Jan Gryczynski1, Shannon Gwin Mitchell2, Robert P Schwartz2, Kristi Dusek2, Kevin E O'Grady3, Alexander J Cowell4, Carolina Barbosa4, Alan Barnosky4, Carlo C DiClemente5. 1. Friends Research Institute, 1040 Park Ave., Ste 103, Baltimore, MD 21201, United States. Electronic address: jgryczynski@friendsresearch.org. 2. Friends Research Institute, 1040 Park Ave., Ste 103, Baltimore, MD 21201, United States. 3. University of Maryland, Department of Psychology, 4094 Campus Drive, College Park, MD 20742, United States. 4. RTI International, 3040 Cornwallis Road, PO Box 12194, NC 27709-2194, United States. 5. University of Maryland Baltimore County, Catonsville MD, Dept. of Psychology, 1000 Hilltop Circle, Baltimore, MD 21250, United States.
Abstract
BACKGROUND: This study examined approaches to delivering brief interventions (BI) for risky substance use and sexual behaviors in school-based health centers (SBHCs). METHODS:300 Adolescents (ages 14-18; 54 % female) with risky marijuana and/or alcohol use identified via CRAFFT screening (scores >1) were recruited from two SBHCs and randomized to computer-delivered BI (CBI) or nurse practitioner-delivered BI (NBI). Both BIs included motivational and didactic content targeting marijuana, alcohol, and risky sexual behaviors. Assessments at baseline, 3-month, and 6-month follow-up included past 30-day frequency of marijuana use, alcohol use, binge drinking, unprotected sex, and sex while intoxicated; marijuana and alcohol problems; and health-related quality-of-life (HRQoL). A focused cost-effectiveness analysis was conducted. An historical 'assessment-only' cohort (N=50) formed a supplementary quasi-experimental comparison group. RESULTS: There were no significant differences between NBI and CBI on any outcomes considered (e.g., days of marijuana use; p=.26). From a cost-effectiveness perspective, CBI was 'dominant' for HRQoL and marijuana use. Participants' satisfaction with BI was significantly higher for NBI than CBI. Compared to the assessment-only cohort, participants who received a BI had lower frequency of marijuana (3-months: Incidence Rate Ratio [IRR] = .74 [.57, .97], p=.03), alcohol (3-months: IRR = .43 [.29, .64], p<.001; 6-months: IRR = .58 [.34, .98], p = .04), alcohol-specific problems (3-months: IRR = .63 [.45, .89], p=.008; 6-months: IRR = .63 [.41, .97], p = .04), and sex while intoxicated (6-months: IRR = .42 [.21, .83], p = .013). CONCLUSIONS: CBI and NBI did not yield different risk behavior outcomes in this randomized trial. Supplementary quasi-experimental comparisons suggested potential superiority over assessment-only. Both NBI and CBI could be useful in SBHCs.
RCT Entities:
BACKGROUND: This study examined approaches to delivering brief interventions (BI) for risky substance use and sexual behaviors in school-based health centers (SBHCs). METHODS: 300 Adolescents (ages 14-18; 54 % female) with risky marijuana and/or alcohol use identified via CRAFFT screening (scores >1) were recruited from two SBHCs and randomized to computer-delivered BI (CBI) or nurse practitioner-delivered BI (NBI). Both BIs included motivational and didactic content targeting marijuana, alcohol, and risky sexual behaviors. Assessments at baseline, 3-month, and 6-month follow-up included past 30-day frequency of marijuana use, alcohol use, binge drinking, unprotected sex, and sex while intoxicated; marijuana and alcohol problems; and health-related quality-of-life (HRQoL). A focused cost-effectiveness analysis was conducted. An historical 'assessment-only' cohort (N=50) formed a supplementary quasi-experimental comparison group. RESULTS: There were no significant differences between NBI and CBI on any outcomes considered (e.g., days of marijuana use; p=.26). From a cost-effectiveness perspective, CBI was 'dominant' for HRQoL and marijuana use. Participants' satisfaction with BI was significantly higher for NBI than CBI. Compared to the assessment-only cohort, participants who received a BI had lower frequency of marijuana (3-months: Incidence Rate Ratio [IRR] = .74 [.57, .97], p=.03), alcohol (3-months: IRR = .43 [.29, .64], p<.001; 6-months: IRR = .58 [.34, .98], p = .04), alcohol-specific problems (3-months: IRR = .63 [.45, .89], p=.008; 6-months: IRR = .63 [.41, .97], p = .04), and sex while intoxicated (6-months: IRR = .42 [.21, .83], p = .013). CONCLUSIONS: CBI and NBI did not yield different risk behavior outcomes in this randomized trial. Supplementary quasi-experimental comparisons suggested potential superiority over assessment-only. Both NBI and CBI could be useful in SBHCs.
Authors: Gabriela Marcu; Steven J Ondersma; Allison N Spiller; Brianna M Broderick; Reema Kadri; Lorraine R Buis Journal: J Med Internet Res Date: 2022-03-30 Impact factor: 5.428