Virtual Screening and Intervention for Adolescent Alcohol Use

Overseen By Stacy A Sterling, DrPH, MSW

Age: < 18

Sex: Any

Trial Phase: Academic

Sponsor: Kaiser Permanente

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Approved in 1 Jurisdiction This treatment is already approved in other countries

Compensation: Varies

Number of Visits: 2

22320 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to determine if a virtual program can help identify and treat alcohol and other drug (AOD) use among teenagers. The study compares a new virtual support method, Centralized Virtual SBIRT (Screening, Brief Intervention, and Referral to Treatment), with the traditional in-person approach. Teens with regular AOD use or any AOD use combined with recent feelings of depression or thoughts of self-harm might be suitable for this trial. The goal is to assess whether the virtual method can be a cost-effective way to improve young people's health by addressing these issues early. As an unphased trial, this study provides a unique opportunity for teens to access innovative support methods that could enhance their well-being.

Do I need to stop my current medications to join the trial?

The trial information does not specify whether you need to stop taking your current medications.

What prior data suggests that this virtual intervention is safe for adolescents?

Research shows that the virtual SBIRT (Screening, Brief Intervention, and Referral to Treatment) method is generally well-received. Studies have found that healthcare providers and patients can effectively use this approach through video or phone calls, offering ease and convenience.

Reports from similar studies indicate that virtual SBIRT interventions have been used without major safety issues. When healthcare providers use this method to help teenagers with alcohol and drug problems, serious side effects are rare. The virtual method focuses on identifying and addressing risky behaviors, which is considered safe and non-invasive.

While specific safety data isn't detailed, the regular use of SBIRT in various settings suggests it is reliably safe. This makes virtual SBIRT a promising option for teenagers needing early help with alcohol and drug use challenges. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the Centralized Virtual SBIRT because it offers a fresh, tech-savvy approach to tackling adolescent alcohol use. Unlike traditional methods where interventions are delivered in-person by a clinician at the clinic, this treatment uses virtual technology to connect with teens via video or telephone. This approach not only makes it more convenient and accessible for adolescents to receive help but also allows for centralized and potentially more consistent care from specialized behavioral health clinicians. By leveraging technology, this method aims to reach more adolescents effectively and efficiently.

What evidence suggests that this trial's treatments could be effective for adolescent alcohol use?

Research shows that Screening, Brief Intervention, and Referral to Treatment (SBIRT) effectively identifies and reduces alcohol and drug use among teenagers. In this trial, participants will join one of two groups: Centralized Virtual SBIRT, which delivers services via video or phone calls, or Usual Care/Traditional SBIRT, where interventions occur in person. Centralized Virtual SBIRT offers a promising alternative to traditional visits. Studies have found that clinics can quickly access virtual SBIRT, making it easier for teens to receive help. This method may improve early detection and treatment for those at high risk, overcoming challenges like limited resources and training in clinics. Early evidence suggests it could be a cost-effective way to address substance use issues in adolescents. ^{2 5 6 7 8}

Are You a Good Fit for This Trial?

This trial is for adolescents who may be at high or severe risk of alcohol or other drug use disorders. It's aimed to help with early identification and treatment, including those with comorbid mental health issues.

Inclusion Criteria

I am a teenager at risk of substance use disorder, showing signs of depression or suicidal thoughts.

Exclusion Criteria

I am an adolescent and have had a recent Well Visit.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

1 week

1 visit (virtual)

Intervention

Brief interventions delivered virtually by video or telephone by a centralized behavioral health clinician

2 years

Multiple visits (virtual)

Follow-up

Participants are monitored for AOD use, mental health diagnoses, and health services utilization

2 years

1- and 2-year follow-up visits

What Are the Treatments Tested in This Trial?

Interventions

• Centralized Virtual SBIRT

Trial Overview

The study is testing a centralized virtual SBIRT (Screening, Brief Intervention, and Referral to Treatment) approach in pediatric primary care settings to see if it can effectively identify and manage adolescent substance use.

How Is the Trial Designed?

Group I: CV SBIRT Experimental Treatment 1 Intervention

Clinics where brief interventions are delivered virtually by video or telephone by a centralized behavioral health clinician (CV-SBIRT arm)

Group II: Usual Care/Traditional SBIRT Active Control 1 Intervention

Clinics where appointment-based brief interventions are delivered by a behavioral health clinician assigned to the clinic (Traditional SBIRT arm)

Centralized Virtual SBIRT is already approved in United States for the following indications:

Approved in United States as SBIRT for:

• Alcohol use disorder
• Substance use disorder
• Comorbid mental health problems

Who Is Running the Clinical Trial?

Kaiser Permanente

Lead Sponsor

Trials

563

Recruited

27,400,000+

Published Research Related to This Trial

A review of 7 randomized controlled trials in emergency departments found that while some interventions using SBIRT showed significant effects on risky drinking among adolescents, no single intervention effectively reduced both alcohol consumption and related consequences.

Interestingly, the process of screening and the experience of receiving emergent care may have a protective effect on alcohol use, as five studies indicated positive outcomes for all participants, regardless of the intervention condition.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Screening, brief intervention, and referral for alcohol use in adolescents: a systematic review. Yuma-Guerrero, PJ., Lawson, KA., Velasquez, MM., et al.[2022]

Adolescent substance use poses significant public health risks, emphasizing the need for healthcare providers, especially pediatricians, to enhance their capabilities in screening and intervening for substance use issues.

The updated clinical report provides a simplified approach to Screening, Brief Intervention, and Referral to Treatment (SBIRT) for adolescents, helping pediatricians implement effective prevention and intervention strategies in various healthcare settings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Substance Use Screening, Brief Intervention, and Referral to Treatment. Levy, SJ., Williams, JF.[2022]

In a study of 1,871 adolescents, the SBIRT (Screening, Brief Intervention, and Referral to Treatment) approach led to fewer psychiatry visits and lower rates of mental health and chronic conditions after one year compared to usual care.

After three years, adolescents receiving SBIRT had fewer total outpatient visits and were less likely to have substance use diagnoses, while also showing an increase in substance use treatment visits, indicating improved health outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Health Care Use Over 3 Years After Adolescent SBIRT. Sterling, S., Kline-Simon, AH., Jones, A., et al.[2020]

A study involving 144 undergraduate nursing students demonstrated that an interactive computer simulation for adolescent SBIRT significantly improved students' self-perceived competence, confidence, and readiness to deliver substance use interventions, with statistically significant results (p < 0.05).

The positive feedback from students regarding the simulation experience highlights the effectiveness of using technology-based training methods in nursing education, suggesting that such simulations can enhance the learning of critical public health interventions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Interactive Computer Simulation for Adolescent Screening, Brief Intervention, and Referral to Treatment (SBIRT) for Substance Use in an Undergraduate Nursing Program. Burmester, KA., Ahluwalia, JP., Ploutz-Snyder, RJ., et al.[2022]

The Remote Brief Intervention and Referral to Treatment (R-BIRT) model was found to be feasible, with a 40% acceptance rate among 125 eligible emergency department patients, indicating potential for wider implementation.

Patients who received consultations during their emergency department visit had a significantly higher completion rate of 90% compared to only 10% for those contacted after their visit, suggesting that immediate intervention may enhance engagement in treatment.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The remote brief intervention and referral to treatment model: Development, functionality, acceptability, and feasibility. Boudreaux, ED., Haskins, B., Harralson, T., et al.[2018]

The SBIRT model, which includes screening, brief interventions, and referral to treatment, shows promise for identifying and helping adolescents at risk for substance use disorders, based on a review of randomized controlled trials.

Current evidence on the effectiveness of SBIRT for adolescents is limited, highlighting the need for more robust studies with larger sample sizes and longer follow-up periods to better understand its impact in various settings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

SBIRT for adolescent drug and alcohol use: current status and future directions. Mitchell, SG., Gryczynski, J., O'Grady, KE., et al.[2022]

The SBIRT (Screening, Brief Intervention, and Referral to Treatment) model is recommended by the American Academy of Pediatrics as an effective approach for pediatricians to address adolescent substance use, which is a significant public health issue.

Research shows that substance use negatively affects the developing brain, highlighting the importance of early screening and intervention; however, comprehensive studies on the combined effectiveness of all SBIRT components in adolescents are still lacking.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Addressing substance misuse in adolescents: a review of the literature on the screening, brief intervention, and referral to treatment model. Beaton, A., Shubkin, CD., Chapman, S.[2022]

In a study involving 2873 adolescents screened for substance use, 52.8% tested positive for alcohol or drug use, highlighting a significant unmet need for treatment in this population.

The implementation of the SBIRT program faced barriers such as adaptability, complexity, and staff turnover, suggesting that future efforts should focus on improving integration into clinical workflows and securing necessary funding.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Implementing SBIRT for adolescents within community mental health organizations: A mixed methods study. Stanhope, V., Manuel, JI., Jessell, L., et al.[2020]

Advanced practice registered nursing (APRN) students showed significant improvements in their self-reported competence and confidence in delivering adolescent SBIRT (screening, brief intervention, and referral to treatment) after participating in a comprehensive training program, with results indicating a p-value of less than 0.001.

The successful integration of adolescent SBIRT into the nursing curriculum suggests that this evidence-based approach can effectively prepare future healthcare providers to address adolescent substance use issues in routine health care settings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Preparing Advanced Practice Registered Nursing Students to Deliver Adolescent SBIRT for Substance Use. Kuzma, EK., Boucher, N., Gray, B., et al.[2019]

In a study of 2252 publicly insured adolescents aged 12-17, 6.8% reported current substance use, with higher rates among non-Hispanic Black adolescents (15.2%) and those with depressive symptoms (14.4%), highlighting the need for effective screening in pediatric care.

Providers identified barriers to implementing SBIRT, such as lack of confidential screening space and referral options, but expressed support for using technology to improve screening and intervention processes, indicating that integrating SBIRT could help address substance use treatment needs in this population.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Addressing adolescent substance use in an urban pediatric federally qualified health center. Yonek, JC., Velez, S., Satre, DD., et al.[2022]

Citations

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reporter.nih.gov

reporter.nih.gov/project-details/11162328

Virtual SBIRT for Pediatric Primary Care - NIH RePORTER

This study's objective is to examine whether a centralized, virtually delivered modality of SBIRT, rapidly accessible by multiple pediatric primary care clinics ...

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clinicaltrials.gov

clinicaltrials.gov/study/NCT06486688

Centralized Virtual SBIRT for Pediatric Primary Care

This study's objective is to examine whether a centralized, virtually delivered modality of SBIRT, rapidly accessible by multiple pediatric primary care clinics ...

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frontiersin.org

frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2022.882486/full

A Phone Consultation Call Line to Support SBIRT in ...

This report presents results of a retrospective audit of telephone consultations and virtual visits over a 1-year period, from Jan 1 through ...

4.

researchprotocols.org

researchprotocols.org/2024/1/e54486

Standard Versus Family-Based Screening, Brief ...

The trial will test the effectiveness of SBIRT-A-Standard versus SBIRT-A-Family for preventing the escalation of AOD use (aim 1); reducing AOD ...

5.

centerwatch.com

centerwatch.com/clinical-trials/listings/NCT06486688/centralized-virtual-sbirt-for-pediatric-primary-care

Centralized Virtual SBIRT for Pediatric Primary Care

This pragmatic, Type 1 Hybrid Comparative Effectiveness Implementation study will examine whether a centralized, virtually-delivered modality of ...

6.

clinicaltrials.gov

clinicaltrials.gov/study/NCT01829308

SBIRT Implementation for Adolescents in Urban Federally ...

The purpose of this study is to examine the implementation of two evidence-based intervention strategies of SBIRT (Generalist vs. Specialist) for adolescent ...

7.

bmchealthservres.biomedcentral.com

bmchealthservres.biomedcentral.com/articles/10.1186/s12913-024-11870-8

Improving screening, brief intervention and referral to ...

A practice-facilitator led implementation study to increase SBIRT and MAUD use in diverse primary care clinics.

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link.springer.com

link.springer.com/article/10.1007/s10615-021-00799-8

A Pilot Study of Peer-to-Peer SBIRT Simulation as ...

This study explores 35 social work graduate students' experiences of learning SBIRT skills in a remote learning format and subsequently delivering a SBIRT ...