Adolescents’ Preferences for Substance Abuse Screening in Primary Care Practice

Abstract

Objective

To assess adolescents’ preferences for substance abuse screening in primary medical care settings.

Design/Methods

Twelve- to 18-year-old patients (N = 2133) arriving for routine care at a network of primary care sites completed an interview that included demographic items, the CRAFFT screen, and a questionnaire assessing preferences for screening method (paper questionnaire, computer, oral interview by nurse or doctor). A subgroup (n = 222) completed the CRAFFT directly on the computer.

Results

Across the entire sample, paper was the screening administration method most preferred (mean rank (MR) = 2.92, 95%CI 2.87–2.96) vs. computer (MR = 2.38, 2.33–2.43), nurse (MR = 2.43, 2.39–2.47), and doctor (MR = 2.30, 2.25–2.35). Among the participants who received the screening on the computer, however, computer (MR = 3.08, 95%CI 2.42–2.52) was statistically tied with paper (MR = 2.88, 2.75–3.02) and both were ranked significantly higher than nurse (MR = 2.06, 1.94–2.17) and doctor (MR = 1.98, 1.82–2.14). The findings were similar for participants’ reports of being “very likely” to be honest when answering substance abuse screening questions.

Conclusions

Adolescents should ideally be screened for substance abuse using paper or computer questionnaires.