Project Summary

Alcohol is the most used substance among US teens. In 2022, 62 percent of students reported using alcohol at least once in their lifetime by 12th grade, with 13 percent of 12th graders reporting recent binge drinking. Reducing adolescent alcohol use is necessary to prevent substance use disorders (SUDs), which can lead to motor vehicle accidents, overdoses and even death. 

Over 90 percent of US adolescents receive care in primary care clinics, and primary care providers are among the most familiar and accessible healthcare professionals in communities nationally. Moreover, primary care providers are already involved in screening for substance use and initiating care for their patients with SUDs. Fortunately, most youth with alcohol and other substance use concerns experience mild-severity problems and do not require intensive specialty behavioral health services, which can be challenging to access. Rather, brief behavioral interventions, including those delivered by lay health workers or via online programs, can be effective in boosting youths’ motivation for change, reducing substance use and avoiding escalating problems. 

Parents and caregivers can also support their adolescent children in making changes, but caregiver involvement can be logistically challenging, requiring additional coordination and cost. Therefore, it is important to study whether and for whom caregiver involvement significantly improves brief interventions to help clinics, families and other stakeholders know what approaches should be used. 

The main goal of this study is to compare the effectiveness of a brief intervention called Teen Intervene when coupled with three different types of caregiver involvement: 

  • No caregiver involvement 
  • A dedicated caregiver session 
  • A self-paced, online parenting program 

Teen Intervene is delivered to adolescents over two sessions and involves discussion of the youth’s readiness to change, goal setting, personal feedback, an analysis of how substance use fits into their lives and a review of coping skills. The Teen Intervene caregiver session addresses events that led to the need for intervention, caregivers’ substance use, and family rules and communication around substance use. The online parenting program, Family Check-up Online, includes modules addressing five key parenting practices associated with reduced adolescent alcohol and other substance use. Additional goals include studying youth and family characteristics that are associated with intervention effects to determine who is most likely to benefit from each intervention, as well as factors associated with implementing each intervention in a primary care setting. 

The study team is partnering with community stakeholders, including youth, caregivers, primary care clinicians and interventionists who will serve on a Patient and Provider Advisory Board (PPAB). The PPAB will provide input and guidance to the researchers on all aspects of the project from design to implementation to sharing study findings with interested audiences. A Stakeholder Advisory Panel of national- and state-level leaders in adolescent health care will also be engaged in the project from start to finish to advise around implementation, dissemination, scalability and sustainability of effective solutions. The study will be carried out in 18 or more primary care clinics located in rural, urban and suburban communities across Indiana where patients are diverse with respect to sociodemographic characteristics. Participants will include 585 adolescents aged 12-17 who receive health care at one of the identified clinics and their parents or caregivers. Adolescents will be identified using standardized screeners during clinic visits. They will then be screened by our team to confirm eligibility to participate, and eligible patients will be invited to enroll. 

Participants will complete assessments at six timepoints including at baseline (before receiving any intervention, upon completing the intervention, and then three, six, nine and 12 months after enrolling. The primary outcome will be alcohol use (frequency and amount). Secondary outcomes (other types of substance use, mental health and well-being, engagement in substance use services) will be measured using online surveys completed by adolescents and caregivers, as well as brief interviews with the research team. Because Teen Intervene and the various caregiver interventions being studied can be delivered by clinical and nonclinical professionals with minimal training and time commitment, findings from this study can be disseminated and implemented quickly in other primary care settings to help reduce adolescent alcohol and other substance use problems nationally.

Project Information

Zachary Adams, Ph.D.
Tamika Zapolski, Ph.D.
Trustees of Indiana University
$4,670,170 *

Key Dates

60 months *
November 2023

*All proposed projects, including requested budgets and project periods, are approved subject to a programmatic and budget review by PCORI staff and the negotiation of a formal award contract.


Award Type
State State The state where the project originates, or where the primary institution or organization is located. View Glossary
Last updated: January 24, 2024