Computer-based screening and brief counseling reduced teen cannabis use and riding with impaired drivers
A computer-facilitated screening system in pediatric primary care reduced youth cannabis use by 38% and riding with impaired drivers by 42% compared to usual care.
Quick Facts
What This Study Found
At-risk youth receiving the computer-based screening and brief intervention (CSBI) showed significantly reduced cannabis use (HR 0.62) and reduced riding with impaired drivers (RR 0.58) compared to usual care over 12 months. Alcohol use and heavy drinking trended lower but did not reach statistical significance.
Key Numbers
869 screened; 211 at-risk at baseline; HR for cannabis use 0.62 (95% CI 0.41-0.94); RR for riding with impaired driver 0.58 (95% CI 0.37-0.91); 82.4% received cannabis counseling in CSBI group.
How They Did This
Pilot randomized clinical trial with 965 youth ages 12-18 across 5 pediatric practices and 54 practitioners, with 12-month follow-up using Timeline Followback assessment. CSBI group (n=628) received computer screening plus practitioner counseling.
Why This Research Matters
Annual pediatric checkups are a missed opportunity for substance use screening. A system that works within existing visit structure and meaningfully reduces cannabis use and dangerous driving behavior could be implemented widely.
The Bigger Picture
Brief interventions for substance use work better when they reach people before problems escalate. Embedding screening into routine pediatric visits catches teens at a critical developmental window.
What This Study Doesn't Tell Us
Pilot study with unequal randomization (628 vs 243). Self-reported outcomes. No significant prevention effect among youth without baseline use. Effect on heavy drinking did not reach significance.
Questions This Raises
- ?Would this system work in non-pediatric settings like school health clinics?
- ?Can the computer-facilitated component be updated to address vaping and newer cannabis products?
Trust & Context
- Key Stat:
- 38% cannabis use reduction
- Evidence Grade:
- Moderate: randomized trial with 12-month follow-up, but pilot-sized with unequal groups.
- Study Age:
- Published in 2019.
- Original Title:
- Effect of Computer-Based Substance Use Screening and Brief Behavioral Counseling vs Usual Care for Youths in Pediatric Primary Care: A Pilot Randomized Clinical Trial.
- Published In:
- JAMA network open, 2(6), e196258 (2019)
- Authors:
- Knight, John R(2), Sherritt, Lon, Gibson, Erin Bray, Levinson, Jordan A, Grubb, Laura K, Samuels, Ronald C, Silva, Thomas, Vernacchio, Louis, Wornham, Wendy, Harris, Sion Kim
- Database ID:
- RTHC-02112
Evidence Hierarchy
Participants are randomly assigned to treatment or placebo groups to test cause and effect.
What do these levels mean? →Frequently Asked Questions
How does the screening system work?
Teens complete a computer questionnaire before their annual checkup, then receive tailored information about substance use risks. Their doctor gets the results with talking points for a brief counseling conversation.
Did the system prevent teens from starting to use substances?
No prevention effect was observed among youth who reported no prior substance use at baseline. The benefits were seen among those already using substances.
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Cite This Study
https://rethinkthc.com/research/RTHC-02112APA
Knight, John R; Sherritt, Lon; Gibson, Erin Bray; Levinson, Jordan A; Grubb, Laura K; Samuels, Ronald C; Silva, Thomas; Vernacchio, Louis; Wornham, Wendy; Harris, Sion Kim. (2019). Effect of Computer-Based Substance Use Screening and Brief Behavioral Counseling vs Usual Care for Youths in Pediatric Primary Care: A Pilot Randomized Clinical Trial.. JAMA network open, 2(6), e196258. https://doi.org/10.1001/jamanetworkopen.2019.6258
MLA
Knight, John R, et al. "Effect of Computer-Based Substance Use Screening and Brief Behavioral Counseling vs Usual Care for Youths in Pediatric Primary Care: A Pilot Randomized Clinical Trial.." JAMA network open, 2019. https://doi.org/10.1001/jamanetworkopen.2019.6258
RethinkTHC
RethinkTHC Research Database. "Effect of Computer-Based Substance Use Screening and Brief B..." RTHC-02112. Retrieved from https://rethinkthc.com/research/knight-2019-effect-of-computerbased-substance
Access the Original Study
Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.
This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.