TY - JOUR
AU - L. A. Hulvershorn
AU - M. Aalsma
AU - T. V. Dellucci
AU - A. Burns
AU - B. R. Marriott
AU - B. Pescosolido
AU - H. D. Green Jr.
AU - L. Saldana
AU - J. Chapman
AU - P. Monahan
AU - S. E. Wiehe
AU - E. J. Miech
AU - Z. W. Adams
A1 - 
AB - BACKGROUND: While the overdose crisis has impacted all ages, overdose-related deaths among adolescents have been increasing more rapidly than any other age group, doubling between 2019 and 2020. Identifying and treating substance use disorders (SUDs) among adolescents is critical to preventing adolescent overdose deaths. While evidence-based interventions for adolescents with SUDs exist, they remain underutilized. Implementing SUD interventions in primary care settings through integrated behavioral health (IBH) is one approach for increasing access to evidence-based SUD services for adolescents. METHODS: This is a Hybrid Type 2, cluster-randomized, stepped-wedge trial comparing SUD IBH to standard primary care treatment. In our open cohort stepped-wedge design, primary care clinics will be randomly designated to one of three cohorts. We will use a mixed-methods approach to evaluate both implementation and effectiveness outcomes, with a focus on assessing the impact of IBH on primary care provider behaviors around SUD interventions. All cohorts will complete baseline surveys during the control condition and then every 6 months. At each time point, we will also collect and analyze patient administrative data to assess patient engagement and outcomes. In addition, we will conduct qualitative interviews at pre-, mid-, and post-implementation during sustainment of the intervention. CONCLUSION: Addressing the overdose crisis is a national priority. IBH has the potential to reduce overdose rates by enhancing primary care provider willingness to deliver SUD services for adolescents.
AD - Adolescent Behavioral Health Research Program, Indiana University School of Medicine, Indianapolis, IN, USA; Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA.; Adolescent Behavioral Health Research Program, Indiana University School of Medicine, Indianapolis, IN, USA; Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA.; Irsay Institute, Indiana University, Bloomington, IN, USA; Department of Sociology, Indiana University, Bloomington, IN, USA.; Irsay Institute, Indiana University, Bloomington, IN, USA; Department of Applied Health Science, Indiana University School of Public Health, Bloomington, IN, USA.; Chestnut Health Systems, Eugene, OR, 1255, Pearl Street, Ste 101, United States of America.; Department of Biostatistics and Health Data Science, Indiana University School of Medicine, Indianapolis, IN, USA.; Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA.; Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, IN, USA.; Adolescent Behavioral Health Research Program, Indiana University School of Medicine, Indianapolis, IN, USA; Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA. Electronic address: zwadams@iu.edu.
AN - 40300712
BT - Contemp Clin Trials
C5 - Education & Workforce; Healthcare Disparities; Opioids & Substance Use
DA - Apr 27
DO - 10.1016/j.cct.2025.107928
DP - NLM
ET - 20250427
JF - Contemp Clin Trials
LA - eng
N2 - BACKGROUND: While the overdose crisis has impacted all ages, overdose-related deaths among adolescents have been increasing more rapidly than any other age group, doubling between 2019 and 2020. Identifying and treating substance use disorders (SUDs) among adolescents is critical to preventing adolescent overdose deaths. While evidence-based interventions for adolescents with SUDs exist, they remain underutilized. Implementing SUD interventions in primary care settings through integrated behavioral health (IBH) is one approach for increasing access to evidence-based SUD services for adolescents. METHODS: This is a Hybrid Type 2, cluster-randomized, stepped-wedge trial comparing SUD IBH to standard primary care treatment. In our open cohort stepped-wedge design, primary care clinics will be randomly designated to one of three cohorts. We will use a mixed-methods approach to evaluate both implementation and effectiveness outcomes, with a focus on assessing the impact of IBH on primary care provider behaviors around SUD interventions. All cohorts will complete baseline surveys during the control condition and then every 6 months. At each time point, we will also collect and analyze patient administrative data to assess patient engagement and outcomes. In addition, we will conduct qualitative interviews at pre-, mid-, and post-implementation during sustainment of the intervention. CONCLUSION: Addressing the overdose crisis is a national priority. IBH has the potential to reduce overdose rates by enhancing primary care provider willingness to deliver SUD services for adolescents.
PY - 2025
SN - 1551-7144
SP - 107928
ST - Workforce and systems change to treat adolescent substance use disorder within integrated pediatric primary care: A cluster-randomized stepped-wedge trial
T1 - Workforce and systems change to treat adolescent substance use disorder within integrated pediatric primary care: A cluster-randomized stepped-wedge trial
T2 - Contemp Clin Trials
TI - Workforce and systems change to treat adolescent substance use disorder within integrated pediatric primary care: A cluster-randomized stepped-wedge trial
U1 - Education & Workforce; Healthcare Disparities; Opioids & Substance Use
U3 - 10.1016/j.cct.2025.107928
VL - 154
VO - 1551-7144
Y1 - 2025
ER -