{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T16:18:01Z","timestamp":1792426681301,"version":"4.5.0"},"reference-count":46,"publisher":"American Medical Association (AMA)","issue":"7","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"Importance<\/jats:title>In the US, 25% of youths have a chronic medical condition (CMC). Alcohol use is prevalent among youths with a CMC and is associated with treatment nonadherence, simultaneous exposure to contraindicated medications, poor self-care, and elevated rates of progression to heavy and problem use by young adulthood. Preventive interventions targeting these youths are scarce and lack evidence about longer-term risk-stratified effects.<\/jats:p><\/jats:sec>Objective<\/jats:title>To evaluate the 12-month effects of a preventive intervention for alcohol use among youths with a CMC reporting baseline no or low-risk alcohol use vs high-risk alcohol use, testing the hypothesis of no difference.<\/jats:p><\/jats:sec>Design, Setting, and Participants<\/jats:title>This presepecified secondary analysis used data from a 2-group, parallel randomized clinical trial of the Take Good Care (TGC) intervention. Convenience samples of youths (aged 14-18 years) with a CMC, such as type 1 diabetes, juvenile idiopathic arthritis, or inflammatory bowel disease, were randomly assigned to the intervention or treatment as usual (TAU) between May 11, 2017, and November 20, 2018, and were followed up for up to 12 months. High-risk alcohol use was defined as heavy episodic (binge) alcohol use in the past 3 months and alcohol-related blackouts, injuries, vomiting, or emergency department visits in the past 12 months. Data were analyzed from September 21, 2023, to February 3, 2024.<\/jats:p><\/jats:sec>Interventions<\/jats:title>The self-administered, tablet computer\u2013based TGC intervention was developed with patient and expert input, and it delivers disease-tailored psychoeducational content about the effects of alcohol use on overall health, disease processes, and treatment safety and efficacy.<\/jats:p><\/jats:sec>Main Outcomes and Measures<\/jats:title>The main outcome was self-reported frequency of alcohol use (in days) over the past 3 months, measured by a single validated question. Maximum likelihood methods incorporating all available data were used assuming data missing at random.<\/jats:p><\/jats:sec>Results<\/jats:title>The trial included 451 participants (229 female youths [50.8%]), with a mean (SD) age of 16.0 (1.4) years. Of these youths, 410 (90.9%) participated in the 12-month follow-up. At baseline, 52 youths (11.5%) reported high-risk alcohol use. Among participants with high-risk alcohol use, the observed mean (SD) frequency of alcohol use from baseline to the 12-month follow-up decreased in the intervention group (from 6.3 [4.6] to 4.9 [4.3] days) and increased in the TAU group (from 5.5 [4.9] to 9.0 [5.8] days), with an adjusted relative rate ratio of 0.60 (95% CI, 0.38 to 0.94). There were no group differences among youths reporting no or low-risk alcohol use.<\/jats:p><\/jats:sec>Conclusions and Relevance<\/jats:title>In this trial of a brief chronic illness\u2013tailored preventive intervention, medically vulnerable youths with a high risk of alcohol use and harm decreased alcohol use. These findings support the use of a personalized preventive intervention with this group.<\/jats:p><\/jats:sec>Trial Registration<\/jats:title>ClinicalTrials.gov Identifier: NCT02803567<\/jats:ext-link><\/jats:p><\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2024.19858","type":"journal-article","created":{"date-parts":[[2024,7,10]],"date-time":"2024-07-10T15:02:31Z","timestamp":1720623751000},"page":"e2419858","source":"Crossref","is-referenced-by-count":7,"title":["Disease-Tailored Brief Intervention for Alcohol Use Among Youths With Chronic Medical Conditions"],"prefix":"10.1001","volume":"7","author":[{"given":"Elissa R.","family":"Weitzman","sequence":"first","affiliation":[{"name":"Division of Addiction Medicine, Boston Children\u2019s Hospital, Boston, Massachusetts"},{"name":"Department of Pediatrics, Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Machiko","family":"Minegishi","sequence":"additional","affiliation":[{"name":"Division of Addiction Medicine, Boston Children\u2019s Hospital, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatma","family":"Dedeoglu","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Harvard Medical School, Boston, Massachusetts"},{"name":"Rheumatology Program, Division of Immunology, Boston Children\u2019s Hospital, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurie N.","family":"Fishman","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Harvard Medical School, Boston, Massachusetts"},{"name":"Division of Gastroenterology, Boston Children\u2019s Hospital, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katharine C.","family":"Garvey","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Harvard Medical School, Boston, Massachusetts"},{"name":"Division of Endocrinology, Boston Children\u2019s Hospital, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren E.","family":"Wisk","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine at the University of California, Los Angeles"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharon","family":"Levy","sequence":"additional","affiliation":[{"name":"Division of Addiction Medicine, Boston Children\u2019s Hospital, Boston, Massachusetts"},{"name":"Department of Pediatrics, Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","published-online":{"date-parts":[[2024,7,10]]},"reference":[{"issue":"7","key":"zoi240640r1","doi-asserted-by":"publisher","first-page":"623","DOI":"10.1001\/jama.2010.104","article-title":"Dynamics of obesity and chronic health conditions among children and youth.","volume":"303","author":"Van Cleave","year":"2010","journal-title":"JAMA"},{"issue":"1","key":"zoi240640r2","doi-asserted-by":"publisher","first-page":"2088","DOI":"10.1186\/s12889-021-11906-2","article-title":"Risk and protective factors of drug abuse among adolescents: a systematic review.","volume":"21","author":"Nawi","year":"2021","journal-title":"BMC Public Health"},{"issue":"1","key":"zoi240640r3","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1016\/j.rdc.2021.08.003","article-title":"Instrumental substance use among youth with rheumatic disease\u2014a biopsychosocial model.","volume":"48","author":"Kossowsky","year":"2022","journal-title":"Rheum Dis Clin North Am"},{"issue":"3","key":"zoi240640r4","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2020-021352","article-title":"Marijuana use to address symptoms and side effects by youth with chronic medical conditions.","volume":"147","author":"Kossowsky","year":"2021","journal-title":"Pediatrics"},{"issue":"1","key":"zoi240640r5","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1016\/j.amepre.2016.01.029","article-title":"Substance use patterns through early adulthood: results for youth with and without chronic conditions.","volume":"51","author":"Wisk","year":"2016","journal-title":"Am J Prev Med"},{"issue":"3","key":"zoi240640r7","doi-asserted-by":"publisher","first-page":"450","DOI":"10.1542\/peds.2015-0722","article-title":"Alcohol and marijuana use and treatment nonadherence among medically vulnerable youth.","volume":"136","author":"Weitzman","year":"2015","journal-title":"Pediatrics"},{"issue":"4","key":"zoi240640r8","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2017-4026","article-title":"Alcohol use and alcohol-interactive medications among medically vulnerable youth.","volume":"142","author":"Weitzman","year":"2018","journal-title":"Pediatrics"},{"issue":"1","key":"zoi240640r9","first-page":"S126","article-title":"Understanding the risk to medication adherence and safety of substance use behaviors for adolescents with chronic medical conditions: skipping, missing, and drug substitution behaviors.","volume":"23","author":"Weitzman","year":"2016","journal-title":"Int J Behav Med"},{"issue":"4","key":"zoi240640r10","doi-asserted-by":"publisher","first-page":"311","DOI":"10.1097\/ADM.0000000000000603","article-title":"Alcohol use behaviors and reasons to abstain from or limit drinking among medically vulnerable youth.","volume":"14","author":"Wisk","year":"2020","journal-title":"J Addict Med"},{"issue":"4","key":"zoi240640r11","doi-asserted-by":"publisher","first-page":"S24","DOI":"10.1016\/j.jadohealth.2021.10.017","article-title":"Effects of a patient-centered intervention to reduce alcohol use among youth with chronic medical conditions.","volume":"71","author":"Weitzman","year":"2022","journal-title":"J Adolesc Health"},{"issue":"4","key":"zoi240640r12","doi-asserted-by":"publisher","first-page":"426","DOI":"10.1007\/s40429-016-0127-6","article-title":"Personality-targeted interventions for substance use and misuse.","volume":"3","author":"Conrod","year":"2016","journal-title":"Curr Addict Rep"},{"issue":"1","key":"zoi240640r13","doi-asserted-by":"publisher","first-page":"1111","DOI":"10.1186\/s12889-022-13072-5","article-title":"Individual-, family- and school-based interventions to prevent multiple risk behaviours relating to alcohol, tobacco and drug use in young people aged 8-25 years: a systematic review and meta-analysis.","volume":"22","author":"Tinner","year":"2022","journal-title":"BMC Public Health"},{"issue":"9","key":"zoi240640r14","doi-asserted-by":"publisher","DOI":"10.2196\/26418","article-title":"Psychoeducational messaging to reduce alcohol use for college students with type 1 diabetes: internet-delivered pilot trial.","volume":"23","author":"Wisk","year":"2021","journal-title":"J Med Internet Res"},{"key":"zoi240640r15","doi-asserted-by":"publisher","first-page":"50","DOI":"10.1016\/j.jsat.2017.10.009","article-title":"Gender and ethnic differences in primary care patients\u2019 response to computerized vs. in-person brief intervention for illicit drug misuse.","volume":"84","author":"Gryczynski","year":"2018","journal-title":"J Subst Abuse Treat"},{"key":"zoi240640r16","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1016\/j.jsat.2014.09.002","article-title":"A randomized trial of computerized vs. in-person brief intervention for illicit drug use in primary care: outcomes through 12 months.","volume":"50","author":"Gryczynski","year":"2015","journal-title":"J Subst Abuse Treat"},{"issue":"8","key":"zoi240640r17","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2022.26886","article-title":"Association of screening and brief intervention with substance use in Massachusetts middle and high schools.","volume":"5","author":"Levy","year":"2022","journal-title":"JAMA Netw Open"},{"issue":"14","key":"zoi240640r18","doi-asserted-by":"publisher","first-page":"54","DOI":"10.15288\/jsas.2002.s14.54","article-title":"A developmental perspective on alcohol use and heavy drinking during adolescence and the transition to young adulthood.","volume":"63","author":"Schulenberg","year":"2002","journal-title":"J Stud Alcohol Suppl"},{"key":"zoi240640r19","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2019.103208","article-title":"The REDCap Consortium: building an international community of software platform partners.","volume":"95","author":"Harris","year":"2019","journal-title":"J Biomed Inform"},{"issue":"2","key":"zoi240640r20","doi-asserted-by":"publisher","first-page":"377","DOI":"10.1016\/j.jbi.2008.08.010","article-title":"Research electronic data capture (REDCap)\u2014a metadata-driven methodology and workflow process for providing translational research informatics support.","volume":"42","author":"Harris","year":"2009","journal-title":"J Biomed Inform"},{"issue":"1","key":"zoi240640r21","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0209963","article-title":"Perspectives on substance use among youth with chronic medical conditions and implications for clinical guidance and prevention: a qualitative study.","volume":"14","author":"Weitzman","year":"2019","journal-title":"PLoS One"},{"key":"zoi240640r22","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2021.109026","article-title":"Validation of a single question for the assessment of past three-month alcohol consumption among adolescents.","volume":"228","author":"Levy","year":"2021","journal-title":"Drug Alcohol Depend"},{"issue":"3","key":"zoi240640r23","doi-asserted-by":"publisher","first-page":"388","DOI":"10.1080\/08897077.2020.1803180","article-title":"Sensitivity and specificity of S2BI for identifying alcohol and cannabis use disorders among adolescents presenting for primary care.","volume":"42","author":"Levy","year":"2021","journal-title":"Subst Abus"},{"issue":"5","key":"zoi240640r24","doi-asserted-by":"publisher","first-page":"479","DOI":"10.1016\/0306-4603(92)90008-J","article-title":"Development of an adolescent alcohol and other drug abuse screening scale: Personal Experience Screening Questionnaire.","volume":"17","author":"Winters","year":"1992","journal-title":"Addict Behav"},{"issue":"2","key":"zoi240640r25","doi-asserted-by":"publisher","first-page":"219","DOI":"10.1093\/jpepsy\/jsaa101","article-title":"Sociodevelopmental challenges faced by young people with chronic pain: a scoping review.","volume":"46","author":"Jones","year":"2021","journal-title":"J Pediatr Psychol"},{"key":"zoi240640r26","doi-asserted-by":"publisher","first-page":"75","DOI":"10.1016\/j.pedn.2019.12.013","article-title":"The lived experiences of children and adolescents with non-communicable disease: a systematic review of qualitative studies.","volume":"51","author":"Shorey","year":"2020","journal-title":"J Pediatr Nurs"},{"issue":"3","key":"zoi240640r27","doi-asserted-by":"publisher","first-page":"455","DOI":"10.1037\/0033-2909.111.3.455","article-title":"Changing AIDS-risk behavior.","volume":"111","author":"Fisher","year":"1992","journal-title":"Psychol Bull"},{"issue":"1","key":"zoi240640r28","doi-asserted-by":"publisher","first-page":"107","DOI":"10.1093\/her\/7.1.107","article-title":"A meta-analysis of studies of the health belief model with adults.","volume":"7","author":"Harrison","year":"1992","journal-title":"Health Educ Res"},{"issue":"2","key":"zoi240640r29","doi-asserted-by":"publisher","first-page":"191","DOI":"10.1037\/0033-295X.84.2.191","article-title":"Self-efficacy: toward a unifying theory of behavioral change.","volume":"84","author":"Bandura","year":"1977","journal-title":"Psychol Rev"},{"issue":"2","key":"zoi240640r30","doi-asserted-by":"publisher","first-page":"175","DOI":"10.1177\/109019818801500203","article-title":"Social learning theory and the health belief model.","volume":"15","author":"Rosenstock","year":"1988","journal-title":"Health Educ Q"},{"key":"zoi240640r31","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.jsat.2014.09.001","article-title":"Brief alcohol interventions for adolescents and young adults: a systematic review and meta-analysis.","volume":"51","author":"Tanner-Smith","year":"2015","journal-title":"J Subst Abuse Treat"},{"issue":"4","key":"zoi240640r32","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2020-0351","article-title":"Brief behavioral interventions for substance use in adolescents: a meta-analysis.","volume":"146","author":"Steele","year":"2020","journal-title":"Pediatrics"},{"issue":"1","key":"zoi240640r33","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1186\/1747-597X-7-25","article-title":"Effectiveness of early interventions for substance-using adolescents: findings from a systematic review and meta-analysis.","volume":"7","author":"Carney","year":"2012","journal-title":"Subst Abuse Treat Prev Policy"},{"issue":"3","key":"zoi240640r34","doi-asserted-by":"publisher","first-page":"337","DOI":"10.1080\/0959523031000154481","article-title":"A systematic review of the effectiveness of brief interventions with substance using adolescents by type of drug.","volume":"22","author":"Tait","year":"2003","journal-title":"Drug Alcohol Rev"},{"key":"zoi240640r35","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2019.107565","article-title":"Brief interventions for cannabis use in emerging adults: a systematic review, meta-analysis, and evidence map.","volume":"204","author":"Halladay","year":"2019","journal-title":"Drug Alcohol Depend"},{"issue":"18","key":"zoi240640r36","doi-asserted-by":"publisher","first-page":"1899","DOI":"10.1001\/jama.2018.16789","article-title":"Screening and behavioral counseling interventions to reduce unhealthy alcohol use in adolescents and adults: US Preventive Services Task Force recommendation statement.","volume":"320","author":"Curry","year":"2018","journal-title":"JAMA"},{"key":"zoi240640r37","doi-asserted-by":"publisher","first-page":"76","DOI":"10.1016\/j.jsat.2014.09.005","article-title":"Web-based personalized feedback: is this an appropriate approach for reducing drinking among high school students?","volume":"50","author":"Doumas","year":"2015","journal-title":"J Subst Abuse Treat"},{"issue":"3","key":"zoi240640r38","doi-asserted-by":"publisher","first-page":"201","DOI":"10.1080\/00048670802653364","article-title":"CLIMATE Schools: alcohol module\u2014cross-validation of a school-based prevention programme for alcohol misuse.","volume":"43","author":"Newton","year":"2009","journal-title":"Aust N Z J Psychiatry"},{"issue":"108423","key":"zoi240640r39","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2020.108423","article-title":"Computer- vs. nurse practitioner-delivered brief intervention for adolescent marijuana, alcohol, and sex risk behaviors in school-based health centers.","volume":"218","author":"Gryczynski","year":"2021","journal-title":"Drug Alcohol Depend"},{"issue":"3","key":"zoi240640r40","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2021-053129","article-title":"Telehealth: improving access to and quality of pediatric health care.","volume":"148","author":"Curfman","year":"2021","journal-title":"Pediatrics"},{"issue":"2S","key":"zoi240640r41","doi-asserted-by":"publisher","first-page":"S24","DOI":"10.1016\/j.jadohealth.2019.10.018","article-title":"Digital health technology to enhance adolescent and young adult clinical preventive services: affordances and challenges.","volume":"67","author":"Wong","year":"2020","journal-title":"J Adolesc Health"},{"issue":"2","key":"zoi240640r42","doi-asserted-by":"publisher","first-page":"277","DOI":"10.1016\/j.jaac.2021.06.003","article-title":"The transition of academic mental health clinics to telehealth during the COVID-19 pandemic.","volume":"61","author":"Folk","year":"2022","journal-title":"J Am Acad Child Adolesc Psychiatry"},{"issue":"2","key":"zoi240640r43","doi-asserted-by":"publisher","first-page":"172","DOI":"10.1016\/j.jadohealth.2020.05.025","article-title":"Outcomes of a rapid adolescent telehealth scale-up during the COVID-19 pandemic.","volume":"67","author":"Wood","year":"2020","journal-title":"J Adolesc Health"},{"issue":"2","key":"zoi240640r44","doi-asserted-by":"publisher","first-page":"164","DOI":"10.1016\/j.jadohealth.2020.05.006","article-title":"The COVID-19 pandemic and rapid implementation of adolescent and young adult telemedicine: challenges and opportunities for innovation.","volume":"67","author":"Barney","year":"2020","journal-title":"J Adolesc Health"},{"issue":"4","key":"zoi240640r45","doi-asserted-by":"publisher","first-page":"245","DOI":"10.1097\/PRA.0000000000000555","article-title":"Using a patient safety\/quality improvement model to assess telehealth for psychiatry and behavioral health services among special populations during COVID-19 and beyond.","volume":"27","author":"Li","year":"2021","journal-title":"J Psychiatr Pract"},{"issue":"1","key":"zoi240640r46","doi-asserted-by":"publisher","first-page":"36","DOI":"10.1080\/08964289.2016.1189396","article-title":"The usability and acceptability of an adolescent mHealth HIV\/STI and drug abuse preventive intervention in primary care.","volume":"44","author":"Cordova","year":"2018","journal-title":"Behav Med"},{"key":"zoi240640r6","unstructured":"National Institute on Alcohol Abuse and Alcoholism. Get the facts about underage drinking. February 2024. Accessed February 22, 2024. https:\/\/www.niaaa.nih.gov\/publications\/brochures-and-fact-sheets\/underage-drinking"}],"container-title":["JAMA Network Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/articlepdf\/2820971\/weitzman_2024_oi_240640_1719929589.09215.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,7,10]],"date-time":"2024-07-10T15:02:36Z","timestamp":1720623756000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/fullarticle\/2820971"}},"subtitle":["A Secondary Analysis of a Randomized Clinical Trial"],"short-title":[],"issued":{"date-parts":[[2024,7,10]]},"references-count":46,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2024,7,1]]}},"URL":"https:\/\/doi.org\/10.1001\/jamanetworkopen.2024.19858","relation":{},"ISSN":["2574-3805"],"issn-type":[{"value":"2574-3805","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,7,10]]}}}