{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T15:20:12Z","timestamp":1788362412755,"version":"build-2803163510"},"reference-count":59,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T00:00:00Z","timestamp":1788307200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000133","name":"Agency for Healthcare Research and Quality","doi-asserted-by":"publisher","award":["5K12HS026385-04"],"award-info":[{"award-number":["5K12HS026385-04"]}],"id":[{"id":"10.13039\/100000133","id-type":"DOI","asserted-by":"publisher"}]},{"award":["5K12HS026385-04"],"award-info":[{"award-number":["5K12HS026385-04"]}],"id":[{"id":"https:\/\/ror.org\/03jmfdf59","id-type":"ROR","asserted-by":"publisher"}]},{"name":"Stanley Manne Children\u2019s Research Institute at Ann & Robert H. Lurie Children\u2019s Hospital of Chicago"},{"id":[{"id":"https:\/\/ror.org\/03a6zw892","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Background\/Objectives: While screening, brief intervention, and referral to treatment (SBIRT) is a widely recommended evidence-based approach for early detection and intervention for alcohol and other drug (AOD) use, limited guidance exists for implementing SBIRT among hospitalized adolescents with chronic medical conditions (A-CMCs). This exploratory qualitative study examined A-CMC and caregiver perspectives on factors that may shape the acceptability, feasibility, and equitable implementation of a proposed inpatient SBIRT approach for A-CMCs. Methods: Two separate focus groups were conducted in an urban pediatric hospital in 2023 with A-CMCs aged 13\u201318 (n = 7), who had a history of hospitalization for their medical condition, and their caregivers (n = 6). Data were coded using thematic analysis guided by the Consolidated Framework for Implementation Research (CFIR) and the Health Equity Implementation Framework (HEIF), which captured implementation and equity-relevant determinants, respectively. Results: Although A-CMCs and caregivers recognized the importance of SBIRT within hospital settings, its acceptability hinged on the conditions of its delivery. The timing, relevance to current health needs, and modality of screening shaped an A-CMC\u2019s willingness to disclose AOD use. Clinician communication style, including the use of a nonjudgmental tone and clear parameters for confidentiality, were also indicated as crucial for SBIRT delivery. Broadly, participants noted the significant impact that the sociopolitical context (e.g., stigma) and structural factors (e.g., financial burden) had on a family\u2019s ability to benefit from SBIRT. Conclusions: In this exploratory qualitative study, participants identified confidentiality-forward, patient-centered workflows, and accessible follow-up supports as potentially important considerations for inpatient SBIRT among A-CMCs. These findings generate hypotheses for future co-design and implementation research across diverse pediatric inpatient settings.<\/jats:p>","DOI":"10.3390\/children13091184","type":"journal-article","created":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T14:35:29Z","timestamp":1788359729000},"page":"1184","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Talk to Me, Not Just My Parent: Teen and Caregiver Perspectives on Implementing Screening, Brief Intervention, and Referral to Treatment Equitably in Pediatric Inpatient Settings for Teens with Chronic Illness"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6999-2202","authenticated-orcid":false,"given":"Faith","family":"Summersett Williams","sequence":"first","affiliation":[{"name":"Division of Adolescent and Young Adult Medicine, Ann & Robert H. Lurie Children\u2019s Hospital of Chicago, Chicago, IL 60611, USA"},{"name":"Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL 60208, USA"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"funding-acquisition","vocabulary":"credit"},{"role":"project-administration","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"},{"role":"resources","vocabulary":"credit"}]},{"given":"Sarah","family":"Welch","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL 60208, USA"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"methodology","vocabulary":"credit"},{"role":"validation","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"},{"role":"visualization","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-2562-4324","authenticated-orcid":false,"given":"Ella","family":"Kuffour","sequence":"additional","affiliation":[{"name":"Division of Adolescent and Young Adult Medicine, Ann & Robert H. Lurie Children\u2019s Hospital of Chicago, Chicago, IL 60611, USA"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"given":"Emily","family":"Lynott","sequence":"additional","affiliation":[{"name":"Division of Adolescent and Young Adult Medicine, Ann & Robert H. Lurie Children\u2019s Hospital of Chicago, Chicago, IL 60611, USA"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"}]},{"given":"Sheridan","family":"Grettenberger","sequence":"additional","affiliation":[{"name":"Division of Adolescent and Young Adult Medicine, Ann & Robert H. Lurie Children\u2019s Hospital of Chicago, Chicago, IL 60611, USA"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"project-administration","vocabulary":"credit"}]},{"given":"Kennedy","family":"Curtis","sequence":"additional","affiliation":[{"name":"Division of Adolescent and Young Adult Medicine, Ann & Robert H. Lurie Children\u2019s Hospital of Chicago, Chicago, IL 60611, USA"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"investigation","vocabulary":"credit"},{"role":"visualization","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"given":"Yiyang","family":"Liu","sequence":"additional","affiliation":[{"name":"Division of Adolescent and Young Adult Medicine, Ann & Robert H. Lurie Children\u2019s Hospital of Chicago, Chicago, IL 60611, USA"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"given":"Ruth","family":"Debono","sequence":"additional","affiliation":[{"name":"Division of Adolescent and Young Adult Medicine, Ann & Robert H. Lurie Children\u2019s Hospital of Chicago, Chicago, IL 60611, USA"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3226-9587","authenticated-orcid":false,"given":"Maria H.","family":"Rahmandar","sequence":"additional","affiliation":[{"name":"Division of Adolescent and Young Adult Medicine, Ann & Robert H. Lurie Children\u2019s Hospital of Chicago, Chicago, IL 60611, USA"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"given":"Sara","family":"Becker","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Feinberg School of Medicine, The Center for Dissemination and Implementation Science (CDIS), Northwestern University, Chicago, IL 60208, USA"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"conceptualization","vocabulary":"credit"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,2]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"S4","DOI":"10.1016\/j.drugalcdep.2006.12.010","article-title":"Comorbidity of substance use disorders and other psychiatric disorders among adolescents: Evidence from an epidemiologic survey","volume":"88","author":"Roberts","year":"2007","journal-title":"Drug Alcohol Depend."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"618","DOI":"10.1111\/jcpp.12783","article-title":"Research Review: What have we learned about adolescent substance use?","volume":"59","author":"Gray","year":"2018","journal-title":"J. Child Psychol. Psychiatry"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1412","DOI":"10.1111\/j.1530-0277.2012.01752.x","article-title":"Associations of alcohol, nicotine, cannabis, and drug use\/dependence with educational attainment: Evidence from cotwin-control analyses","volume":"36","author":"Grant","year":"2012","journal-title":"Alcohol. Clin. Exp. Res."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Heradstveit, O., Skogen, J.C., Hetland, J., and Hysing, M. (2017). Alcohol and Illicit Drug Use Are Important Factors for School-Related Problems among Adolescents. Front. Psychol., 8.","DOI":"10.3389\/fpsyg.2017.01023"},{"key":"ref_5","unstructured":"Substance Abuse and Mental Health Services Administration (2014). Alcohol and Drug Combinations Are More Likely to Have a Serious Outcome Than Alcohol Alone in Emergency Department Visits Involving Underage Drinking, in The DAWN Report."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"e1113","DOI":"10.1542\/peds.2008-1479","article-title":"Health risk behaviors in adolescents with chronic conditions","volume":"122","author":"Suris","year":"2008","journal-title":"Pediatrics"},{"key":"ref_7","doi-asserted-by":"crossref","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."},{"key":"ref_8","doi-asserted-by":"crossref","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"},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Weitzman, E.R., Salimian, P.K., Rabinow, L., and Levy, S. (2019). Perspectives on substance use among youth with chronic medical conditions and implications for clinical guidance and prevention: A qualitative study. PLoS ONE, 14.","DOI":"10.1371\/journal.pone.0209963"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"2367","DOI":"10.1111\/j.1365-2648.2009.05098.x","article-title":"Healthcare routines of university students with Type 1 diabetes","volume":"65","author":"Balfe","year":"2009","journal-title":"J. Adv. Nurs."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"e2020021352","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"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1111\/acer.12633","article-title":"Prevalence of alcohol-interactive prescription medication use among current drinkers: United States 1999 to 2010","volume":"39","author":"Breslow","year":"2015","journal-title":"Alcohol. Clin. Exp. Res."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"e20174026","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"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"e20152413","DOI":"10.1542\/peds.2015-2413","article-title":"Predictors of Care Gaps in Adolescents with Complex Chronic Condition Transitioning to Adulthood","volume":"137","author":"Goossens","year":"2016","journal-title":"Pediatrics"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"e150951","DOI":"10.1001\/jamapediatrics.2015.0951","article-title":"Predictors of timing of transfer from pediatric- to adult-focused primary care","volume":"169","author":"Wisk","year":"2015","journal-title":"JAMA Pediatr."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1186\/s12969-017-0197-6","article-title":"Assessment of transition readiness in adolescents and young adults with chronic health conditions","volume":"15","author":"Jensen","year":"2017","journal-title":"Pediatr. Rheumatol."},{"key":"ref_17","unstructured":"Substance Abuse and Mental Health Services Administration (2013). Systems-Level Implementation of Screening, Brief Intervention, and Referral to Treatment, in Technical Assistance Publication (TAP) Series."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"463","DOI":"10.1016\/j.jsat.2012.11.005","article-title":"SBIRT for adolescent drug and alcohol use: Current status and future directions","volume":"44","author":"Mitchell","year":"2013","journal-title":"J. Subst. Abus. Treat."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1080\/08897077.2011.645950","article-title":"Results of a statewide survey of adolescent substance use screening rates and practices in primary care","volume":"33","author":"Harris","year":"2012","journal-title":"Subst. Abus."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1007\/s44250-026-00357-4","article-title":"Health professional perspectives on integrating substance use services into pediatric hospitals for adolescents with chronic medical conditions","volume":"5","author":"Williams","year":"2026","journal-title":"Discov. Health Syst."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"e559","DOI":"10.1542\/peds.2012-1455","article-title":"Medical complexity and pediatric emergency department and inpatient utilization","volume":"131","author":"Simon","year":"2013","journal-title":"Pediatrics"},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Mah, S.S., Teare, G.F., Law, J., and Adhikari, K. (2024). Facilitators and barriers for implementing screening brief intervention and referral for health promotion in a rural hospital in Alberta: Using consolidated framework for implementation research. BMC Health Serv. Res., 24.","DOI":"10.1186\/s12913-024-10676-y"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1186\/1940-0640-7-13","article-title":"Screening for adolescent alcohol and drug use in pediatric health-care settings: Predictors and implications for practice and policy","volume":"7","author":"Sterling","year":"2012","journal-title":"Addict. Sci. Clin. Pract."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"418","DOI":"10.1177\/00099228211034334","article-title":"Provider and Practice Characteristics and Perceived Barriers Associated with Different Levels of Adolescent SBIRT Implementation Among a National Sample of US Pediatricians","volume":"60","author":"Hammond","year":"2021","journal-title":"Clin. Pediatr."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1186\/s13012-021-01116-0","article-title":"Perceptions of the barriers, facilitators, outcomes, and helpfulness of strategies to implement screening, brief intervention, and referral to treatment in acute care","volume":"16","author":"Keen","year":"2021","journal-title":"Implement. Sci."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1016\/S1054-139X(03)00047-8","article-title":"Chronically ill adolescents\u2019 experiences of communicating with doctors: A qualitative study","volume":"33","author":"Beresford","year":"2003","journal-title":"J. Adolesc. Health"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1272","DOI":"10.1542\/peds.2003-1134-L","article-title":"Health care preferences and priorities of adolescents with chronic illnesses","volume":"114","author":"Britto","year":"2004","journal-title":"Pediatrics"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"804","DOI":"10.1016\/j.jadohealth.2019.02.011","article-title":"Screening and Counseling for Alcohol Use in Adolescents with Chronic Medical Conditions in the Ambulatory Setting","volume":"64","author":"Lunstead","year":"2019","journal-title":"J. Adolesc. Health"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"357","DOI":"10.18865\/ed.31.S1.357","article-title":"Recommendations for Addressing Structural Racism in Implementation Science: A Call to the Field","volume":"31","author":"Shelton","year":"2021","journal-title":"Ethn. Dis."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"375","DOI":"10.18865\/ed.31.S1.375","article-title":"Applying a Race(ism)-Conscious Adaptation of the CFIR Framework to Understand Implementation of a School-Based Equity-Oriented Intervention","volume":"31","author":"Allen","year":"2021","journal-title":"Ethn. Dis."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1186\/s13012-016-0437-z","article-title":"A systematic review of the use of the Consolidated Framework for Implementation Research","volume":"11","author":"Kirk","year":"2016","journal-title":"Implement. Sci."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1186\/1748-5908-4-50","article-title":"Fostering implementation of health services research findings into practice: A consolidated framework for advancing implementation science","volume":"4","author":"Damschroder","year":"2009","journal-title":"Implement. Sci."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1186\/s13012-019-0861-y","article-title":"The health equity implementation framework: Proposal and preliminary study of hepatitis C virus treatment","volume":"14","author":"Woodward","year":"2019","journal-title":"Implement. Sci."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1186\/s43058-021-00146-5","article-title":"A more practical guide to incorporating health equity domains in implementation determinant frameworks","volume":"2","author":"Woodward","year":"2021","journal-title":"Implement. Sci. Commun."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1245","DOI":"10.1097\/ACM.0000000000000388","article-title":"Standards for reporting qualitative research: A synthesis of recommendations","volume":"89","author":"Harris","year":"2014","journal-title":"Acad. Med."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1753","DOI":"10.1177\/1049732315617444","article-title":"Sample Size in Qualitative Interview Studies: Guided by Information Power","volume":"26","author":"Malterud","year":"2016","journal-title":"Qual. Health Res."},{"key":"ref_37","unstructured":"(Dedoose, 2025). Dedoose, Cloud Application for Managing, Analyzing, and Presenting Qualitative and Mixed Method Research Data."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"7610","DOI":"10.1080\/09638288.2021.1979667","article-title":"Co-designed healthcare transition interventions for adolescents and young adults with chronic conditions: A scoping review","volume":"44","author":"Bray","year":"2022","journal-title":"Disabil. Rehabil."},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Zolfaghari, E., Armaghanian, N., Waller, D., Medlow, S., Hobbs, A., Perry, L., Nguyen, K., and Steinbeck, K. (2022). Implementation science in adolescent healthcare research: An integrative review. BMC Health Serv. Res., 22.","DOI":"10.1186\/s12913-022-07941-3"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1016\/S1083-3188(00)00004-8","article-title":"Sexual activity and other high-risk behaviors in adolescents with chronic illness: A review","volume":"13","author":"Valencia","year":"2000","journal-title":"J. Pediatr. Adolesc. Gynecol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1177\/1524839917691944","article-title":"Perceived Barriers and Enablers of Help-Seeking for Substance Use Problems During Adolescence","volume":"19","author":"Berridge","year":"2018","journal-title":"Health Promot. Pract."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1111\/josh.13430","article-title":"Substance Use Screening, Brief Intervention, and Referral to Treatment in Urban Settings: Barriers and Facilitators to Implementation with Minoritized Youth","volume":"94","author":"Fisher","year":"2024","journal-title":"J. Sch. Health"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1016\/j.chc.2024.03.002","article-title":"Creating an Equitable System of Care for Minoritized Youth and Addressing Systemic and Structural Barriers","volume":"33","author":"Shaligram","year":"2024","journal-title":"Child Adolesc. Psychiatr. Clin. N. Am."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1486","DOI":"10.1007\/s10964-014-0111-1","article-title":"Social norms in the development of adolescent substance use: A longitudinal analysis of the International Youth Development Study","volume":"43","author":"Eisenberg","year":"2014","journal-title":"J. Youth Adolesc."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"981","DOI":"10.1007\/s10964-009-9455-3","article-title":"Adolescents\u2019 media-related cognitions and substance use in the context of parental and peer influences","volume":"39","author":"Scull","year":"2010","journal-title":"J. Youth Adolesc."},{"key":"ref_46","first-page":"133","article-title":"\u201cIf You Need to Light Up \u2026 You Gotta Do What You Gotta Do\u201d: A Qualitative Study of Adolescent Attitudes Towards Cannabis Use and Comparison with Alcohol Attitudes","volume":"8","author":"Clement","year":"2025","journal-title":"Cannabis"},{"key":"ref_47","first-page":"3397","article-title":"Perceived ease of access to alcohol, tobacco and other substances in rural and urban US students","volume":"15","author":"Warren","year":"2015","journal-title":"Rural. Remote Health"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"541","DOI":"10.1016\/j.jadohealth.2018.10.009","article-title":"Disclosure of Adolescent Substance Use in Primary Care: Comparison of Routine Clinical Screening and Anonymous Research Interviews","volume":"64","author":"Gryczynski","year":"2019","journal-title":"J. Adolesc. Health"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1080\/10410236.2020.1816309","article-title":"Identifying Conversational Strategies for Psychiatrists in Discussing Substance Use with Adolescent Patients","volume":"37","author":"Wombacher","year":"2022","journal-title":"Health Commun."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1016\/S1054-139X(03)00184-8","article-title":"Truth and consequences: Ethics, confidentiality, and disclosure in adolescent longitudinal prevention research","volume":"33","author":"Howard","year":"2003","journal-title":"J. Adolesc. Health"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"885","DOI":"10.1001\/archpedi.154.9.885","article-title":"Confidentiality and adolescents\u2019 use of providers for health information and for pelvic examinations","volume":"154","author":"Thrall","year":"2000","journal-title":"Arch. Pediatr. Adolesc. Med."},{"key":"ref_52","first-page":"239","article-title":"Confidentiality and consent in adolescent substance abuse: An update","volume":"7","author":"Weddle","year":"2005","journal-title":"AMA J. Ethics"},{"key":"ref_53","doi-asserted-by":"crossref","unstructured":"Committee on Substance Abuse, Levy, S.J., and Kokotailo, P.K. (2011). Substance use screening, brief intervention, and referral to treatment for pediatricians. Pediatrics, 128, e1330\u2013e1340.","DOI":"10.1542\/peds.2011-1754"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"1645","DOI":"10.1111\/jan.14674","article-title":"An integrative review of adolescent trust in the healthcare provider relationship","volume":"77","author":"Hardin","year":"2021","journal-title":"J. Adv. Nurs."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"e12406","DOI":"10.2196\/12406","article-title":"Considerations of Privacy and Confidentiality in Developing a Clinical Support Tool for Adolescent Tobacco Prevention: Qualitative Study","volume":"3","author":"Theis","year":"2019","journal-title":"JMIR Form. Res."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1016\/j.jsat.2015.10.006","article-title":"SBIRT-A: Adapting SBIRT to Maximize Developmental Fit for Adolescents in Primary Care","volume":"62","author":"Ozechowski","year":"2016","journal-title":"J. Subst. Abus. Treat."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"20552076231219117","DOI":"10.1177\/20552076231219117","article-title":"Co-design of digital health interventions with young people: A scoping review","volume":"9","author":"Malloy","year":"2023","journal-title":"Digit. Health"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"928","DOI":"10.1111\/jcpp.13258","article-title":"Practitioner review: Co-design of digital mental health technologies with children and young people","volume":"61","author":"Stallard","year":"2020","journal-title":"J. Child Psychol. Psychiatry"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"399","DOI":"10.20882\/adicciones.1912","article-title":"Integrated vs. parallel treatment in adolescents with substance use and comorbid disorders: A randomized trial","volume":"36","author":"Goti","year":"2024","journal-title":"Adicciones"}],"container-title":["Children"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2227-9067\/13\/9\/1184\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T14:50:02Z","timestamp":1788360602000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2227-9067\/13\/9\/1184"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,2]]},"references-count":59,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2026,9]]}},"alternative-id":["children13091184"],"URL":"https:\/\/doi.org\/10.3390\/children13091184","relation":{},"ISSN":["2227-9067"],"issn-type":[{"value":"2227-9067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,2]]}}}