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

Abstract

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

Keywords:

• Adolescent
• substance use
• SBIRT
• school-based health
• technology

Acknowledgments

We would like to thank Cristina Adriana Arghira, Katie Hellerud, Elsie Rockers, Kelly Serafini, and Garret Zieve for their contributions to data collection and study implementation. We are also appreciative of the staff members and providers at participating SBHCs for their involvement in the study.

Disclosure statement

Seattle Children’s Hospital and Shift Health have entered into an agreement under which 2 authors (Carolyn A. McCarty and Laura P. Richardson) will receive a share of the royalties related to sales of the Check Yourself tool.

Additional information

Funding

This project was supported by grant R21 AA023050 from the National Institute on Alcohol Abuse and Alcoholism (NIAAA). The funding source had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

Notes on contributors

Carolyn A. McCarty

All of the authors meet the requirements for authorship per the Uniform Guidelines for Biomedical Journals Requirements of the ICMJE for determining authorship (Vancouver Group Guidelines, 2010). No other individuals meet these guidelines for authorship. C.M. initially conceived of the project and designed the study with collaborative input from L.R. and C.L. G.S. contributed to site recruitment and K.K. oversaw data collection for the study and obtained IRB approval with consultation from C.M. and L.R. E.G. conducted data analyses. The manuscript was prepared by C.M. with help from E.G. and K.K. All authors participated in interpretation of the results and editing the manuscript.

Elon Gersh

All of the authors meet the requirements for authorship per the Uniform Guidelines for Biomedical Journals Requirements of the ICMJE for determining authorship (Vancouver Group Guidelines, 2010). No other individuals meet these guidelines for authorship. C.M. initially conceived of the project and designed the study with collaborative input from L.R. and C.L. G.S. contributed to site recruitment and K.K. oversaw data collection for the study and obtained IRB approval with consultation from C.M. and L.R. E.G. conducted data analyses. The manuscript was prepared by C.M. with help from E.G. and K.K. All authors participated in interpretation of the results and editing the manuscript.

Katherine Katzman

All of the authors meet the requirements for authorship per the Uniform Guidelines for Biomedical Journals Requirements of the ICMJE for determining authorship (Vancouver Group Guidelines, 2010). No other individuals meet these guidelines for authorship. C.M. initially conceived of the project and designed the study with collaborative input from L.R. and C.L. G.S. contributed to site recruitment and K.K. oversaw data collection for the study and obtained IRB approval with consultation from C.M. and L.R. E.G. conducted data analyses. The manuscript was prepared by C.M. with help from E.G. and K.K. All authors participated in interpretation of the results and editing the manuscript.

Christine M. Lee

All of the authors meet the requirements for authorship per the Uniform Guidelines for Biomedical Journals Requirements of the ICMJE for determining authorship (Vancouver Group Guidelines, 2010). No other individuals meet these guidelines for authorship. C.M. initially conceived of the project and designed the study with collaborative input from L.R. and C.L. G.S. contributed to site recruitment and K.K. oversaw data collection for the study and obtained IRB approval with consultation from C.M. and L.R. E.G. conducted data analyses. The manuscript was prepared by C.M. with help from E.G. and K.K. All authors participated in interpretation of the results and editing the manuscript.

Gina S. Sucato

All of the authors meet the requirements for authorship per the Uniform Guidelines for Biomedical Journals Requirements of the ICMJE for determining authorship (Vancouver Group Guidelines, 2010). No other individuals meet these guidelines for authorship. C.M. initially conceived of the project and designed the study with collaborative input from L.R. and C.L. G.S. contributed to site recruitment and K.K. oversaw data collection for the study and obtained IRB approval with consultation from C.M. and L.R. E.G. conducted data analyses. The manuscript was prepared by C.M. with help from E.G. and K.K. All authors participated in interpretation of the results and editing the manuscript.

Laura P. Richardson

All of the authors meet the requirements for authorship per the Uniform Guidelines for Biomedical Journals Requirements of the ICMJE for determining authorship (Vancouver Group Guidelines, 2010). No other individuals meet these guidelines for authorship. C.M. initially conceived of the project and designed the study with collaborative input from L.R. and C.L. G.S. contributed to site recruitment and K.K. oversaw data collection for the study and obtained IRB approval with consultation from C.M. and L.R. E.G. conducted data analyses. The manuscript was prepared by C.M. with help from E.G. and K.K. All authors participated in interpretation of the results and editing the manuscript.