Citation

Greiner MV, Nidey N, Unkrich J, Fox K, Radenhausen M, Beal SJ. Pediatrics 2024; ePub(ePub): ePub.

Copyright

(Copyright © 2024, American Academy of Pediatrics)

DOI

10.1542/peds.2023-065057

PMID

39091259

Abstract

There are >390 000 children in foster care (ie, in the custody of a county or state children's services agency and placed with temporary caregivers, including licensed foster caregivers, approved kinship caregivers, or in congregate or independent living situations with staff serving as caregivers) in the United States.1 Children in foster care face many health challenges compared with the general population, including increased rates of substance use and substance use disorders.2 Standardized screening, through Screening, Brief Intervention, and Referral to Treatment (SBIRT), is an evidence-based approach that assesses current substance use and provides the appropriate level of treatment.3 For standardized screening to be effective, substance use disclosure is critical. Adolescents report preferring self-administered (paper, digital) substance use screeners and response patterns suggest adolescents disclose substance use reliably.4 Electronic health record advances have made tablet-based screening efficient and cost-effective. However, before accepting tablet-based standardized substance use screening as a standard of care among youth in foster care, it is important to describe the validity of standardized substance use screening in a foster care clinic and factors associated with patterns of responding.

During our study period, 373 youth completed CRAFFT substance use screening; if multiple screenings were completed, the first screening occurrence was used in analyses. Initially, 93 CRAFFT screens were positive. Among the 280 negative CRAFFT substance use screens, 34 (12.1%) endorsed substance use during the confidential interview with health care providers, resulting in an overall sample total of 127 (34.0%) youth who endorsed substance use (Table 1). Youth who denied substance use on screeners and endorsed use with providers were, on average, 2 years older and were more likely to live in independent living placements when compared with youth who did not change responses (Table 2). Rates of past 30-day alcohol, cannabis, and nicotine use reported to the interventionist for youth who did and did not revise their responses during the confidential interview did not significantly differ. ...

Language: en