Pediatric Emergency Department-initiated Support program To Link Care (PEDS-TLC) for youth with substance use

The purpose of this K23 career development award is to prepare Dr. Renny to become an independentphysician-investigator focused on improving care for youth with substance use through emergency department(ED)-based behavioral interventions and use of technology to facilitate interventions and linkages more broadlythroughout health systems. In her K23 research project Dr. Renny will address the critical deficit of researchon evidence-based approaches to link youth who use substances with needed outpatient care after their EDvisit. She will develop and pilot test a pediatric emergency department-initiated program the PediatricEmergency Department-initiated Support program To Link Care (PEDS-TLC) for youth with substance use.PEDS-TLC will link youth who report monthly or more substance use on the Screening to Brief Intervention(S2BI) screening tool (higher risk for a SUD) with outpatient care (adolescent medicine or addictiontreatment depending on severity of use) to receive further treatment after their PED visit. In Aim 1 Dr. Renny will adapt and integrate into the electronic health record (EHR) an evidence-based briefnegotiated interview (BNI) and change plan for youth at higher risk of a SUD to facilitate linkage to care.Following the ADAPT-ITT framework and with the assistance of a key stakeholder board and pilot testing byyouth Dr. Renny will adapt the BNI and change plan to be age- and setting-specific including a more detailedaction plan and motivational interviewing theory-based post-PED messaging (e.g. appointment remindersaction plan reminders) as part of the PEDS-TLC program. Once all components of PEDS-TLC are finalizedthe action plan and interim messaging will be integrated into the EHR through the EPIC MyChart CareCompanion application to assist with transition to outpatient care. In Aim 2 Dr. Renny will conduct a pilotrandomized controlled trial (RCT) of the PEDS-TLC program versus standard care to examine feasibilityacceptability and short-term efficacy of linkage to care and also substance use reduction at 30- and 90-dayfollow-up. During the K23 award period Dr. Renny will build on her experience and skills as a pediatric emergencymedicine physician medical toxicologist and healthcare researcher to gain new expertise in: (1) adaptingbehavioral interventions for youth with substance use; (2) engaging stakeholders in research; (3) usabilitytesting of information technology (IT) interventions; and (4) designing executing and analyzing behavioralintervention trials for youth. She will receive in-depth mentorship from a multi-disciplinary team of experts inED-based behavioral health interventions adolescent substance use stakeholder engagement IT and digitalhealth clinical trials and statistical analysis. The products of this K23 project will provide Dr. Renny with a well-designed innovative program (PEDS-TLC) and critical preliminary data that informs the anticipated effect sizeand sample size needed for a subsequent NIH R01 RCT of PEDS-TLC.