors about the adoption of SBIRT in adolescent health care.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Laura Dunlap
- RTI International, Research Triangle Park, NC USA
| | | | - Kevin E O'Grady
- University of Maryland, College Park, Department of Psychology, College Park, MD USA
| | - Barry S Brown
- Friends Research Institute, Baltimore, MD USA; University of North Carolina at Wilmington, Wilmington, NC USA
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Roberts SP, Siegel MB, DeJong W, Ross CS, Naimi T, Albers A, Skeer M, Rosenbloom DL, Jernigan DH. Brands matter: Major findings from the Alcohol Brand Research Among Underage Drinkers (ABRAND) project. ADDICTION RESEARCH & THEORY 2015; 24:32-39. [PMID: 27034628 PMCID: PMC4809540 DOI: 10.3109/16066359.2015.1051039] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
BACKGROUND Alcohol research focused on underage drinkers has not comprehensively assessed the landscape of brand-level drinking behaviors among youth. This information is needed to profile youth alcohol use accurately, explore its antecedents, and develop appropriate interventions. METHODS We collected national data on the alcohol brand-level consumption of underage drinkers in the United States and then examined the association between those preferences and several factors including youth exposure to brand-specific alcohol advertising, corporate sponsorships, popular music lyrics, and social networking sites, and alcohol pricing. This paper summarizes our findings, plus the results of other published studies on alcohol branding and youth drinking. RESULTS Our findings revealed several interesting facts regarding youth drinking. For example, we found that: 1) youth are not drinking the cheapest alcohol brands; 2) youth brand preferences differ from those of adult drinkers; 3) underage drinkers are not opportunistic in their alcohol consumption, but instead consume a very specific set of brands; 4) the brands that youth are heavily exposed to in magazines and television advertising correspond to the brands they most often report consuming; and 5) youth consume more of the alcohol brands to whose advertising they are most heavily exposed. CONCLUSION The findings presented here suggests that brand-level alcohol research will provide important insight into youth drinking behaviors, the factors that contribute to youth alcohol consumption, and potential avenues for effective public health surveillance and programming.
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Affiliation(s)
- Sarah P. Roberts
- Boston University School of Public Health, Department of Community Health Sciences, 801 Massachusetts Ave., Boston MA 02118
| | - Michael B. Siegel
- Boston University School of Public Health, Department of Community Health Sciences, 801 Massachusetts Ave., Boston MA 02118
| | - William DeJong
- Boston University School of Public Health, Department of Community Health Sciences, 801 Massachusetts Ave., Boston MA 02118
| | | | - Timothy Naimi
- Boston University Schools of Medicine and Public Health, Department of Community Health Sciences and Section of General Internal Medicine, 801 Massachusetts Ave., Boston MA 02118
| | - Alison Albers
- Boston University School of Public Health, Department of Community Health Sciences, 801 Massachusetts Ave., Boston MA 02118
| | - Margie Skeer
- Tufts University School of Medicine, 136 Harrison Avenue, Boston MA 02111
| | - David L. Rosenbloom
- Boston University School of Public Health, Department of Health Policy and Management, 715 Albany Street, Boston MA 02118
| | - David H. Jernigan
- Department of Health, Behavior, and Society and Center on Alcohol Marketing and Youth, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205
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Maggs JL, Staff J, Patrick ME, Wray-Lake L, Schulenberg JE. Alcohol use at the cusp of adolescence: a prospective national birth cohort study of prevalence and risk factors. J Adolesc Health 2015; 56:639-45. [PMID: 26003579 PMCID: PMC4442274 DOI: 10.1016/j.jadohealth.2015.02.010] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2014] [Revised: 02/09/2015] [Accepted: 02/09/2015] [Indexed: 02/03/2023]
Abstract
PURPOSE To estimate the prevalence of alcohol use at the age of 10-11 years and document variation by early sociodemographic and concurrent alcohol-specific risk factors. METHODS The Millennium Cohort Study is a prospective, nationally representative study of live births in the United Kingdom across 12 months. A random sample of electoral wards was stratified to adequately represent U.K. countries, economically deprived areas, and areas with high concentrations of Asian and Black British families. A total of 12,305 child-mother pairs provided self-report data at 9 months (mother's marital status, age, education, occupational level; child gender, ethnicity, country) and age 10-11 years (adolescent alcohol use and attitudes). RESULTS After adjusting for attrition and sampling design, 13.4% of 10- to 11-year-olds had had an alcoholic drink (more than few sips), 1.2% had felt drunk, and .6% had five or more drinks at a time. Odds of ever drinking were higher among boys (1.47, 95% confidence interval, 1.29-1.68) and lower among early adolescents who were Asian British (vs. white; .09, .05-.17) or Black British (.42, .29-.62). Beyond sociodemographic differences, more positive attitudes about alcohol were associated with greater odds of drinking (1.70, 1.51-1.91), feeling drunk (2.96, 2.07-4.24), and having five or more drinks (4.20, 2.66-6.61). CONCLUSIONS Alcohol use in the last year of primary school was identified but not common. Its use varied by sociodemographic groups; early adolescents with more positive alcohol attitudes had especially high risks of early alcohol initiation. Results support calls for increased surveillance and screening for very early drinking.
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Affiliation(s)
- Jennifer L Maggs
- Department of Human Development and Family Studies, Pennsylvania State University, University Park, Pennsylvania; Centre for Longitudinal Studies, Department of Quantitative Social Science, UCL Institute of Education, London, United Kingdom.
| | - Jeremy Staff
- Department of Sociology and Criminology 211 Oswald Tower Pennsylvania State University University Park, PA 16802, USA
| | - Megan E. Patrick
- Institute for Social Research University of Michigan Ann Arbor, MI 48106-1248, USA
| | - Laura Wray-Lake
- Dept of Clinical and Social Sciences in Psychology University of Rochester Rochester, NY 14627, USA
| | - John E. Schulenberg
- Institute for Social Research University of Michigan Ann Arbor, MI 48106-1248, USA and Department of Psychology 1012 East Hall, 530 Church St University of Michigan Ann Arbor, MI 48109-1043, USA
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Ridenour TA, Willis D, Bogen DL, Novak S, Scherer J, Reynolds MD, Zhai ZW, Tarter RE. Detecting initiation or risk for initiation of substance use before high school during pediatric well-child check-ups. Drug Alcohol Depend 2015; 150:54-62. [PMID: 25765481 PMCID: PMC4405881 DOI: 10.1016/j.drugalcdep.2015.02.013] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2014] [Revised: 02/04/2015] [Accepted: 02/06/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND Youth substance use (SU) is prevalent and costly, affecting mental and physical health. American Academy of Pediatrics and Affordable Care Act call for SU screening and prevention. The Youth Risk Index(©) (YRI) was tested as a screening tool for having initiated and propensity to initiate SU before high school (which forecasts SU disorder). YRI was hypothesized to have good to excellent psychometrics, feasibility and stakeholder acceptability for use during well-child check-ups. DESIGN A high-risk longitudinal design with two cross-sectional replication samples, ages 9-13 was used. Analyses included receiver operating characteristics and regression analyses. PARTICIPANTS A one-year longitudinal sample (N=640) was used for YRI derivation. Replication samples were a cross-sectional sample (N=345) and well-child check-up patients (N=105) for testing feasibility, validity and acceptability as a screening tool. RESULTS YRI has excellent test-retest reliability and good sensitivity and specificity for concurrent and one-year-later SU (odds ratios=7.44, CI=4.3-13.0) and conduct problems (odds ratios=7.33, CI=3.9-13.7). Results were replicated in both cross-sectional samples. Well-child patients, parents and pediatric staff rated YRI screening as important, acceptable, and a needed service. CONCLUSIONS Identifying at-risk youth prior to age 13 could reap years of opportunity to intervene before onset of SU disorder. Most results pertained to YRI's association with concurrent or recent past risky behaviors; further replication ought to specify its predictive validity, especially adolescent-onset risky behaviors. YRI well identifies youth at risk for SU and conduct problems prior to high school, is feasible and valid for screening during well-child check-ups, and is acceptable to stakeholders.
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Affiliation(s)
- Ty A. Ridenour
- Research Triangle Institute, Research Triangle Park, NC,University of Pittsburgh, Pittsburgh, PA
| | - David Willis
- Health Resources and Services Administration, Rockville, MD
| | | | - Scott Novak
- Research Triangle Institute, Research Triangle Park, NC
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Ross CS, Ostroff J, Naimi TS, DeJong W, Siegel MB, Jernigan DH. Selection of branded alcoholic beverages by underage drinkers. J Adolesc Health 2015; 56:564-70. [PMID: 25907655 PMCID: PMC4409663 DOI: 10.1016/j.jadohealth.2015.01.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2014] [Revised: 01/29/2015] [Accepted: 01/29/2015] [Indexed: 11/22/2022]
Abstract
PURPOSE The purpose of this study was to identify reasons why youth choose to drink specific brands of alcohol and to determine if these reasons are associated with problem drinking patterns and outcomes. METHODS We conducted an Internet survey of 1,031 youth aged 13-20 years who reported drinking within the past 30 days. Of these, 541 youth who reported having a choice of multiple brands of alcohol the last time they drank stated (yes/no) whether each of 16 different reasons had influenced their choice of a specific brand. We reduced these 16 reasons to three principal components and used latent class modeling to identify five groups of youth with similar reasons for selecting a brand, which we then profiled. RESULTS We grouped respondents into the following brand selection groups: "Brand Ambassadors" who were distinguished from other clusters by selecting a brand because they identified with it (32.5% of respondents), "Tasters" who selected a brand because they expected it to taste good (27.2%), "Bargain Hunters" who selected a brand because it was inexpensive (18.5%), "Copycats" who selected a brand because they had seen adults drinking it or seen it consumed in movies or other media (10.4%), and "Others" (11.5%). Brand ambassadors and copycats reported the largest amount of alcohol consumed and had the greatest prevalence of both heavy episodic drinking and negative alcohol-related health consequences. CONCLUSIONS Underage drinkers who cite marketing influences and adult or media modeling of brand choices as their reasons for selecting alcohol brands are likely to drink more and incur adverse consequences from drinking.
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Affiliation(s)
| | | | - Timothy S Naimi
- Department of Community Health Sciences, Boston University School of Public Health, Boston, Massachusetts; Clinical Addiction Research and Education Unit, Section of General Internal Medicine, Boston Medical Center, Boston, Massachusetts
| | - William DeJong
- Department of Community Health Sciences, Boston University School of Public Health, Boston, Massachusetts
| | - Michael B Siegel
- Department of Community Health Sciences, Boston University School of Public Health, Boston, Massachusetts
| | - David H Jernigan
- Center on Alcohol Marketing and Youth, Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
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Roberts SP, Siegel MB, DeJong W, Naimi TS, Jernigan DH. Brand preferences of underage drinkers who report alcohol-related fights and injuries. Subst Use Misuse 2015; 50:619-929. [PMID: 25612075 PMCID: PMC4441549 DOI: 10.3109/10826084.2014.997392] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND A significant body of research has demonstrated an association between adolescent alcohol consumption and subsequent fights and injuries. To date, however, no research has identified which brands are associated with alcohol-related fights and injuries among underage drinkers. OBJECTIVES We aimed to: (1) report the prevalence of alcohol-related fights and injuries among a national sample of underage drinkers in the U.S. and (2) describe the relationship between specific alcohol brand consumption and these alcohol-related negative consequences. METHODS We recruited 1,031 self-reported drinkers (ages 13-20 years) via an internet panel maintained by Knowledge Networks to complete an online survey. Respondents reported their past-month overall and brand-specific alcohol consumption, risky drinking behavior, and past-year alcohol-related fights and injuries. RESULTS Over one-quarter of the respondents (26.7%, N = 232) reported at least one alcohol-related fight or injury in the past year. Heavy episodic drinkers were over six times more likely to report one of these negative alcohol-related consequences (AOR: 6.4, 95% CI: 4.1-9.9). Respondents of black race and those from higher-income households were also significantly more likely to report that experience (AOR: 2.2, 95% CI: 1.3-3.7; AOR: 1.8, 95% CI: 1.1-3.0 and 1.1-3.2, respectively). We identified eight alcohol brands that were significantly associated with alcohol-related fights and injuries. CONCLUSIONS/IMPORTANCE: Alcohol-related fights and injuries were frequently reported by adolescent respondents. Eight alcohol brands were significantly more popular among drinkers who experienced these adverse consequences. These results point to the need for further research on brand-specific correlates of underage drinking and negative health outcomes.
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Affiliation(s)
- Sarah P Roberts
- 1Department of Community Health Sciences, Boston University School of Public Health , Boston, Massachusetts , USA
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Knychala MA, Jorge MLMP, Muniz CK, Faria PN, Jorge PT. High-risk alcohol use and anxiety and depression symptoms in adolescents and adults with type 1 diabetes mellitus: a cross-sectional study. Diabetol Metab Syndr 2015; 7:24. [PMID: 25821523 PMCID: PMC4376997 DOI: 10.1186/s13098-015-0020-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Accepted: 03/05/2015] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND The medical literature shows that alcohol consumption is common among diabetic individuals and is associated with poor adherence to treatment, resulting in increased morbidity and mortality. However, no study has assessed the association between high-risk alcohol consumption and the presence of anxiety and depression in individuals with type 1 diabetes mellitus (1DM). METHODS The present cross-sectional study was conducted in Uberlândia, Brazil, and it assessed 209 outpatients in relation to alcohol consumption and the presence of anxiety and depression symptoms, using the Alcohol Use Disorders Identification Test (AUDIT), the Hospital Anxiety and Depression (HAD) scale, and glycemic control, according to the levels of glycated hemoglobin (HbA1c). The chi-square test and logistic regression analysis were used to investigate the association between the investigated variables. RESULTS The prevalence of high-risk alcohol consumption (AUDIT ≥ 8) among individuals with 1DM was high, specifically 24.9% among the entire group of subjects, 12.9% among the adolescents, 14.7% among the females, and 34.6% among the males. In comparisons based on gender and age, the odds of high-risk drinking were higher among males and participants aged 30 to 40 years (33.9%). The frequency of high-risk alcohol consumption did not differ as a function of gender among adolescents (females: 9.0%, males: 16.2%; p = 0.374). There was a linear trend in proportions related to the scores of anxiety and depression symptoms with high-risk alcohol consumption scores, indicating the association of these variables (p = 0.0229 and p = 0.0262, respectively). Moreover, the odds of female subjects exhibiting anxiety and depression symptoms were higher (odds ratio - OR: 4.4 and OR: 7.4, respectively). Glycemic control did not exhibit an association between high-risk alcohol consumption and the presence of anxiety and depression symptoms. CONCLUSIONS The frequency of high-risk drinking increased along with age and was greater among males; however, this frequency did not exhibit differences in terms of gender among adolescents. There was a positive association between high risk alcohol consumption and anxiety and depression symptoms, although glycemic control was inadequate in most of the sample independent of alcohol consumption and the presence of anxiety and depression symptoms.
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Affiliation(s)
- Maria Aparecida Knychala
- />Graduate Program in Health Sciences, School of Medicine, Federal University of Uberlândia, Uberlândia, MG CEP: 38400-902 Brazil
| | | | - Cinara Knychala Muniz
- />Management of Nutrition and Dietetics, Clinical Hospital, Federal University of Uberlândia, Uberlândia, MG Brazil
| | | | - Paulo Tannús Jorge
- />Graduate Program in Health Sciences, School of Medicine, Federal University of Uberlândia, Uberlândia, MG CEP: 38400-902 Brazil
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Malta DC, Mascarenhas MDM, Porto DL, Barreto SM, Morais Neto OLD. [Exposure to alcohol among adolescent students and associated factors]. Rev Saude Publica 2014; 48:52-62. [PMID: 24789637 PMCID: PMC4206131 DOI: 10.1590/s0034-8910.2014048004563] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2012] [Accepted: 10/17/2013] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To describe the prevalence of alcohol consumption among adolescent school students and identify its individual and contextual associated factors. METHODS The present research used data from the 2009 National School Health Survey (PeNSE), which included a sample of 59,699 9th grade students in Brazilian capitals and the Federal District. The association between regular alcohol consumption and independent explanatory variables was measured by means of the Pearson's Chi-square test, with a 0.05 significance level. The explanatory variables were divided into four groups based on affinity (sociodemographic; school and family context; risk factors; and protection factors). A multivariate analysis was carried out for each group, always adjusting for age and sex. Variables with p < 0.10 were used in the final multivariate analysis model. RESULTS The highest alcohol consumption in the preceding 30 days was independently associated with pupils aged 15 years (OR = 1.46) and over, female (OR = 1.72), white, children of mothers with higher education, studying in private school, students who had tried smoking (OR = 1.72) and drug use (OR = 1.81), with regular tobacco consumption (OR = 2.16) and those who have had sexual intercourse (OR = 2.37). The factors related to family were skipping school without parental knowledge (OR = 1.49), parents not knowing what children do in their free time (OR = 1.34), having fewer meals with their parents (OR = 1.22), reporting that parents do not care (OR = 3.05), or care little (OR = 3.39) if they go home drunk, and having suffered domestic violence (OR = 1.36). CONCLUSIONS The results reinforce the importance of viewing alcohol consumption among adolescents as a complex, multifactorial and socially determined phenomenon.
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Roberts SP, Siegel MB, DeJong W, Naimi TS, Jernigan DH. The relationships between alcohol source, autonomy in brand selection, and brand preference among youth in the USA. Alcohol Alcohol 2014; 49:563-71. [PMID: 25113176 PMCID: PMC4128668 DOI: 10.1093/alcalc/agu034] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2014] [Revised: 05/14/2014] [Accepted: 05/15/2014] [Indexed: 11/12/2022] Open
Abstract
AIMS We aimed to describe the sources from which youth in the USA commonly obtain alcohol, their role in selecting the brands they drink and the relationship of these variables to their indicated alcohol brand preferences. METHODS We recruited 1031 underage drinkers in the age range of 13-20 through an internet panel managed by Knowledge Networks. Respondents completed an online survey assessing their recent brand-specific alcohol use, the source of their most recently consumed alcohol and whether the respondent or another person selected the brand they drank. RESULTS Alcohol sources were more often passive than transactional. Nearly equal proportions of youth reported that they did versus did not choose the brand of their most recent drink. Analysis revealed that the brand preferences of passive versus active source drinkers were highly similar, as were the brand preferences of respondent versus non-respondent choice drinkers. Stratification of respondents by age did not significantly change these results. CONCLUSION Our findings suggest that youth are consuming a homogenous list of preferred brands regardless of the source of their most recently obtained alcohol or who selected the brand they drank.
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Affiliation(s)
- Sarah P Roberts
- Department of Community Health Sciences, Boston University School of Public Health, 801 Massachusetts Avenue, Boston, MA 02118, USA
| | - Michael B Siegel
- Department of Community Health Sciences, Boston University School of Public Health, 801 Massachusetts Avenue, Boston, MA 02118, USA
| | - William DeJong
- Department of Community Health Sciences, Boston University School of Public Health, 801 Massachusetts Avenue, Boston, MA 02118, USA
| | - Timothy S Naimi
- Department of Community Health Sciences and Section of General Internal Medicine, Boston University Schools of Medicine and Public Health, 801 Massachusetts Avenue, Boston, MA 02118, USA
| | - David H Jernigan
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, 624 West Broadway, Room 292, Baltimore, MD 21205, USA
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48
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Roberts SP, Siegel MB, DeJong W, Jernigan DH. A comparison between brand-specific and traditional alcohol surveillance methods to assess underage drinkers' reported alcohol use. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2014; 40:447-54. [PMID: 25062357 DOI: 10.3109/00952990.2014.938160] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Adolescent alcohol consumption remains common and is associated with many negative health outcomes. Unfortunately, common alcohol surveillance methods often underestimate consumption. Improved alcohol use measures are needed to characterize the landscape of youth drinking. OBJECTIVES We aimed to compare a standard quantity-frequency measure of youth alcohol consumption to a novel brand-specific measure. METHODS We recruited a sample of 1031 respondents across the United States to complete an online survey. Analyses included 833 male and female underage drinkers ages 13-20. Respondents reported on how many of the past 30 days they consumed alcohol, and the number of drinks consumed on an average drinking day. Using our brand-specific measure, respondents identified which brands they consumed, how many days they consumed each brand, and how many drinks per brand they usually had. RESULTS Youth reported consuming significantly more alcohol (on average, 11 drinks more per month) when responding to the brand-specific versus the standard measure (p < 0.001). The two major predictors of the difference between the two measures were being a heavy episodic drinker (p < 0.001, 95% CI = 4.1-12.0) and the total number of brands consumed (p < 0.001, 95% CI = 2.0-2.8). CONCLUSION This study contributes to the field of alcohol and adolescent research first by investigating a potentially more accurate alcohol surveillance method, and secondly by promoting the assessment of alcohol use among adolescents vulnerable to risky alcohol use. Finally, our survey addresses the potential impact of alcohol marketing on youth and their subsequent alcohol brand preferences and consumption.
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Affiliation(s)
- Sarah P Roberts
- Boston University School of Public Health, Department of Community Health Sciences , Boston, MA and
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49
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Li K, Simons-Morton BG, Hingson R. Impaired-driving prevalence among US high school students: associations with substance use and risky driving behaviors. Am J Public Health 2013; 103:e71-7. [PMID: 24028236 PMCID: PMC3828696 DOI: 10.2105/ajph.2013.301296] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/18/2013] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We examined the prevalence of impaired driving among US high school students and associations with substance use and risky driving behavior. METHODS We assessed driving while alcohol or drug impaired (DWI) and riding with alcohol- or drug-impaired drivers (RWI) in a nationally representative sample of 11th-grade US high school students (n = 2431). We examined associations with drinking and binge drinking, illicit drug use, risky driving, and demographic factors using multivariate sequential logistic regression analysis. RESULTS Thirteen percent of 11th-grade students reported DWI at least 1 of the past 30 days, and 24% reported RWI at least once in the past year. Risky driving was positively associated with DWI (odds ratio [OR] = 1.25; P < .001) and RWI (OR = 1.09; P < .05), controlling for binge drinking (DWI: OR = 3.17; P < .01; RWI: OR = 6.12; P < .001) and illicit drug use (DWI: OR = 5.91; P < .001; RWI: OR = 2.29; P = .05). DWI was higher for adolescents who drove after midnight (OR = 15.7), drove while sleepy or drowsy (OR = 8.6), read text messages (OR = 11.8), sent text messages (OR = 5.0), and made cell phone calls (OR = 3.2) while driving. CONCLUSIONS Our findings suggest the need for comprehensive approaches to the prevention of DWI, RWI, and other risky driving behavior.
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Affiliation(s)
- Kaigang Li
- Kaigang Li and Bruce G. Simons-Morton are with the Health Behavior Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD. Ralph Hingson is with the Epidemiology and Prevention Research Division, National Institute on Alcohol Abuse and Alcoholism, Bethesda
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50
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Armstrong JM, Ruttle PL, Burk LR, Costanzo PR, Strauman TJ, Essex MJ. Early risk factors for alcohol use across high school and its covariation with deviant friends. J Stud Alcohol Drugs 2013; 74:746-56. [PMID: 23948534 PMCID: PMC3749318 DOI: 10.15288/jsad.2013.74.746] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2012] [Accepted: 02/26/2013] [Indexed: 01/05/2023] Open
Abstract
OBJECTIVE Past research has associated childhood characteristics and experiences with alcohol use at single time points in adolescence. Other work has focused on drinking trajectories across adolescence but with risk factors typically no earlier than middle or high school. Similarly, although the connection between underage drinking and affiliation with deviant friends is well established, early risk factors for their covariation across adolescence are uncertain. The present study examines the influence of early individual and contextual factors on (a) trajectories across high school of per-occasion alcohol use and (b) the covariation of alcohol use and deviant friends over time. METHOD In a longitudinal community sample (n = 374; 51% female), temperamental disinhibition, authoritarian and authoritative parenting, and parental alcohol use were assessed during childhood, and adolescents reported on alcohol use and affiliation with deviant friends in the spring of Grades 9, 10, 11, and 12. RESULTS Early parental alcohol use predicted the intercept of adolescent drinking. Subsequent patterns of adolescent alcohol use were predicted by sex and interactions of sex and childhood disinhibition with early authoritarian parenting. Additionally, childhood disinhibition interacted with parental alcohol use to moderate the covariation of drinking and deviant friends. CONCLUSIONS These findings highlight early individual and contextual risk factors for alcohol use across high school, extending previous work and underscoring the importance of developmental approaches and longitudinal techniques for understanding patterns of growth in underage drinking.
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Affiliation(s)
- Jeffrey M Armstrong
- Department of Psychiatry, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin 53719, USA.
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