Boggis, Jesse

D'Souza-Li, Lilia

Harris, Sion K

Knight, John R

Sherritt, Lon

Addiction Science & Clinical Practice

Lilia D'Souza-Li

John R Knight

Lon Sherritt

Jesse Boggis

Sion K Harris

Springer - Publisher Connector

ORAL PRESENTATION Open Access
Does patient or clinician gender modify the
efficacy of a primary care brief intervention for
adolescent alcohol use?
Lilia D’Souza-Li1,3*, John R Knight1,2, Lon Sherritt1,2, Jesse Boggis1, Sion K Harris1,2
From INEBRIA 12th Congress,
Atlanda, GA, USA. 24-25 September 2015
Background
A previous large, multi-site trial showed that computer-
facilitated screening and physician brief advice (cSBA)
was an effective way to reduce adolescents’ alcohol use
[1]. What is unknown is whether the intervention effect
varies by patients’ or physicians’ characteristics, such as
gender. We assessed whether patient and physician gen-
der moderates cSBA effectiveness.
Material and methods
We analyzed a subset of data from a quasi-experimental,
asynchronous effectiveness trial of 12-18 y/o patients at
primary care sites. An initial 18-month Treatment as
Usual (TAU) phase was followed by a 1-hour physician
training and an 18-month cSBA phase with computerized
screening, immediate feedback and information on the
health risks of drugs, follow by physicians brief advice.
Adolescents rated their visit and physician immediately
post-visit. Only data for physicians with >5 patients in
each study arm were included. We conducted stratified
multiple logistic regression modeling with adjustment for
known covariates and within-site clustering. Endpoints
were past 3- and 12-month alcohol at follow-ups.
Results
Subjects: 20 physicians (11 females; 85% pediatricians) and
1158 patients, mean age 15.6+2.0 yrs. Youth-provider con-
nectedness was high (median score 32 [IQR 29-34] out of
35 max). However, female physicians’ patients scored sig-
nificantly higher on youth-provider connectedness than
patients of male physicians (p<0.0001), regardless of
patient gender. The 3-month effect of cSBA on adolescent
alcohol use was stronger among girls and female physi-
cians (Table 1).
Conclusion
Physician advice regarding alcohol use may be particu-
larly effective for girls within the context of an ongoing
relationship with their physician, and when delivered by
female physicians whose care is associated with higher
patient-provider connectedness.
Acknowledgements
The authors thank the physicians and staff of The New England Partnership for
Substance Abuse Research for their help in implementation of the original
study, to the adolescent patients who participated and their parents who gave
permission and the funding agencies: National Institute on Drug Abuse
R01DA018848 and R01DA018848e03S1; National Institute on Alcohol Abuse
and Alcoholism K07 AA013280; CNPq 202418/2014; CAPES BEX 6951/14-7.
Authors’ details
1Boston Children’s Hospital Center for Adolescent Substance Abuse
Research, Boston, MA, 02115, USA. 2Department of Pediatrics, Harvard
Medical School, Boston MA, 02115, USA. 3Department of Pediatrics, Faculty
of Medical Science, University of Campinas, Campinas, SP, 13087-970, Brazil.
Published: 24 September 2015
* Correspondence: lilia.li@childrens.harvard.edu
1Boston Children’s Hospital Center for Adolescent Substance Abuse
Research, Boston, MA, 02115, USA
Full list of author information is available at the end of the article
Table 1 Adjusted relative risk ratios (ARRR) comparing
cSBA vs. TAU adolescent alcohol use rates at 3 and
12 months post-visit.
3 MONTHS 12 MONTHS
ARRR 95%CI ARRR 95% CI
Girl patient (n=546) 0.47* 0.25-0.87 0.82 0.52-1.31
Boy patients (n=612) 0.54 0.26-1.19 0.71 0.45-1.11
Female doctors(n=6581) 0.41* 0.22-0.76 0.63 0.38-1.03
Male doctors (n=5001) 0.62 0.30-1.29 0.77 0.50-1.17
*p<0.05; 1 Number of patients
D’Souza-Li et al. Addiction Science & Clinical Practice 2015, 10(Suppl 2):O16
http://www.ascpjournal.org/content/10/S2/O16
© 2015 D’Souza-Li et al. This is an Open Access article distributed under the terms of the Creative Commons Attribution License
(http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided
the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/
publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
Reference
1. Harris SK, Csemy L, Sherritt L, Starostova O, Van Hook S, Johnson J,
Boulter S, Brooks T, Carey P, Kossack R, Kulig JW, Van Vranken N, Knight JR:
Computer-facilitated substance use screening and brief advice for teens
in primary care: An international trial. Pediatrics 2012, 129:1072e82.
doi:10.1186/1940-0640-10-S2-O16
Cite this article as: D’Souza-Li et al.: Does patient or clinician gender
modify the efficacy of a primary care brief intervention for adolescent
alcohol use? Addiction Science & Clinical Practice 2015 10(Suppl 2):O16.
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Does patient or clinician gender modify the efficacy of a primary care brief intervention for adolescent alcohol use?

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Does patient or clinician gender modify the efficacy of a primary care brief intervention for adolescent alcohol use?

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