Creation and Evaluation of an App to Facilitate Implementation of a Screening and Referral for Prevention Protocol to Prevent Adolescent Alcohol Use

Research

Purpose: To develop a mobile app and electronic health records integration to host, score, and report results from the Parent Evaluation Risk Index (PERI) and the Youth Risk Index (YRI) assessments to increase identification of young adolescents at risk for early onset of alcohol use.

OVERVIEW

About 1/3 of U.S. citizens experience Alcohol Use Disorders (AUD) in their lifetime and underage AU costs $61.9 billion annually.

Recent attempts to improve early screening and referral for prevention (SRP) of alcohol use (AU) and alcohol use disorders (AUD) during general practitioner check-ups, emergency room visits, and other medical services have been challenging, because they have not been efficacious; their dissemination and adoption by practitioners have been minimal; and they have failed to increase intervention enrollment over care-as-usual, which is 15% at best.

The program content and format of the Aware Program address the unique challenges that exist for providing adolescents with FASD the skills needed to control their feelings and behaviors in order to make healthy decisions. The Program includes four main topics, each representing the foundations of mindfulness (i.e., awareness of body, feelings, thoughts, and relationships). A randomized controlled trial was conducted in order to evaluate the efficacy of the Program.

Expand

In contrast, the tools and protocol proposed in this project were specifically designed for screening of risk for AU by 9-13 year-olds; designed to prevent or curb any substance use before high school; developed collaboratively with pediatricians for use during well-child, check-up appointments at their practices; created so it can be implemented by other health care providers such as behavior specialists or pediatric nurses, and not just by pediatricians; and has led over 80% of parents of high-risk youth from low-resource, urban communities to enroll into family-based preventive interventions (over 90% of whom completed the intervention).

This Screening and Referral for Prevention (SRP) protocol developed in basic research studies addresses historical barriers to pediatricians’ use of screening tools that target AU, and has high acceptability among children, parents, and pediatric health care staff. In a randomized trial of these screening tools, over 75% of all parents of at-risk youth completed an assessment and 45% sought out further intervention.

This Phase 1 proposal and the planned Phase 2 activities will prepare the SRP for commercialization in collaboration with pediatricians working in both urban and rural practices who represent the anticipated early adopters. The first aim is to edit and enhance iRT’s existing native pediatric screening app to include the parent-report, Parent Evaluation Risk Index (PERI), and the youth self-report, Youth Risk Index (YRI), tools, so that they are accessible for completion on a native app (offline mobile devices such as tablets that do not have internet connectivity), and are integrated into an electronic health record (EHR). Both Usability Studies, as well as a Feasibility and Acceptance Study, will result in benchmark evaluations to inform the submission of a Phase 2 application.