Bridging Opportunities for Substance Use Screening and Treatment for Teens With Chronic Illness

NCT07446075 | Not Yet Recruiting

• 1 other identifier: STUDY00000381
• Study Type: interventional
• Target: 50
• Locations: 0 countries
• Sites: N/A

Brief Summary

Adolescents with a chronic medical condition (A-CMC) are more likely to misuse and initiate alcohol and other drugs (AOD) at younger ages compared to adolescents without CMCs. A-CMCs account for the majority of pediatric inpatient hospitalizations as A-CMCs are often admitted for an acute inpatient stay following an emergency department visit for an exacerbation of their disease. However, A-CMCs are not routinely screened for alcohol use in pediatric inpatient settings. Thus, the pediatric inpatient setting provides clinicians a critical, but missed, opportunity to universally screen for alcohol use among A-CMCs once medical concerns are stabilized. The current study addresses this gap in the care cascade by examining the workflow processes in an urban pediatric hospital's inpatient units, adapting Screening, Brief Intervention, and Referral to Treatment (SBIRT) to the population and setting, and identifying SBIRT implementation strategies to pilot in a single arm hybrid type III effectiveness-implementation trial. This research is attained via three Specific Aims. In Aim 1, the candidate will observe inpatient workflows and collaborate with a Partner Steering Committee (PSC) composed of hospital staff (e.g., clinicians, administrators, information technology), A-CMCs, and parents to adapt SBIRT delivery and intervention components for the inpatient setting and population. Aim 2 will involve continued partnership with the PSC, to select, specify, and prioritize a set of SBIRT implementation strategies ideally suited for the inpatient setting and population. Aim 3 will consist of a single arm pilot hybrid type III effectiveness-implementation trial that simultaneously tests the set of implementation strategies selected in Aim 2 (primary outcome) and the SBIRT intervention adapted in Aim 1 (secondary outcome). To conduct this research, the candidate, Dr. Summersett Williams, requires training in three key areas: 1) expert knowledge and application of intermediate and advanced IS methods, including implementation strategy selection and evaluation of implementation outcomes; 2) application of human- and equity-centered design methods, including intervention adaptation and usability testing; and 3) expert application of the learning health system model to improve the health of A-CMCs who engage in risky drinking through enhanced healthcare system performance. These training aims will be supported by Ann \& Robert H. Lurie Children's Hospital of Chicago and by the candidate's mentorship team. The mentorship team will be led by Primary Mentor Dr. Sara Becker, an expert in implementing SBIRT targeting risky drinking in pediatric health settings. The proposal will also be supported by Drs. Robert Garofalo, Lisa Kuhns, and Patricia Franklin, experts in intervention adaptation, human- and equity-centered design methods, and the learning health system model, respectively. Taken together, this research and career development plan will advance a significant public health issue by advancing access to evidence-based alcohol health services for a vulnerable pediatric population while launching Dr. Summersett William's career as an independent implementation scientist.

Conditions

Alcohol Misuse

Keywords

alcohol; adolescents with chronic medical conditions; SBIRT; pediatric inpatient screening; implementation science

Outcome Measures

Primary Outcomes (4)

• Reach of SBIRT Among Adolescents With Complex Medical Conditions (Proportion Receiving SBIRT Over 12 Months)

  Reach will be assessed as the proportion of admitted adolescents with complex medical conditions (A-CMCs) on each inpatient unit who receive each SBIRT component over the 12-month pilot period. For each unit, we will calculate: (a) percentage of A-CMCs screened with the validated S2BI screener, (b) percentage who receive an indicated brief intervention (BI), and (c) percentage who receive an indicated referral to treatment (RT), summarized as proportions with 95% confidence intervals

  12-month implementation period on each inpatient unit.

• Adoption of SBIRT by Inpatient Clinicians (Proportion of Clinicians Delivering at Least One SBIRT Encounter Over 12 Months)

  Adoption will be assessed as the proportion of clinicians on each inpatient unit who deliver SBIRT to at least one A-CMC during the 12-month pilot period. The numerator is the number of clinicians documented as delivering SBIRT to ≥1 A-CMC, and the denominator is the number of clinicians who treated ≥1 A-CMC on that unit; results will be summarized as proportions by unit.

  12-month implementation period on each inpatient unit.

• Feasibility of SBIRT Implementation Assessed by the Feasibility of Implementation Measure (FIM)

  Feasibility will be measured using the 4-item Feasibility of Implementation Measure (FIM), a validated Likert-type clinician-reported scale. All clinicians on the two inpatient units will complete the FIM at baseline (pre-implementation) and at 3 and 6 months after implementation; scores (range and scoring rules as per FIM) will be summarized as mean (SD) and change over time.

  Baseline (pre-implementation) and 3 and 6 months after implementation start.

• Acceptability of SBIRT Implementation Assessed by the Acceptability of Implementation Measure (AIM)

  Acceptability will be measured using the 4-item Acceptability of Implementation Measure (AIM), a validated Likert-type clinician-reported scale. Clinicians will complete the AIM at baseline and at 3 and 6 months post-implementation; scores will be summarized as mean (SD) and change over time.

  Baseline (pre-implementation) and 3 and 6 months after implementation start.

Secondary Outcomes (4)

• Alcohol and Other Drug Use Among A-CMCs (Number of Days of Alcohol Use and S2BI Score at Baseline, 3 Months, and 6 Months)

  Hospital admission (baseline) and 3 and 6 months post-discharge.

• Linkage to Alcohol and Other Drug Treatment (Self-Reported Receipt of Counseling and Follow-up Services by 6 Months)

  3 and 6 months post-discharge from the index hospitalization.

• Alcohol-Related Problems Assessed by the Rutgers Alcohol Problem Index (RAPI)

  Hospital admission (baseline) and 3 and 6 months post-discharge.

• Alcohol Consumption Assessed by the Timeline Followback (Average Drinks, Binge Days, and Maximum Drinks Per Occasion)

  Hospital admission (baseline, covering the 3 months prior to admission) and 3 and 6 months post-discharge (each covering the prior 3-month period).

Study Arms (1)

Pilot SBIRT among 50 A-CMCs aged 12-18 years in two inpatient units at a pediatric hospital.

EXPERIMENTAL

SBIRT arm

Other: Screening, Brief Intervention, and Referral to Treatment (SBIRT)

Interventions

Screening, Brief Intervention, and Referral to Treatment (SBIRT) OTHER

Screening, Brief Intervention, and Referral to Treatment (SBIRT) is a widely endorsed EBP for detection and early intervention of risky drinking in adolescents.8,9 The goal of the SBIRT model is to employ universal screening (S) to identify adolescents at risk of alcohol use disorders, administer appropriate brief intervention (BI), and initiate referral to treatment (RT).8,9 NIAAA, the American Academy of Pediatrics (AAP), and the scientific community have widely endorsed the SBIRT model as an intervention that should be implemented across pediatric ambulatory and ED settings to prevent and reduce alcohol use among adolescents.35-40 The potential of SBIRT has been illustrated through multiple studies in both adolescent healthcare settings.8,9 Use of SBIRT is included in the guidelines for AOD use disorder treatment by the AAP, with recently published guidelines recommending that SBIRT be routinely used with A-CMCs.35

Pilot SBIRT among 50 A-CMCs aged 12-18 years in two inpatient units at a pediatric hospital.

Eligibility Criteria

• Age: 12 Years - 18 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64)

You may qualify if:

• A-CMCs who screen positive for alcohol misuse on the S2BI during their hospital admission.

Sponsors & Collaborators

• Faith Summersett Williams: lead

MeSH Terms

Interventions

Mass Screening; Crisis Intervention

Intervention Hierarchy (Ancestors)

Diagnostic Techniques and Procedures; Diagnosis; Health Surveys; Surveys and Questionnaires; Data Collection; Epidemiologic Methods; Investigative Techniques; Diagnostic Services; Preventive Health Services; Health Services; Health Care Facilities Workforce and Services; Health Care Evaluation Mechanisms; Quality of Health Care; Health Care Quality, Access, and Evaluation; Public Health; Environment and Public Health; Public Health Practice; Psychotherapy; Behavioral Disciplines and Activities

Study Officials

• Sara Becker, PhD, MS

  Northwestern University Feinberg School of Medicine

  STUDY CHAIR

Central Study Contacts

Faith C Summersett Williams, PhD, MS

CONTACT

312-227-7729; fswilliams@luriechildrens.org

Sheridan Grettenberger, MT

CONTACT

586-744-9013; fsummersettringgold@luriechildrens.org

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NA
• Masking: NONE
• Purpose: PREVENTION
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: SPONSOR INVESTIGATOR
• PI Title: Assistant Professor - Tenure Track

Model Details: Conduct a pilot single-arm hybrid type III effectiveness-implementation trial of SBIRT. Pilot SBIRT among 50 A-CMCs aged 12-18 years in two inpatient units at a pediatric hospital to test EHR integration bundled with implementation strategies identified in Aim 2. Primary IS outcomes will be assessed from the EHR and include SBIRT reach, adoption, and equity. In addition, a subset of 50 patients who screened positive for alcohol will be followed 3- and 6-months post-discharge to assess SBIRT effectiveness outcomes, including linkage to treatment and alcohol use.

Study Record Dates

• First Submitted: February 4, 2026
• First Posted: March 3, 2026
• Study Start (Estimated): September 1, 2028
• Primary Completion (Estimated): August 31, 2029
• Study Completion (Estimated): August 31, 2029
• Last Updated: March 3, 2026

Record last verified: 2026-02