Adolescents' Perceptions of Screening, Brief Intervention, and Referral to Treatment Service at Pediatric Trauma Centers.

Substance use : research and treatment Pub Date : 2024-08-21 eCollection Date: 2024-01-01 DOI:10.1177/29768357241272356
Michael J Mello, Janette Baird, Anthony Spirito, Kelli Scott, Mark R Zonfrillo, Lois K Lee, Andrew Kiragu, Emily Christison-Lagay, Julie Bromberg, Stephanie Ruest, Charles Pruitt, Karla A Lawson, Isam W Nasr, Jeremy T Aidlen, Robert Todd Maxson, Sara Becker
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Abstract

Objective: Screening, brief intervention, and referral to treatment (SBIRT) for adolescent alcohol and drug (AOD) use is recommended to occur with adolescents admitted to pediatric trauma centers. Most metrics on SBIRT service delivery only reference medical record documentation. In this analysis we examined changes in adolescents' perception of SBIRT services and concordance of adolescent-report and medical record data, among a sample of adolescents admitted before and after institutional SBIRT implementation.

Methods: We implemented SBIRT for adolescent AOD use using the Science to Service Laboratory implementation strategy and enrolled adolescents at 9 pediatric trauma centers. The recommended clinical workflow was for nursing to screen, social work to provide adolescents screening positive with brief intervention and referral to their PCP for continued AOD discussions with those. Adolescents screening as high-risk also referred to specialty services. Adolescents were enrolled and contacted 30 days after discharge and asked about their perception of any SBIRT services received. Data were also extracted from enrolled patient's medical record.

Results: There were 430 adolescents enrolled, with 424 that were matched to their EHR data and 329 completed the 30-day survey. In this sample, EHR documented screening increased from pre-implementation to post-implementation (16.3%-65.7%) and brief interventions increased (27.1%-40.7%). Adolescents self-reported higher rates of being asked about alcohol or drug use than in EHR data both pre- and post-implementation (80.7%-81%). Both EHR data and adolescent self-reported data demonstrated low referral back to PCP for continued AOD discussions.

Conclusions: Implementation of SBIRT at pediatric trauma centers was not associated with change in adolescent perceptions of SBIRT, despite improved documentation of delivery of AOD screening and interventions. Adolescents perceived being asked about AOD use more often than was documented. Referral to PCP or specialty care for continued AOD discussion remains an area of needed attention.

Trial registration: Clinicaltrials.gov NCT03297060.

青少年对儿科创伤中心筛查、简单干预和转诊治疗服务的看法。
目的:针对青少年酗酒和使用毒品(AOD)的筛查、简单干预和转诊治疗(SBIRT)被推荐给儿科创伤中心收治的青少年。大多数有关 SBIRT 服务提供情况的指标仅参考了医疗记录文件。在这项分析中,我们研究了机构实施 SBIRT 之前和之后入院的青少年样本中,青少年对 SBIRT 服务看法的变化以及青少年报告和病历数据的一致性:我们采用 "科学服务实验室"(Science to Service Laboratory)实施策略,在 9 家儿科创伤中心对青少年使用 AOD 的情况实施 SBIRT。推荐的临床工作流程是由护理人员进行筛查,社工为筛查结果呈阳性的青少年提供简短的干预措施,并将其转诊至初级保健医生,继续与这些医生讨论 AOD 问题。筛查出高风险的青少年还需转诊至专科服务机构。青少年在出院 30 天后进行登记和联系,并询问他们对所接受的任何 SBIRT 服务的看法。此外,还从登记患者的医疗记录中提取了数据:共有 430 名青少年注册,其中 424 人与他们的电子病历数据相匹配,329 人完成了 30 天的调查。在该样本中,电子病历记录的筛查率从实施前增加到实施后(16.3%-65.7%),简短干预率也有所增加(27.1%-40.7%)。在实施前和实施后,青少年自我报告被问及酗酒或吸毒情况的比例均高于电子健康记录数据(80.7%-81%)。电子病历数据和青少年自我报告数据均显示,转回初级保健医生继续讨论酒精和药物使用问题的比例较低:在儿科创伤中心实施 SBIRT 并未改变青少年对 SBIRT 的看法,尽管提供 AOD 筛查和干预的记录有所改善。青少年认为被问及使用 AOD 的次数多于记录的次数。转诊至初级保健医生或专科医疗机构以继续进行有关 AOD 的讨论仍是一个需要关注的领域:试验注册:Clinicaltrials.gov NCT03297060。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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