Emergency Department (ED) Adolescent Alcohol Prevention Intervention

Our long term goal is to develop, implement, and evaluate a program to prevent or delay the
initiation of alcohol use in young adolescents by increasing protective factors and reducing
risk through a family-based brief prevention intervention started in the pediatric emergency
department (PED). The primary aims of the proposed developmental study include: (1) To pilot
test a prevention intervention in alcohol-naïve adolescents, make necessary revisions, and
finalize an intervention manual and (2) conduct a randomized pilot trial comparing the
prevention intervention with enhanced standard care. After conducting an open trial of the
prevention intervention with 10 adolescents, ages 12-14, and their accompanying parent(s),
and refining the intervention, we will use a two-group randomized design to test the
hypothesis that the prevention intervention will prevent/delay the initiation of alcohol use
significantly more than enhanced standard care only. 100 adolescents, ages 12-14, who
present to the PED and their accompanying parent(s)/caregiver will be enrolled into the
study. Eligible, assenting adolescents and their consenting parent(s)/caregiver will
complete a series of assessment instruments relating to alcohol and other drug (AOD) use,
communication styles, parenting styles, and alcohol attitudes and behaviors. Parent/youth
family units will then be randomly assigned to one of two conditions: 1) Enhanced Standard
Care (ESC) or 2) Brief Targeted Prevention Intervention with Boosters (BTP). The initial
session will be comprised of parent-targeted skill building directed primarily at parental
monitoring and the importance of parent-adolescent communication as the precursor to
successful monitoring. The primary goal of the prevention session will be the mobilization
of the parents' own resources to increase communication and monitoring using motivational
interviewing techniques. Parents within this condition will also receive periodic brochures
and telephone booster sessions at 1 and 3 months to explore parental implementation of the
plan from the previous session(s) and make revisions as necessary. Adolescents and parents
will then be reassessed six months following their PED visit. Adolescents will also be
assessed with monthly, brief, web-based follow-up contacts to determine the status of their
alcohol use.

Inclusion Criteria:

1. Adolescents, age 12-14, who are being seen in the Pediatric ED for a non
life-threatening injury and their parent/caregiver;

2. Adolescent must be medically stable;

3. For a parent/adolescent family unit to be eligible, one or both of the adolescent's
parents must be present in the ED with the adolescent; and

4. The adolescent must report not having initiated alcohol use.

Exclusion Criteria:

1. Family units in which either the parent or the adolescent are cognitively unable to
take part in the intervention;

2. Those in which the youth is suspected by the clinical staff of being a victim of
child abuse (these adolescents will be reported to child protective services);

3. Those in which the youth is medically or surgically unstable;

4. Family units in which the adolescent is being evaluated for a possible psychiatric
disorder; and those without a telephone and/or a verifiable address of residence.