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Bradley O. Boekeloo, MS, PhD; Judith Jerry, MPH; Wilhelmena I. Lee-Ougo, MA, PhD; Kevin D. Worrell, MD; Ellen K. Hamburger, MD; Estelle Russek-Cohen, PhD; Mark H. Snyder, MD

Arch Pediatr Adolesc Med. 2004;158:635-642.

Objective  To determine whether office-based interventions change adolescents' alcohol beliefs and alcohol use.

Design  Randomized, controlled trial.

Setting  Five managed care group practices in Washington, DC.

Participants  Consecutive 12- to 17-year-olds (N = 409) seeing primary care providers (N = 26) for general check-ups. Most of the adolescents (79%) were African American, 44% were male, and 16% currently drank.

Interventions  Usual care (Group I), adolescent priming with alcohol self-assessment just prior to check-up (Group II), adolescent priming and provider prompting with adolescent self-assessment and brochure (Group III).

Main Outcome Measures  Adolescent alcohol beliefs at exit interview and self-reported behaviors at 6- and 12-month follow-up.

Results  At exit interview, Groups II and III reported that less alcohol was needed for impaired thinking and a greater intent to drink alcohol in the next 3 months than Group I. At 6 months, Group III reported more resistance to peer pressure to drink, and Groups II and III reported more bingeing than Group I. At 1-year follow-up, controlling for baseline levels, Groups II (odds ratio [OR], 3.44; 95% confidence interval [CI], 1.44-6.24) and III (OR, 2.86; CI, 1.13-7.26) reported more bingeing in the last 3 months than Group I. Group II reported more drinking in the last 30 days (OR, 2.31; CI, 1.31-4.07) and in the last 3 months (OR, 1.76; CI, 1.12-2.77) than Group I.

Conclusion  Brief office-based interventions were ineffective in reducing adolescent alcohol use but may increase adolescent reporting of alcohol use.

From the Department of Public and Community Health, College of Health and Human Performance (Drs Boekeloo and Lee-Ougo and Ms Jerry), and the Biometrics Program, Department of Animal and Avian Sciences (Dr Russek-Cohen), University of Maryland, College Park; the Mid-Atlantic Permanente Medical Group, Rockville, Md (Drs Worrell and Snyder); and the Departments of Medicine and Pediatrics, School of Medicine and Health Sciences, George Washington University, Washington, DC (Dr Hamburger).

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