Alcohol contributes to over 93,000 deaths, and the loss of 2.7 million years of potential life in the U.S. each year. Alcohol use disorders frequently have a pediatric origin, and pediatric primary care offices, where the majority of adolescents receive health care, are a promising venue for early identification and intervention through screening and brief counseling. The goal of the ASPIRE (Adolescent Substance use Prevention Intervention Research) study is to address the evidence gap in primary care-based alcohol screening and brief intervention for adolescents. ASPIRE is a large, multi-site, cluster-randomized effectiveness trial comparing a computer-facilitated Screening and Brief Intervention (cSBI) system to usual care in patients ages 14 to 17 arriving for well-visits at pediatric primary care practices within the national American Academy of Pediatric Research in Office Settings (PROS) network.
PI: Howard, Sturner, Harris, Shrier
The purpose of the this project is to integrate a computer-facilitated CRAFFT screening and clinician brief counseling system into the CHADIS online clinical process support tool (www.chadis.com) to support pediatric primary care clinicians more effectively addressing substance use in their adolescent patients. The project includes development of a new adolescent substance use module in the CHADIS system, informed by both clinician and teen feedback, and testing its implementation and efficacy outcomes in a multi-site quality improvement trial.
PI: Harris, Seale
The GROW Zambia project was a pilot randomized controlled trial of the GROW (Global Resilience Oral Workshop) curriculum among young adolescents in Zambia. GROW is a spiritually-based character strengths and resiliency training curriculum developed by Dana Seale, MAPP, to strengthen youth resilience and hope, and reduce risk for substance use and related risk behaviors. Each curriculum lesson teaches one of the 24 character strengths from positive psychology, and utilizes evidence-based teaching strategies to make the lesson engaging and interactive. The Zambian trial was the first large implementation and efficacy trial of GROW in the world. More information about the program and trial results can be found at www.growglobalresilience.com.
MARSSI (Momentary Affect Regulation – Safer Sex Intervention) aims to reduce unintended pregnancy among young women with depression by combining clinic-based counseling with mobile technology. The MARSSI program offers brief sexual risk reduction counseling and cognitive-behavioral skill teaching in a clinical setting. At home, mobile technology supports self-monitoring, and provides real-time, context-responsive messaging for young women reporting poor affective states or maladaptive cognitive states.
The MOMENT (Momentary Self-Monitoring and Feedback + Motivational Enhancement Therapy) ecological momentary intervention combines substance use counseling with smartphone-based messaging technology. Cannabis-using youth ages 15 to 24 randomized to the intervention group use their smartphone to monitor their cannabis use as well as triggers, desire, and effort to not use, and they receive real-time, context-responsive motivational messages. The MOMENT intervention has been evaluated for its feasibility and intervention effects, showing high feasibility and promising outcomes in a primary care setting.
The Safer Sex Intervention is designed to reduce sexual risk behaviors and prevent the recurrence of sexually transmitted infection (STI) among young women ages 12 to 23 diagnosed with an STI. This clinic-based, individualized intervention is delivered at the time of STI diagnosis and/or treatment by a female health educator in one 30- to 50-minute session. One of two interventions will guide the session, based on the young woman’s discussion with the health educator and self-identified stage of behavior change.
PI: Woodberry, BCH Site PI: Shrier
The SEE-ME (Screening for Early and Emerging Mental Experiences) study pilot tests a 23-item scale assessing recent psychotic-like experiences among youth ages 14 to 21. These questions are designed to fill a gap in primary care psychosis screening and treatment, as there is a lack of consensus around whether all youth should be screened for psychotic symptoms. The questionnaire will be compared to the Patient Health Questionnaire (PHQ-9), a validated depression screening tool, for overlap.
This project was a collaborative effort between Dr. Sion Kim Harris and Dr. Marisa Silveri, director of the Neurodevelopmental Laboratory on Addictions and Mental Health (NLAMH) at McLean Hospital. The aim of this longitudinal multi-modal brain imaging study was to ascertain the effects of alcohol use initiation among early adolescents (ages 13-14) on brain structure/connectivity and cognition using multiple magnetic resonance-based imaging approaches (MRI, fMRI, DTI, MRS) and neuropsychological assessments over 3 years of follow-up.