title: The future of screening, brief intervention and referral to treatment in adolescent primary care: research directions and dissemination challenges.
abstract: Screening, brief intervention and referral to treatment (SBIRT) offers a practical, integrated model for addressing substance use in primary care settings. This review provides an update of the research on SBIRT for adolescents in primary care, examines current dissemination challenges and suggests future research directions.
  
  
  
  A number of brief screening tools for adolescents have been developed and tested relative to Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) substance use disorders. Computerized previsit screening promotes standardization and is a more time-efficient alternative to provider interview. The adolescent brief intervention literature is growing, particularly with respect to technology-based tools, but is still limited, with evidence greatest for alcohol, and for motivational enhancement therapy interventions. Increasing SBIRT implementation in pediatric primary care remains a challenge. Using nonphysician behavioral health providers to deliver SBIRT, and embedding a screener and decision support tool in electronic medical record systems are strategies being investigated to promote SBIRT implementation.
  
  
  
  Substance use begins in adolescence, and pediatric SBIRT could help to achieve a population-level reduction of substance use-related harms. With a growing number of available tools, adolescent SBIRT effectiveness and feasibility are increasing, but more studies are needed to grow its evidence base, and elucidate strategies to increase implementation.
authors.affiliation: aDepartment of Pediatrics at Faculty of Medical Science at University of Campinas, Campinas, Brazil bDepartment of Pediatrics at Harvard Medical School cCenter for Adolescent Substance Abuse Research dDivision of Adolescent/Young Adult Medicine eDivision of Developmental Medicine, Boston Children's Hospital, Boston, Massachusetts, USA.
authors.forename: Lilia
authors.initials: L
authors.lastname: DʼSouza-Li
authors.forename: Sion Kim
authors.initials: SK
authors.lastname: Harris
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D016497:Adolescent Health Services / Q000639:trends; D003661:Decision Support Techniques; D006302:Health Services Research; D006801:Humans; D033181:Information Dissemination; D008403:Mass Screening / Q000458:organization & administration / Q000639:trends; D017063:Outcome Assessment, Health Care; D011320:Primary Health Care / Q000458:organization & administration / Q000639:trends; D012017:Referral and Consultation / Q000458:organization & administration* / Q000639:trends; D019966:Substance-Related Disorders / Q000175:diagnosis* / Q000517:prevention & control / Q000628:therapy