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  • 标题:Screening for adolescent alcohol and drug use in pediatric health-care settings: predictors and implications for practice and policy
  • 本地全文:下载
  • 作者:Stacy Sterling ; Andrea H Kline-Simon ; Charles Wibbelsman
  • 期刊名称:Addiction Science & Clinical Practice
  • 电子版ISSN:1940-0640
  • 出版年度:2012
  • 卷号:7
  • 期号:1
  • 页码:13
  • DOI:10.1186/1940-0640-7-13
  • 语种:English
  • 出版社:BioMed Central
  • 摘要:

    Objective

    This paper used data from a study of pediatric primary care provider (PCP) screening practices to examine barriers to and facilitators of adolescent alcohol and other drug (AOD) screening in pediatric primary care.

    Methods

    A web-based survey (N = 437) was used to examine the influence of PCP factors (attitudes and knowledge, training, self-efficacy, comfort with alcohol and drug issues); patient characteristics (age, gender, ethnicity, comorbidities and risk factors); and organizational factors (screening barriers, staffing resources, confidentiality issues) on AOD screening practices. Self-reported and electronic medical record (EMR)-recorded screening rates were also assessed.

    Results

    More PCPs felt unprepared to diagnose alcohol abuse (42%) and other drug abuse (56%) than depression (29%) (p < 0.001). Overall, PCPs were more likely to screen boys than girls, and male PCPs were even more likely than female PCPs to screen boys (23% versus 6%, p < 0.0001). Having more time and having other staff screen and review results were identified as potential screening facilitators. Self-reported screening rates were significantly higher than actual (EMR-recorded) rates for all substances. Feeling prepared to diagnose AOD problems predicted higher self-reported screening rates (OR = 1.02, p <0.001), and identifying time constraints as a barrier to screening predicted lower self-reported screening rates (OR = 0.91, p < 0.001). Higher average panel age was a significant predictor of increased EMR-recorded screening rates (OR = 1.11, p < 0.001).

    Conclusions

    Organizational factors, lack of training, and discomfort with AOD screening may impact adolescent substance-abuse screening and intervention, but organizational approaches (e.g., EMR tools and workflow) may matter more than PCP or patient factors in determining screening.

  • 关键词:Adolescent; Screening; Brief intervention; Alcohol; Drugs; Primary care; Behavioral; SBIRT
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