Virtual SBIRT for Pediatric Primary Care: Increasing Access to Screening, Brief Intervention and Referral to Treatment for Alcohol and Other Drug Use Via Telehealth

What this Trial Is About

Adolescent alcohol and other drug use is a major public health problem that leads to serious health, social, and economic consequences for young people. Early identification and intervention are crucial to improving outcomes. This study evaluates whether a centralized, virtually delivered version of Screening, Brief Intervention and Referral to Treatment (SBIRT) can be implemented cost-effectively in pediatric primary care to better identify and treat adolescents at high or severe risk of substance use and related mental health problems. It compares this virtual model to the traditional in-person SBIRT approach in a large, diverse health system. The trial involves two groups of pediatric primary care clinics: one where behavioral health clinicians provide brief interventions in person by appointment (Traditional SBIRT), and another where interventions are delivered virtually by video or telephone through a centralized behavioral health clinician (Centralized Virtual SBIRT). This approach aims to overcome barriers like lack of trained staff and time constraints in busy clinics. Both methods focus on adolescents aged 12 to 17 identified as at risk during routine Well Visits. Participants will be monitored over a two-year intervention period. Researchers will track referrals to behavioral health clinicians, brief interventions delivered, initiation and engagement in specialty treatment, diagnoses related to substance use and mental health, substance use behaviors, depressive symptoms, suicidality, and health services utilization. These assessments occur at 1- and 2-year follow-ups, with specialty treatment monitored within specific timeframes after screening. The study seeks to understand which SBIRT delivery method best supports early intervention and care for adolescent substance use and mental health issues.

Centralized Virtual SBIRT for Pediatric Primary Care