A Universal Primary Care Based Intervention to Reduce Youth Overdose Risk Aim 3

A Universal Primary Care Based Intervention to Reduce Youth Overdose Risk Aim 3

Between 2015 and 2019, overdose deaths translated to 1.25 million years of life lost among adolescents and young adults (youth) aged 12 to 24 years, and the percent change in fatal overdose rates among adolescents ages 14 to 18 was higher than adults between 2019 and 2020.3-5 Primary care providers are uniquely positioned to provide evidence-based information to youth to both improve awareness of overdose risk (individual benefit) and simultaneously ensure that youth are prepared to recognize and respond to an overdose (public health benefit). However, currently there is no evidence-based intervention for pediatric primary care to reduce youth overdose risk and ensure youth can recognize and respond to an overdose.

To address the gap in evidence-based overdose prevention interventions for youth, we propose a randomized controlled trial (RCT) to evaluate the efficacy of a brief universal overdose prevention intervention in pediatric primary care. We will enroll 24 providers and 624 youth patient participants randomized (at the provider level) to receive either the brief overdose prevention intervention or usual care.

Inclusion Criteria:

Providers:

• Physicians and advance practice providers (nurse practitioners and physician assistants) within Pediatric Primary Care and Family Medicine at Boston Medical Center, NeighborHealth, and South Boston Community Health Center
• ≥ 1 clinic session per week

Youth:

• Ages 13 - 26
• Scheduled for a CPE or follow-up clinical appointment with a provider who is participating in the trial
• English speaking

Exclusion Criteria:

Providers:

• Participated as an intervention provider in the R61 pilot RCT (H-45731)
• Participated in the Community Advisory Board that assisted in the development of the intervention (H-45388)

Youth:

• Caregivers of youth ages 13-17 unable to provide informed consent or are not English speaking
• Cognitive limitation or intellectual disability that in the opinion of their provider would not be able to complete the requirements of the research
• Young adults ages 18-26 with a legal guardian
• Any medical/psychiatric condition that causes acute distress and requires emergency evaluation
• Under legal custody of the Department of Children and Families (DCF)
• Participated in the intervention arm of the R61 pilot RCT (H-45731)