Cross-sectional online survey of clinicians' knowledge, attitudes and challenges to screening and counselling adolescents and young adults for substance use. Issue 11 (22nd November 2022)

• Record Type: Journal Article
• Authors: Gorukanti, Anu L; Kimminau, Kim S; Tindle, Hilary A; Klein, Jonathan D; Gorzkowski, Julie; Kaseeska, Kristen; Ali, Raabiah; Singh, Lavisha; David, Sean P; Halpern-Felsher, Bonnie
• Is Part Of: BMJ open. Volume 12:Issue 11(2022)
• Publication Date: 2022-11-22
• Subjects: Child & adolescent psychiatry -- PAEDIATRICS -- PUBLIC HEALTH -- PRIMARY CARE; Medicine -- Research -- Periodicals; 610.72
• DOI: 10.1136/bmjopen-2021-059019
• Languages: English
• ISSNs: 2044-6055

Abstract

Abstract : Objective: To examine adolescent healthcare clinicians' self-reported screening practices as well as their knowledge, attitudes, comfort level and challenges with screening and counselling adolescents and young adults (AYA) for cigarette, e-cigarette, alcohol, marijuana, hookah and blunt use. Design: A 2016 cross-sectional survey. Setting: Academic departments and community-based internal medicine, family medicine and paediatrics practices. Participants: Adolescent healthcare clinicians (N=771) from 12 US medical schools and respondents to national surveys. Of the participants, 36% indicated male, 64% female, mean age was 44 years (SD=12.3); 12.3% of participants identified as Asian, 73.7% as white, 4.8% as black, 4.2% as Hispanic and 3.8% as other. Primary and secondary outcome measures: Survey items queried clinicians about knowledge, attitudes, comfort level, self-efficacy and challenges with screening and counselling AYA patients about marijuana, blunts, cigarettes, e-cigarettes, hookah and alcohol. Results: Participants were asked what percentage of their 10–17 years old patients they screened for substance use. The median number of physicians reported screening 100% of their patients for cigarette (1st, 3rd quartiles; 80, 100) and alcohol use (75, 100) and 99.5% for marijuana use (50, 100); for e-cigarettes, participants reported screening half of their patients and 0.0% (0, 50), (0, 75)) reported screening for hookah and blunts, respectively. On average (median), clinicians estimated that 15.0% of all 10–17 years old patients smoked cigarettes, 10.0% used e-cigarettes, 20.0% used marijuana, 25.0% drank alcohol and 5.0% used hookah or blunts, respectively; yet they estimated lower than national rates of use of each product for their own patients. Clinicians reported greater comfort discussing cigarettes and alcohol with patients and less comfort discussing e-cigarettes, hookah, marijuana and blunts. Conclusions: This study identified low rates of screening and counselling AYA patients for use of e-cigarettes, hookahs and blunts by adolescent healthcare clinicians and points to potential missed opportunities to improve prevention efforts.