Check Yourself Screening Tool

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Advertising? Template:Undisclosed paid Based off the research from Seattle Children's Hospital and the University of Washington and adapted for SBIRT, Check Yourself is a teen-friendly, electronic mental health screening tool designed to be used for the screening component of SBIRT that promotes important discussions between adolescents and their providers about substance use.

History and Development

According to the Surgeon General's Report Facing Addiction in America [1] the misuse of substances such as alcohol and drugs is a growing problem in the United States. Although substance misuse can occur at any age, the teenage and young adult years are particularly critical at-risk periods. Importantly, researchers have found that students with supporting school environments and engaged parents are less likely to use alcohol and drugs and engage in sexual behaviours that put them at risk for HIV, STDs, or pregnancy.[2] In order to address these issues in schools, a nationwide school-based program called Screening, Brief Intervention, and Referral To services (SBIRT-SB) was launched to lessen the risks and increase protective factors for teens.

Adapted for the SBIRT-SB, the Check Yourself tool is a tablet-based screening instrument developed by researchers at Seattle Children's Hospital and the University of Washington, in conjunction with the digital health company, called Tickit Health.[3] This tool is currently being used in the screening process of Best Start for Kids, an initiative taken by Executive Constantine of King County to tackle youth mental health and substance use issues in the county. The Check Yourself Tool is in a pilot phase and will be funded through the Best Starts for Kids for the next three years, with its first-year results coming in August 2019.[4]

Substance Abuse and Prevention

Substance use disorders are costly to individuals, families, and communities: binge drinking, substance misuse, and addiction lead to negative health and social outcomes, intensify mental health problems, and develop difficulty staying in school and in the workplace.[5] In 2013, the Board of Directors of the Conrad N. Hilton Foundation approved a five-year strategy [6] focused on developing and implementing substance use prevention and early intervention services for youth. As part of this strategy, Foundation focused on prevention and early intervention for youth age 15 to 22 and worked towards increasing visibility to the public health program, SBIRT. The foundation particularly invested in initiatives aimed at increasing training among youth-serving providers, improving youth access to SBIRT services, and increasing research and learning on the effectiveness of the SBIRT framework. One such investment in substance use prevention was Hilton grant in partnership with Seattle Children's Hospital to investigate the usability and effectiveness of a web-based interactive health screening application, Check Yourself, to implement Screening, Brief Intervention, and Referral to Treatment (SBIRT) in primary care.[7]

Best Start for Kids

Best Starts for Kids is a voter-approved initiative led by Executive Constantine of King County to promote health and wellbeing amongst youth in the country. Through its investment in prevention and early intervention strategies, it is promoting healthier, more resilient children, youth, families, and communities.[8] With increasing rates of suicide in King County,[9] Best start for kids introduced universal screening for mental health and substance use risk factors to local middle school students as part of its SBIRT implementation. An integral part of the universal screening program at King County is a digital screening tool, Check Yourself, an interactive, web based strengths-based screening tool used to screen for at-risk behavioural amongst youth in schools of King County.[4] The tool is aimed at taking a proactive approach in preventing youth mental health and substance use issues by screening for multiple risk behaviours, giving personalized motivational feedback, and reporting on the responses for providers to analyze the responses of students.[3]

Literature Review

Behaviours such as using drugs or alcohol, not getting enough exercise, or having sex without protection, are activities that may harm a person's health, hence called health risk behaviours.[10] Adolescents have some of the highest rates of health risk behaviours of all age groups, and such behaviours that start at a young age can last into adulthood.[11] Screening, Brief Intervention, and Referral to Treatment (SBIRT) is an evidence-based approach to reduce such risk behaviours among adolescents.[12] The SBIRT approach was originally developed and applied in adult clinical populations and primarily administered in clinical settings,[13] however new studies have shown the effectiveness of SBIRT with adolescents in clinical settings and schools.[14] School-based Screening, Brief Intervention, and Referral To services (SBIRT-SB) have been established.[15]

With the advent of SBIRT in school setting, research has been conducted to investigate the best approach in conducting screening for adolescents and connecting them with appropriate resources. One such study examined the effect of electronic screening with personalized feedback on adolescent health risk behaviours in a primary care setting.[16] In a randomized clinical trial, involving 300 youth randomly assigned to receive screening through an electronic screening tool called Check Yourself with personalized feedback vs usual care, youths who received the electronic screening intervention were more likely than controls to receive risk counseling and also, scored lower on risk behavior.

References

  1. "Facing Addiction in America". https://addiction.surgeongeneral.gov/sites/default/files/surgeon-generals-report.pdf. 
  2. Hawkins, J. David; Catalano, Richard F.; Miller, Janet Y. (1992). "Risk and protective factors for alcohol and other drug problems in adolescence and early adulthood: Implications for substance abuse prevention.". Psychological Bulletin 112 (1): 64–105. Template:Citation error. ISSN 0033-2909. PMID 1529040. 
  3. 3.0 3.1 McCarty, Carolyn A.; Whitehouse, Sandy; Spielvogle, Heather; Katzman, Katherine; Richardson, Laura P.; Zieve, Garret G. (2017). "Adolescents' Perspectives on Personalized E-Feedback in the Context of Health Risk Behavior Screening for Primary Care: Qualitative Study". Journal of Medical Internet Research 19 (7): e261. Template:Citation error. PMC 5544900. PMID 28729236. //www.ncbi.nlm.nih.gov/pmc/articles/PMC5544900/. 
  4. 4.0 4.1 Miller, Madison (2018-08-31). "Universal mental health screenings to be introduced in local middle schools". http://www.kirklandreporter.com/news/universal-mental-health-screenings-to-be-introduced-in-local-middle-schools/. 
  5. Foundation 818.851.3700, Conrad N. Hilton. "Our Approach to Substance Use Prevention". https://www.hiltonfoundation.org/priorities/substance-use-prevention/our-approach. 
  6. Foundation 818.851.3700, Conrad N. Hilton. "Substance Use Prevention". https://www.hiltonfoundation.org/priorities/substance-use-prevention. 
  7. Foundation 818.851.3700, Conrad N. Hilton. "Conrad N. Hilton Foundation Awards $26 Million in Grants in the Third Quarter of 2017". https://www.hiltonfoundation.org/news/223-conrad-n-hilton-foundation-awards-26-million-in-grants-in-the-third-quarter-of-2017. 
  8. "Best Start for Kids". https://www.kingcounty.gov/elected/executive/constantine/initiatives/best-starts-for-kids.aspx. 
  9. "Suicide Satistics| #EndSuicideWA". http://depts.washington.edu/hiprc/suicide/stats/. 
  10. Behavioral Risk Factors. 
  11. 1995 Federal Research and Development Program in Materials Science and Technology. 1995-12-01. Template:Citation error. https://digital.library.unt.edu/ark:/67531/metadc716763/. 
  12. Lipsey, MW (2015). "Brief alcohol interventions for adolescents and young adults: a systematic review and meta-analysis.". J Subst Abuse Treat 51: 1–8. Template:Citation error. PMC 4346408. PMID 25300577. //www.ncbi.nlm.nih.gov/pmc/articles/PMC4346408/. 
  13. Agerwala, Suneel M.; McCance-Katz, Elinore F. (September 2012). "Integrating Screening, Brief Intervention, and Referral to Treatment (SBIRT) into Clinical Practice Settings: A Brief Review". Journal of Psychoactive Drugs 44 (4): 307–317. Template:Citation error. ISSN 0279-1072. PMC 3801194. PMID 23210379. //www.ncbi.nlm.nih.gov/pmc/articles/PMC3801194/. 
  14. Yuma-Guerrero, P. J.; Lawson, K. A.; Velasquez, M. M.; von Sternberg, K.; Maxson, T.; Garcia, N. (2012-07-01). "Screening, Brief Intervention, and Referral for Alcohol Use in Adolescents: A Systematic Review". Pediatrics 130 (1): 115–122. Template:Citation error. ISSN 0031-4005. PMID 22665407. 
  15. Maslowsky, J.; Whelan Capell, J.; Moberg, D. P.; Brown, R. L. (2017). "Universal School-Based Implementation of Screening Brief Intervention and Referral to Treatment to Reduce and Prevent Alcohol, Marijuana, Tobacco, and Other Drug Use: Process and Feasibility". Substance Abuse : Research and Treatment 11: 1178221817746668. Template:Citation error. PMC 5753915. PMID 29317825. //www.ncbi.nlm.nih.gov/pmc/articles/PMC5753915/. 
  16. McCarty, Carolyn A.; Taylor, James A.; Spielvogle, Heather; Gersh, Elon; Zhou, Chuan; Richardson, Laura P. (2019-05-03). "Effect of Electronic Screening With Personalized Feedback on Adolescent Health Risk Behaviors in a Primary Care Setting: A Randomized Clinical Trial". JAMA Network Open 2 (5): e193581. Template:Citation error. PMC 6512281. PMID 31074815. https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2733175.