Fifty percent of all adolescents will use some form of illicit drugs before the end of high school and 20% to 25% will meet criteria for depression, while many others will engage in health-compromising behaviors like delinquency and violence—with consequences for their long-term health. Evidence-based parenting interventions shown to prevent these behavioral health concerns could improve adolescent health trajectories if implemented widely in pediatric primary care. The American Academy of Pediatrics’ Bright Futures recommends that pediatricians offer developmentally tailored anticipatory guidance to all parents to support their children’s healthy development, but programs providing guidance are not offered universally.

The GGC4H Demonstration Project is a cluster-randomized trial that will use the RE-AIM framework to test the feasibility and effectiveness of implementing Guiding Good Choices—a universal evidence-based anticipatory guidance curriculum for parents of early adolescents—in three large, integrated healthcare systems serving socioeconomically diverse families. In two previous randomized controlled trials, this intervention reduced adolescent alcohol, tobacco, and marijuana use; depression; and delinquent behavior. It also strengthened parenting practices and parent–adolescent relationship quality, both broadly protective against behavioral health concerns. Guiding Good Choices has the capacity to achieve population-level impact on adolescent health if made widely available through pediatric primary care. Parents trust pediatricians’ advice regarding their children’s well-being, and current research with socioeconomically diverse groups suggests parents are eager to participate in family-focused programs offered in primary care clinics.

The primary goals of the UG3 planning phase are to partner with the pediatric primary care clinics in which the intervention will be implemented, finalize the study design, protocols, and RE-AIM measures needed for a successful pragmatic trial, fulfill all Collaboratory requirements, and conduct a pilot study of the intervention and related implementation processes in all three healthcare systems.

NIH Project Information