Validating Adolescent SBIRT Measures

A policy level mandate now exists to deliver screening, brief intervention, and referral to
treatment (SBIRT) to all adolescents in primary care. This mandate is spurred by the
imperative to reduce the enormous and preventable morbidity and mortality caused by
adolescent substance use. Despite this mandate and the opportunity to reach large cohorts of
youth early within primary and specialty pediatric care, SBIRT is not routinely delivered nor
used in ways that optimize outcomes. The National Institute on Drug Abuse, National Institute
on Alcoholism and Alcohol Abuse, the Substance Use and Mental Health Services Administration
and the Hilton Foundation have all included adolescent SBIRT in their research, training and
service project portfolios. Lacking validated measures that can be used to assess impacts and
guide early action, opportunities to glean the most effective strategies and components of
brief interventions are hampered despite these considerable investments. This threatens the
relevance and sustainability of this work.

To address the needs for efficient and informative measurement for evaluating adolescent
Screening, Brief Intervention, and Referral to Treatment (SBIRT) strategies, the
investigators will undertake a longitudinal cohort study to build and validate a substance
specific measurement battery that includes patient-centered and intermediary outcomes which
can be integrated into a range of healthcare and research settings. This is a construct
validity study in which the investigators will be interested in seeing whether a brief set of
questions will accurately measure substance use when compared to lengthy gold standard
measures. This is also a predictive validity study, in which the investigators are interested
in seeing whether proposed patient-centered and intermediary outcomes are relevant in
predicting future substance use risk or patterns of use. The results of this project will
enable evaluation of SBIRT trials and clinical efforts by validating a parsimonious set of
measurement tools that can be incorporated into electronic health records.

This project is one component of a two part study in which the investigators will enroll a
total of 900 adolescents. The investigators will enroll a total of 450 participants from the
Adolescent/Young Adult Medical Clinic for this study and will attempt to follow participant
for one year. Accounting for attrition at 6 months and 12 months follow-up, the investigators
expect 300 participants will complete the entire study.

Inclusion Criteria:

- 14-17 year-old youth presenting for routine medical care at the Adolescent and Young
Adult clinic at BCH, with informed assent/consent.

- To be eligible, youth must be between 14-17 years old at the time of enrollment and be
able to read and understand English at a middle school level or greater.

- Participants must consent to participation in the study and consent to the 6 month and
12 month follow up assessments.

Exclusion Criteria:

- Patients who are medically or emotionally unstable or otherwise unable to
assent/consent at the time of their appointment as determined by their clinician or
the research team, those who are unable to speak/read English at a middle school
reading level, use a computer keyboard and/or complete an interviewer-assisted
questionnaire will be excluded.

- Participants who do not consent to 6 month and 12 month re-assessment will also be
excluded.

- Patients who are pregnant at baseline will be excluded from the study.

- If a participant enrolls in the study and becomes pregnant after baseline, the
participant will not be excluded from the follow up assessments.