@article{ref1,
title="Perceived risk of harm mediates the effects of primary care alcohol use screening and brief advice in adolescents",
journal="Journal of Adolescent Health",
year="2021",
author="Byregowda, Himani and Flynn, Amy L. and Knight, John R. and Harris, Sion K.",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="PURPOSE: A previous trial found lower alcohol use risk during follow-up among adolescent primary care patients receiving computer-facilitated Screening and provider Brief Advice (cSBA) compared to treatment-as-usual (TAU). We tested whether the effect was mediated by alcohol-related perceived risk of harm (PRoH). <br><br>METHODS: We analyzed data from the cSBA trial on 12- to 18-year-old patients at 9 New England practices (n = 2,096, 58% females). The trial used a quasi-experimental pre-post design with practices being their own controls (TAU followed by cSBA). Because prior alcohol experience could modify effects, we stratified analyses by baseline past 12-month drinking. Among baseline nondrinkers, we tested baseline to 3-month trajectories in PRoH of &quot;trying alcohol&quot; as an effect mediator for drinking at 3- and 12-month follow-up. Similarly, among those with prior drinking, we examined baseline to 3-month trajectories in PRoH of &quot;weekly binge drinking&quot; as an effect mediator for drinking and binge drinking. We used the Hayes product of coefficients mediation approach. <br><br>RESULTS: Among baseline nondrinkers (n = 1,449), cSBA had higher PRoH compared to TAU for &quot;trying alcohol,&quot; and higher PRoH in turn was associated with lower follow-up drinking risk. PRoH mediated their cSBA effect at 12 months, but not 3 months. Among adolescents with prior drinking (n = 647), cSBA had higher PRoH for &quot;weekly binge drinking,&quot; which was associated with lower drinking risk at both follow-ups, and lower binge drinking risk at 3 months. PRoH mediated their cSBA effect on drinking at both follow-ups, and binge drinking at 3 months. <br><br>CONCLUSION: A computer-facilitated primary care intervention enhanced adolescents' perceived alcohol risks which in turn was associated with lower drinking risk.<p /> <p>Language: en</p>",
language="en",
issn="1054-139X",
doi="10.1016/j.jadohealth.2021.09.029",
url="http://dx.doi.org/10.1016/j.jadohealth.2021.09.029"
}