Brief Intervention for Underage Drinking

Recruiting at 1 trial location

Overseen By Alina I Palimaru, PhD

Age: < 18

Sex: Any

Trial Phase: Academic

Sponsor: RAND

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: 6

500 Participants Needed

Trial Summary

What is the purpose of this trial?

Brief motivational interviewing intervention to address alcohol use among diverse teens 12-17.

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 data supports the effectiveness of the treatment Chat, CHAT, Motivational Interviewing for Adolescents At-Risk for Substance Use?

Research shows that Motivational Interviewing (MI) can help reduce substance use among adolescents, with many studies reporting improved outcomes. For example, a pilot study found that many teens reduced their substance use and risky behaviors after MI sessions, and a review of 39 studies found that 67% showed significant improvements in substance use outcomes. ^{1 2 3 4 5}

Is Motivational Interviewing safe for adolescents?

Motivational Interviewing (MI) has been used safely in various studies with adolescents to address substance use, including alcohol and cannabis. These studies did not report any significant safety concerns, suggesting that MI is generally safe for young people. ^{1 4 6 7 8}

How is the treatment Chat different from other treatments for underage drinking?

The treatment Chat, which uses Motivational Interviewing (MI), is unique because it focuses on enhancing a young person's motivation to change their drinking behavior through guided conversations. Unlike other treatments that may rely on education or strict rules, MI is more about helping teens find their own reasons to reduce or stop drinking, making it a personalized and supportive approach. ^{1 4 5 6 8}

Eligibility Criteria

This trial is for diverse teens aged 12-17 who are at risk for alcohol or cannabis use, as indicated by the CRAFFT screening tool. Participants must receive health care from one of two specific health systems to join.

Inclusion Criteria

Receive health care at one of two participating health systems

Screen positive for being at risk for alcohol or cannabis use using the CRAFFT

I am between 12 and 17 years old.

Exclusion Criteria

If they don't meet the inclusion criteria, they will be excluded

Timeline

Screening

Participants are screened for eligibility to participate in the trial

1 month

1 visit (in-person or virtual)

Baseline Survey and Intervention Assignment

Teens complete a baseline survey and are assigned to either Enhanced Usual Care or Chat Intervention

1 month

1 visit (in-person or virtual)

Intervention

Participants receive either Enhanced Usual Care or the Chat Intervention

1 month

1 visit (in-person or virtual)

Follow-up

Participants are monitored through web-based surveys at 3, 6, and 12 months after baseline survey completion

12 months

3 visits (virtual)

Treatment Details

Interventions

• Chat

Trial Overview The study is testing a brief motivational interviewing intervention called Chat against an Enhanced Usual Care approach to see if it can effectively address underage drinking and cannabis use among young people.

Participant Groups

Group I: Chat Intervention Experimental Treatment 1 Intervention

When the online consent/assent form is completed, the teen will be sent a personalized link to complete their baseline survey. Upon survey completion, the teen will receive a link that has their electronic gift card payment, and the case manager will be notified that a particular ID has completed the survey. The case manager will be informed by study staff whether to schedule that ID for enhanced usual care (EUC) or the Chat Intervention. If they are randomized as Chat Intervention, Chat will take place either via a virtual or in-person visit. Whether the teen completes EUC or Chat, every teen will be followed by the RAND Survey Research Group to complete their paid follow-up web-based surveys based on timing of completion of their baseline survey.

Group II: Enhanced Usual Care Active Control 1 Intervention

When the online consent/assent form is completed, the teen will be sent a personalized link to complete their baseline survey. Upon survey completion, the teen will receive a link that has their electronic gift card payment, and the case manager will be notified that a particular ID has completed the survey. The case manager will be informed by study staff whether to schedule that ID for enhanced usual care (EUC) or the Chat intervention. If they are randomized as EUC, the informational brochure for the EUC will be handed to the teen during the visit or securely emailed to them. Whether the teen completes EUC or Chat, every teen will be followed by the RAND Survey Research Group to complete their paid follow-up web-based surveys based on timing of completion of their baseline survey.

Chat is already approved in United States for the following indications:

Approved in United States as CHAT for:

• Alcohol use disorder prevention in adolescents

Who Is Running the Clinical Trial?

RAND

Lead Sponsor

Trials

145

Recruited

617,000+

University of Pittsburgh Medical Center

Collaborator

Trials

78

Recruited

77,600+

AltaMed Health Services Corporation

Collaborator

Trials

11

Recruited

37,700+

Patient-Centered Outcomes Research Institute

Collaborator

Trials

592

Recruited

27,110,000+

Findings from Research

A pilot study tested a 2-session motivational interviewing intervention for substance use among medical patients aged 14 to 18, highlighting the challenges in recruiting and retaining participants.

Despite these challenges, many participants who completed the intervention reported a reduction in substance use and a decreased risk of driving after drinking over a 3-month follow-up period.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Motivational interviewing for adolescent substance use: a pilot study. Knight, JR., Sherritt, L., Van Hook, S., et al.[2009]

Motivational Interviewing (MI) has been shown to be effective in reducing substance use among adolescents, with 67% of the 39 studies reviewed reporting significant improvements in outcomes.

The review found no significant differences in effectiveness between MI interventions that included feedback or were combined with other treatments compared to those that used MI alone, highlighting the need for further research into the mechanisms that drive these changes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Motivational Interviewing for adolescent substance use: a review of the literature. Barnett, E., Sussman, S., Smith, C., et al.[2021]

A study involving 101 first-time adolescent offenders showed that a six-session motivational interviewing (MI) group intervention, called Free Talk, was well-received and effective in engaging participants.

Feedback from the sessions indicated high levels of key MI components such as evocation, collaboration, and empathy, suggesting that this approach is acceptable and beneficial for at-risk youth dealing with alcohol and drug offenses.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Developing a Group Motivational Interviewing Intervention for Adolescents At-Risk for Developing an Alcohol or Drug use Disorder. D'Amico, EJ., Osilla, KC., Hunter, SB.[2021]

A brief motivational interviewing (MI) intervention was successfully implemented with 573 adolescents in a randomized controlled trial, showing it can be a practical addition to school-based substance abuse prevention programs.

The MI intervention was delivered with adequate fidelity, indicating that it can be effectively integrated into existing programs to potentially enhance their impact on preventing substance abuse among high school students.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Boosting a teen substance use prevention program with motivational interviewing. Barnett, E., Spruijt-Metz, D., Unger, JB., et al.[2021]

A group motivational interviewing (MI) intervention targeting at-risk youth in a teen court setting showed promising results, with both AOD use and delinquency decreasing for participants in both the MI and usual care groups over 3 months.

Participants in the Free Talk group, which utilized a group MI approach, reported higher satisfaction and quality ratings, suggesting that MI may enhance engagement compared to standard care, although long-term outcomes need further investigation.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A randomized controlled trial of a group motivational interviewing intervention for adolescents with a first time alcohol or drug offense. D'Amico, EJ., Hunter, SB., Miles, JN., et al.[2022]

Motivational interviewing (MI) delivered during emergency care is at least as effective as control interventions in reducing alcohol consumption among young people, based on a systematic review of six trials with 1433 participants aged 13-25.

The analysis showed that MI significantly decreased both the frequency and quantity of alcohol consumption, particularly in high-volume drinkers, suggesting it may be a valuable intervention for risky drinking behaviors in this age group.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Can motivational interviewing in emergency care reduce alcohol consumption in young people? A systematic review and meta-analysis. Kohler, S., Hofmann, A.[2018]

A study involving 506 adolescents showed that motivational interviewing (MI) led to significant reductions in alcohol use over 12 months, slightly outperforming alcohol and cannabis education (ACE).

Both MI and ACE effectively reduced cannabis use, with no significant differences between the two groups, indicating that MI's culturally adaptive approach is beneficial for diverse youth populations.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Long-Term RCT outcomes for adolescent alcohol and cannabis use within a predominantly Hispanic sample. Dash, GF., Bryan, AD., Montanaro, E., et al.[2023]

A randomized trial involving 69 American Indian and Alaska Native youth showed that both Motivational Interviewing (MI) and Psycho-Education (PE) significantly reduced the quantity and frequency of drinking among those already consuming alcohol, with MI particularly benefiting male drinkers.

The interventions also helped prevent underage drinking initiation, as only 17% of non-drinkers started drinking by follow-up, highlighting the effectiveness of these approaches in addressing underage drinking in this high-risk population.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A pilot randomized trial of Motivational Interviewing compared to Psycho-Education for reducing and preventing underage drinking in American Indian adolescents. Gilder, DA., Geisler, JR., Luna, JA., et al.[2018]

References

1. United States pubmed.ncbi.nlm.nih.gov

Motivational interviewing for adolescent substance use: a pilot study. [2009]

2. England pubmed.ncbi.nlm.nih.gov

Motivational Interviewing for adolescent substance use: a review of the literature. [2021]

3. United States pubmed.ncbi.nlm.nih.gov

Developing a Group Motivational Interviewing Intervention for Adolescents At-Risk for Developing an Alcohol or Drug use Disorder. [2021]

4. England pubmed.ncbi.nlm.nih.gov

Boosting a teen substance use prevention program with motivational interviewing. [2021]

5. United States pubmed.ncbi.nlm.nih.gov

A randomized controlled trial of a group motivational interviewing intervention for adolescents with a first time alcohol or drug offense. [2022]

6. England pubmed.ncbi.nlm.nih.gov

Can motivational interviewing in emergency care reduce alcohol consumption in young people? A systematic review and meta-analysis. [2018]

7. United States pubmed.ncbi.nlm.nih.gov

Long-Term RCT outcomes for adolescent alcohol and cannabis use within a predominantly Hispanic sample. [2023]

8. United States pubmed.ncbi.nlm.nih.gov

A pilot randomized trial of Motivational Interviewing compared to Psycho-Education for reducing and preventing underage drinking in American Indian adolescents. [2018]