Using Technology to Improve Clinical Counseling of Adolescent Risky Behaviors

Period of Performance: 05/01/2017 - 04/30/2018


Phase 2 SBIR

Recipient Firm

Possibilities for Change, LLC
Ann Arbor, MI 48109
Principal Investigator


The Phase II SBIR goal is to rigorously evaluate the web-based counseling module Adolescent Counseling Technologies - Tobacco (ACT-TOB). ACT-TOB provides virtual health education through interactive, technology-driven tobacco assessment and reduction counseling to adolescents, individualized to their positive responses in the assessment as well as self-reported stage of readiness to change their behaviors. A text message reminder component maintains user engagement and supports treatment adherence. Provision of this virtual health education system in primary care settings will improve adolescent care by overcoming barriers of healthcare provider time, skill, and teen engagement when providing effective tobacco use reduction counseling. The ACT-TOB was developed in Phase I and demonstrated feasible by both adolescent and healthcare provider user groups. In Phase II, the tool will be rigorously evaluated in an 18-month randomized controlled trial with 14 school-based health centers (SBHCs): 7 intervention and 7 control. 1,750 adolescents will receive the intervention or control based on the designation of the SBHC where they receive care, with 875 receiving the intervention of RAAPS and ACT-TOB and the control 875 receiving only RAAPS. Long Term Goal: The ACT-TOB will be used for broad dissemination of an effective and cost-efficient web-based tobacco screening and counseling program for use in health care settings, resulting in reductions in adolescent tobacco use and escalation and their associated health care costs. Phase II Hypothesis: The provision of ACT-TOB to tobacco-using adolescents (aged 13-19) will result in a significant and sustained lessening of tobacco use. Specific Aim 1: Evaluate the real-world utility of ACT-TOB in the lives of adolescents and healthcare providers who care for adolescents. Specific Aim 2: Evaluate the success of ACT-TOB in promoting smoking cessation in tobacco-using adolescents. Health Relatedness of Project: The success of the Phase II evaluation will result in a new model for risk counseling within healthcare settings: a web-based module that provides interactive, technology-driven risk reduction counseling, individualized to adolescents' readiness to change their tobacco use behaviors, and circumvents many of the challenges currently facing healthcare settings in the provision of risk assessment and tobacco cessation support, including limited time, clinical skills and confidence, and teen engagement. Leveraging technology has been shown to help create a safe environment from which to engage adolescents?a notoriously hard to reach population?to disclose risky behaviors. This disclosure is the critical first step in a trajectory of improved health outcomes, as 90% of tobacco addiction begins in adolescence.