Adolescents' Preferences for Substance Abuse Screening in Primary Care Practice

SUMMARY

Objective: To assess adolescents' preferences for substance abuse screening in primary medical care settings.

Design/Methods: Twelve- to 18-year-old patients (N = 2133) arriving for routine care at a network of primary care sites completed an interview that included demographic items, the CRAFFT screen, and a questionnaire assessing preferences for screening method (paper questionnaire, computer, oral interview by nurse or doctor). A subgroup (n = 222) completed the CRAFFT directly on the computer.

Results: Across the entire sample, paper was the screening administration method most preferred (mean rank (MR) = 2.92, 95%CI 2.87–2.96) vs. computer (MR = 2.38, 2.33–2.43), nurse (MR = 2.43, 2.39–2.47), and doctor (MR = 2.30, 2.25–2.35). Among the participants who received the screening on the computer, however, computer (MR = 3.08, 95%CI 2.42–2.52) was statistically tied with paper (MR = 2.88, 2.75–3.02) and both were ranked significantly higher than nurse (MR = 2.06, 1.94–2.17) and doctor (MR = 1.98, 1.82–2.14). The findings were similar for participants' reports of being “very likely” to be honest when answering substance abuse screening questions.

Conclusions: Adolescents should ideally be screened for substance abuse using paper or computer questionnaires.

Key Words:

• Substance-related disorders
• alcoholism
• adolescence
• screening
• questionnaire
• drug abuse detection