Alcohol Screening & Brief Lntervention in Juvenile Justice: Filling the Gap

Overview

This proposal is in response to RFA-AA-12-008, Evaluation of NIAAA's Alcohol Screening Guide for Children and Adolescents. Of particular interest to the agency are evaluation of the Screener in clinical and/or other settings to predict alcohol-related consequences including use disorder; its use as an initial screen for drug use, cigarette smoking, conduct disorder, and unprotected sex; and its performance in making predictions concurrently and prospectively. This proposal targets these areas of interest. In addition, the investigators will study implementation of the Brief Intervention (BI) associated with the Screener. There is a great need for both screening and BI in juvenile probation settings as many of these youths have great need but are underserved.Many probation departments are turning to BI to work with probationers and parolees. Screening and BI has demonstrated efficacy in these settings, and yet no randomized control trials have been conducted to evaluate effectiveness in juvenile probation settings. Probation Officers (POs; n=40) are randomized to Screener (S), Screener+BI (SBI), or coaching (CSBI). Youths (N=1000) are randomized to 1 of these 3 conditions, and all receive usual services (US). US consist of regular check-in with PO and access to referral services as needed (counseling, academic tutoring, etc.). Research staffers conduct in-depth assessment at baseline, 6- and 12- months. Sensitivity, specificity, and positive and negative predictive powers (SN, SP, PP, NP) are calculated to predict alcohol risk and consequences, as well as other risky behaviors concurrently and prospectively across age-groups. A 1-way design (S vs SBI vs CSBI) will be used to determine whether SBI and CSBI enhance youth services-use and reduce risks (e.g., alcohol use, risky sex). We examine moderators of outcomes (youth age, PO characteristics) and whether coaching (an important consideration in implementation science) in use of BI improves outcomes. This study will be the first randomized controlled trial evaluating the effectiveness of SBI in a juvenile probation setting.

1. A) To evaluate SN, SP, PP and NP of the 2-question Alcohol Screener to detect: a) alcohol problems (academic, social, injuries, intoxicated driving, unprotected sex), b) abuse/dependence, c) past 4 week binge drinking. 1B) This will be repeated to predict risk prospectively over 12 months. Classification rates will be compared for race, ethnicity, gender, and age groups. 2. A) To evaluate SN, SP, PP and NP of the 2-question Screener to detect a) 30-day drug use, b) 30-day cigarette use, c) conduct disorder, d) unprotected sex. 2B) This will be repeated to predict risk prospectively over 12 months. Classification rates will be compared for race, ethnicity, gender, and age groups. 3) To evaluate BI as compared to usual procedures. The investigators hypothesize those youths in BI will a) receive more services, b) be more satisfied with services, c) rate the relationship with the PO more highly, and d) have improved outcomes (alcohol, alcohol-related problems, problem recognition).