# Online System for Primary Care to Prevent and Address Teen Substance Use

> **NIH NIH R44** · TOTAL CHILD HEALTH, INC. · 2020 · $426,524

## Abstract

Substance use usually (90%) begins during adolescence, causing brain and liver damage, risky sexual 
and driving behavior, and potentially leading to addiction therefore prevention and early 
intervention programs targeting teens are needed to prevent this morbidity, gain productive years 
of life and reduce costs.  This proposal presents innovations to overcome the barriers to 
effectively addressing teen substance use during primary care visits through further  development 
of a promising computerized alcohol and substance use computerized Screening and provider Brief 
Advice system (cSBA) and integration with an online “clinical process  support system” called 
CHADIS.  CHADIS addresses all pediatric screening needs and is currently widely used in pediatric 
practice making widespread dissemination of a CHADIS-cSBA module immediately feasible.   However, 
because of limitations related to time and training the approach of motivational interviewing (MI), 
with strong evidence for effecting behavior change in substance users, was not a part of cSBA.  An 
innovation proposed here will take pre-visit teen data related to strengths and goals and 
acknowledged reasons for usage to populate individualized “teleprompters” accessible at the moment 
of care by PCP’s along with options for sharing graphical representations for use in reinforcing 
abstinence or motivate discontinuing usage.  In addition, the prompts for discussion of teen 
identified strengths and goals will include wording from teen studies using “incremental theory”(or 
 the belief that people have the potential to change), which has shown result in improvements in 
social coping.  CHADIS-cSBA will also provide each teen a confidential individualized portal 
automatically populated with supports for their endorsed strengths and other supports as well as 
substance-related follow-up messaging.  Post-visit parent education will include access to a Teen 
Safe course.  Teens found to have serious substance abuse or dual diagnoses will have referrals 
facilitated by care coordination functionality.  PCP participation will be reinforced by a American 
Board of Pediatrics accredited quality improvement program for their required re-certification 
(MOC-4). In Phase 1, the CHADIS-cSBA module will be created with both professional and teen 
feedback and MOC-4 certification obtained.  In Phase 2 the resulting system will be piloted; a 
baseline of substance use screening conducted; then CHADIS-cSBA module will be randomly assigned to 
doctors and a quality improvement intervention will be conducted to measure reduction in rates of 
any substance use at 3 and 12 month follow-up compared to treatment as usual.

## Key facts

- **NIH application ID:** 10179532
- **Project number:** 4R44DA046262-02
- **Recipient organization:** TOTAL CHILD HEALTH, INC.
- **Principal Investigator:** Sion Kim Harris
- **Activity code:** R44 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $426,524
- **Award type:** 4N
- **Project period:** 2019-08-01 → 2023-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10179532

## Citation

> US National Institutes of Health, RePORTER application 10179532, Online System for Primary Care to Prevent and Address Teen Substance Use (4R44DA046262-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10179532. Licensed CC0.

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