# Computer-facilitated Screening and Brief Intervention in pediatric primary care to reduce underage drinking: a large multi-site randomized trial

> **NIH NIH R01** · BOSTON CHILDREN'S HOSPITAL · 2021 · $653,079

## Abstract

PROJECT SUMMARY/ABSTRACT
Alcohol use disorders frequently have a pediatric origin. Pediatric primary care offices, where the majority of
adolescents receive health care, are a promising venue for early identification and intervention through
universal screening and brief counseling. However, while the U.S. Preventive Services Task Force
recommends primary care-based alcohol screening and brief intervention for adults, it found insufficient
evidence to recommend it for adolescents. The goal of the proposed study is to address this evidence gap by
testing the effectiveness of a promising computer-facilitated Screening and Brief Intervention (cSBI) system for
delivery by pediatric primary care clinicians to adolescents at well-visits. This cluster-randomized controlled
trial will be conducted in the American Academy of Pediatrics' (AAP) Pediatric Research in Office Settings
(PROS) national primary care practice-based research network. PROS has demonstrated success in >30
years of practice-based research, with >600 practices participating in recent studies. Drawing on more than 15
years of our prior research on adolescent alcohol screening and brief counseling in primary care offices, the
cSBI system was developed to provide a time-efficient and feasible way for pediatric practices to improve both
the frequency and quality of alcohol screening and counseling. cSBI includes: 1) computer self-administered
screening that adolescents complete prior to seeing their clinician, 2) computer-delivered personalized
feedback to the adolescent, 3) 10 interactive psychoeducational pages for the adolescent on substance use
health risks, 4) a Clinician Report Form with screen results and prompts that clinicians use to provide
motivational interviewing-based individualized counseling, and 5) clinician training materials and protocol. In
our New England-based pilot study, we found that, compared to usual care (UC), the cSBI approach: 1)
increased patient receipt of alcohol-related counseling during well-visits; 2) improved patients' ratings of the
quality of their clinician encounter; and 3) among those who reported past-year use at baseline (n=192), was
associated with a 34% lower risk of a heavy episodic drinking episode during 12 months follow-up. cSBI also
reduced risk of riding with an impaired driver, a major safety risk associated with alcohol, by 42% among those
with prior riding risk. A larger RCT of this approach, which employs an adequately-powered sample and tests
generalizability of effects beyond New England, is needed. We propose to randomize >30 pediatric primary
care clinicians in 10 practices nationwide to deliver UC or cSBI (1:1) to their eligible and assenting 14- to 17-
year-old patients arriving for well-visits. Our aims are to test cSBI's effect on heavy episodic drinking, and on
riding with an impaired driver/driving while impaired, during 12 months follow-up among 1,268 adolescents
screen-identified as at-risk. If effective, cSBI disseminatio...

## Key facts

- **NIH application ID:** 10140253
- **Project number:** 5R01AA027253-02
- **Recipient organization:** BOSTON CHILDREN'S HOSPITAL
- **Principal Investigator:** Sion Kim Harris
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $653,079
- **Award type:** 5
- **Project period:** 2020-04-10 → 2025-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10140253

## Citation

> US National Institutes of Health, RePORTER application 10140253, Computer-facilitated Screening and Brief Intervention in pediatric primary care to reduce underage drinking: a large multi-site randomized trial (5R01AA027253-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10140253. Licensed CC0.

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