Substance Use Screening and Prevention for Adolescents in Pediatric Primary Care

This study is to test the effectiveness of integrating and adapting two National Institute on
Drug Abuse (NIDA)-funded procedures for use in primary care pediatric clinics serving
low-income youth: 1) the Youth Risk Index (YRI) and Transmissible Liability Index (TLI-P)
nurse and/or research assistant-administered screening tools for high risk of substance use
(SU) prior to high school and thus also for SUD and 2) the Family Check-Up (FCU) - a brief,
family-based program to prevent SU/SUD with replicated efficacy.

The following three aims focus on evaluating and refining the adaptation of the YRI & TLI-P
program for primary-care use: 1) to replicate the effectiveness of the YRI & TLI-P screening
tool in terms of concurrent and predictive validity and the engagement rate in the FCU; 2) to
identify and address challenges in implementing and integrating the YRI & TLI-P/FCU
prevention strategy within a primary care clinic serving urban, low-income youth; and 3) to
test the effectiveness of the YRI & TLI-P/FCU on emerging SU, sexual activity, and conduct
problems, as well as the putative mediators of these outcomes including parenting and
parental well-being.

Based on prior FCU efficacy studies, 500 dyads of parents and their 9 years, 9 months to 13
years, 11 months old children from low-income, ethnically diverse families will be recruited
from two large primary care clinics in an urban community. The FCU will be delivered for two
or three years to test impact of dosage. Participants will be followed-up one year after
completing FCU to evaluate longitudinal outcomes of the Integrated YRI & TLI-P/FCU .

Inclusion Criteria:

- Child Aged 9 years, 9 months to 13 years, 11 months.

- A biological or adoptive parents or legal guardian with appropriate documentation with
custody of the child.

- Either child or parent's score on screening assessment score must fall in elevated
risk range.

- Child must be recipient of needs based Medicaid or family income must be at or below
150% Health and Human Services (HHS) Poverty Guidelines.

Exclusion Criteria:

- Inability to read English,

- Having moderate to severe mental disability (based on medical records),

- Child not accompanied by a biological or adoptive parent with legal custody or legal
guardian with appropriate documentation

- Participant in the Early Steps Project