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APHA Scientific Session and Event Listing

Recorded presentation

Edward Bernstein, MD¹, David H. Dorfman, MD², Anel Marchena-Suazo, RN¹, Kathleen McKenna, MPH³, Danielle A. Lawrence, MPH¹, and Judith Bernstein, PhD, RNC¹. (1) Youth Alcohol Prevention Center, Boston University School of Public Health, 715 Albany St., Boston, MA 02118, 617-534-3453, ebernste@bu.edu, (2) Youth Alcohol Prevention Center, Boston University Medical Campus, 715 Albany Street, 580, 3rd Floor, Boston, MA 02118-2526, (3) Youth Alcohol Prevention Center Data Coordinating Center, Boston University School of Public Health, 715 Albany Street, 580, 3rd Floor, Boston, MA 02118-2526

Background: Brief motivational interventions have proven effective in primary care settings to reduce use of alcohol and other substances and decrease associated negative health outcomes. Project RAP (Reaching Adolescents for Prevention) is a randomized, controlled trial, currently in progress, of a developmentally appropriate peer intervention in an urban PED. We present here a profile of risky behaviors among patient enrollees who screened positive for alcohol/marijuana use. Methods: 1) screening survey of PED patients; 2) baseline assessment of RAP enrollees for quantity/frequency of substance use and associated risk behaviors. Results: Out of 1,441 surveys, 142 adolescents aged 14 to 21 met eligibility requirements based on AUDIT scores (mean=4 for 14-17 year olds and 8 for 18-21), marijuana use, or experience of consequences related to substance use and enrolled in Project RAP. A third had positive PTSD scores on the PCL-C, 9% a major depressive disorder, 6% a minor disorder on the PHQ-A, and 25% were positive on the Simpson & Joe scale of risk-taking propensity; 39% were heavy episodic drinkers, 66% frequent marijuana users, 13% used cocaine and 4% used heroin; 28% had prior arrest, 30% carried a weapon, 32% were threatened in their neighborhood, 28% threatened at school; 18% either experienced or caused >2 pregnancies; 14% had been physically hurt by a date, 11% felt unsafe because of a date. Conclusion: The PED offers an opportunity to reach adolescents who engage in a constellation of risky behaviors with brief intervention and/or referral that might address major issues in adolescent health.

Learning Objectives: At the conclusion of this session, the participant will be able to

• list five risky behaviors that are associated with adolescent substance use;
• describe three advantages to screening for substance use in a pediatric emergency department
• explain the importance of access to mental health services for adolescents who screen positive for alcohol and marijuana use.

Keywords: Alcohol, Adolescent Health

Related Web page: www.bu.edu/dbin/sph/research_centers/niaaa.php

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation