Research Cooperative Receives
Funding for Intervention Study
The Northwest Pennsylvania Adolescent Alcohol Research Cooperative has received a $3.2 million grant from the National Institute on Alcohol and Alcoholism to test an intervention to reduce alcohol use among rural adolescents.
The cooperative is comprised of three University of Pittsburgh Centers: the Center for Rural Health Practice at the University of Pittsburgh at Bradford, the Pittsburgh Adolescent Alcohol Research Center and the University of Pittsburgh Center for Research on Health Care.
“Rural youth are at risk of having more alcohol-related problems and earlier, too,” said Dr. Youmasu Siewe, director of the Center for Rural Health at Pitt-Bradford.
“Because of the bio-psychosocial roles that physicians play in their rural medical practice communities, this study will enhance teen-physician interaction in the clinical setting and allow better assessment of under-age drinking, prevention of related psychosocial problems and fatal motor-vehicle crashes.”
The Center for Rural Health Practice will receive about one-third of the grant money over five years to conduct its portion of the research project.
Dr. Duncan Clark, principal investigator of the project and director of the Pittsburgh Adolescent Research Center at the Western Psychiatric Institute and Clinic, said that work on this project began when the NIAAA was looking for plans to engage rural doctors in addressing underage drinking.
In 2006, the Pitt coalition was one of four groups nationwide chosen to receive funding to develop an approach with collaborating primary care practitioners. The Pitt group has now received a five-year grant to test the approach.
Through the Center for Rural Health Practice, primary care physicians in an eight-county region were surveyed. Researchers conducted focus groups of doctors, adolescents (those under 20) and parents to determine the extent of underage drinking.
They also asked the groups whether they would be receptive to using a computer survey to help identify problems with alcohol and use an Internet-based intervention.
The physicians indicated that they realize underage drinking is a problem and would like to perform some sort of intervention, but felt they had neither the time nor the training to do so, Clark said.
He proposed using adolescents’ comfort with technology to allow them to complete an alcohol assessment that would be immediately sent to the physician along with a recommended prevention or treatment plan.
Three practices in Bradford, Warren and Punxsutawney have tested the computer survey and Internet-based intervention.
“About 500 adolescents from these three practices have participated so far,” Clark explained. “A psychiatric diagnosis of alcohol abuse or dependence was unusual in younger adolescents (about 2 percent for ages 12 to 14 years old), but the percentage reached adult levels of 8 or 9 percent among those 15 to 20 years old. These statistics indicate that alcohol problems occur in many teens in our area.”
While patients were in the practices’ waiting rooms, they used a computer to complete the assessment. Physicians use the report generated by the system to discuss any alcohol use or related problems with the patient.
One advantage to the computer-administered assessment, research associate Tony Sowers noted, is that adolescents often feel more comfortable answering sensitive questions this way instead of face-to-face with a physician.
Research associate Nickole Egger, who worked with Warren Pediatric Associates to test its patients, agreed. “Kids are engaged in the process,” she said. “They like that it’s confidential, and some parents said they are glad because someone will talk with their children about alcohol.”
Sowers, who worked with a physician in Punxsutawney, said he also received a lot of positive feedback from parents as well as physicians.
“The practitioners are really welcoming this information,” he said.
After reviewing the assessment, physicians can recommend a confidential, customized Internet-based prevention program that has been successfully used at the high school and university level.
“It’s a modest intervention,” Clark said, “but it is adequate for the vast majority of adolescents.”
Physicians could also recommend traditional addictions treatment for the patient, if needed.
Having tested the method in a small number of rural practices with success, the second phase of the project will involve 2,000 adolescents in 10 practices.
“This project would be impossible without the vital combination of these three centers,” Clark said, noting that the project now involves 37 physicians, a dozen faculty members and a dozen research assistants, including Eggers and Sowers at Pitt-Bradford.
The cooperative is comprised of three University of Pittsburgh Centers: the Center for Rural Health Practice at the University of Pittsburgh at Bradford, the Pittsburgh Adolescent Alcohol Research Center and the University of Pittsburgh Center for Research on Health Care.
“Rural youth are at risk of having more alcohol-related problems and earlier, too,” said Dr. Youmasu Siewe, director of the Center for Rural Health at Pitt-Bradford.
“Because of the bio-psychosocial roles that physicians play in their rural medical practice communities, this study will enhance teen-physician interaction in the clinical setting and allow better assessment of under-age drinking, prevention of related psychosocial problems and fatal motor-vehicle crashes.”
The Center for Rural Health Practice will receive about one-third of the grant money over five years to conduct its portion of the research project.
Dr. Duncan Clark, principal investigator of the project and director of the Pittsburgh Adolescent Research Center at the Western Psychiatric Institute and Clinic, said that work on this project began when the NIAAA was looking for plans to engage rural doctors in addressing underage drinking.
In 2006, the Pitt coalition was one of four groups nationwide chosen to receive funding to develop an approach with collaborating primary care practitioners. The Pitt group has now received a five-year grant to test the approach.
Through the Center for Rural Health Practice, primary care physicians in an eight-county region were surveyed. Researchers conducted focus groups of doctors, adolescents (those under 20) and parents to determine the extent of underage drinking.
They also asked the groups whether they would be receptive to using a computer survey to help identify problems with alcohol and use an Internet-based intervention.
The physicians indicated that they realize underage drinking is a problem and would like to perform some sort of intervention, but felt they had neither the time nor the training to do so, Clark said.
He proposed using adolescents’ comfort with technology to allow them to complete an alcohol assessment that would be immediately sent to the physician along with a recommended prevention or treatment plan.
Three practices in Bradford, Warren and Punxsutawney have tested the computer survey and Internet-based intervention.
“About 500 adolescents from these three practices have participated so far,” Clark explained. “A psychiatric diagnosis of alcohol abuse or dependence was unusual in younger adolescents (about 2 percent for ages 12 to 14 years old), but the percentage reached adult levels of 8 or 9 percent among those 15 to 20 years old. These statistics indicate that alcohol problems occur in many teens in our area.”
While patients were in the practices’ waiting rooms, they used a computer to complete the assessment. Physicians use the report generated by the system to discuss any alcohol use or related problems with the patient.
One advantage to the computer-administered assessment, research associate Tony Sowers noted, is that adolescents often feel more comfortable answering sensitive questions this way instead of face-to-face with a physician.
Research associate Nickole Egger, who worked with Warren Pediatric Associates to test its patients, agreed. “Kids are engaged in the process,” she said. “They like that it’s confidential, and some parents said they are glad because someone will talk with their children about alcohol.”
Sowers, who worked with a physician in Punxsutawney, said he also received a lot of positive feedback from parents as well as physicians.
“The practitioners are really welcoming this information,” he said.
After reviewing the assessment, physicians can recommend a confidential, customized Internet-based prevention program that has been successfully used at the high school and university level.
“It’s a modest intervention,” Clark said, “but it is adequate for the vast majority of adolescents.”
Physicians could also recommend traditional addictions treatment for the patient, if needed.
Having tested the method in a small number of rural practices with success, the second phase of the project will involve 2,000 adolescents in 10 practices.
“This project would be impossible without the vital combination of these three centers,” Clark said, noting that the project now involves 37 physicians, a dozen faculty members and a dozen research assistants, including Eggers and Sowers at Pitt-Bradford.
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