Current Environment: Production

Past Research Projects | Overview

The Weitzman Lab is advancing knowledge about disease and treatment experiences, quality of life, risk behaviors, and health outcomes of youth with a chronic illness, including in investigations that “add the voice of the patient” into disease registries and cohort studies. The Weitzman Lab is currently recruiting for several studies and periodically has openings for post-doctoral fellows or collaborative opportunities. If you are interested in learning more, please feel free to contact us for more information.

Substance Use Among Youth

Evaluation of School Screening, Brief Intervention, and Referral to Treatment in Massachusetts Public Schools

In 2015, Massachusetts passed a law calling for schools to offer Screening, Brief Intervention and Referral to Treatment (SBIRT) to all students statewide. MA House Bill 4056 calls for the implementation of verbal substance use screening protocols to be implemented in all public schools by 2018. As SBIRT programs are implemented in schools across the state, there is an opportunity to assess how SBIRT impacts student health and behaviors.

This project aimed to evaluate the impact of school SBIRT on health and behavioral outcomes among adolescents through case-control comparison of youth in school who are implementing on different timelines, under a quasi-experimental model, additionally evaluating SBIRT implementation models using stakeholder interviews. Results informed effective, sustainable policy change in school-based SBIRT efforts.

Project Co-PIs: Dr. Elissa Weitzman, ScD, MSc; Dr. Sharon Levy, MD, MPH

Funder: Peter and Elizabeth C. Tower Foundation

Publications:
Levy S, Wisk LE, Minegishi M, et al. Association of Screening and Brief Intervention With Substance Use in Massachusetts Middle and High Schools. JAMA Netw Open. 2022;5(8):e2226886. doi:10.1001/jamanetworkopen.2022.26886

Marin AM, Wisk LE, Minegishi M, Lunstead J, Levy S, Weitzman ER. Adolescent Attitudes Toward Substance Use Screening in School Settings. Journal of Adolescent Health. 2021 Feb; 68(2), S53 - S54.

Chadi N, Levy S, Wisk LE, Weitzman ER. Student Experience of School Screening, Brief Intervention and Referral to Treatment (SBIRT). Journal of School Health. 2020, Mar; 90(6): 431-438. PMID: 32212160.

Lunstead J, Weitzman ER, Kaye D, Levy S. Screening and brief intervention in high schools: School nurses' practices and attitudes in Massachusetts. Subst Abus. 2017;38(3):257-260. doi:10.1080/08897077.2016.1275926

Presentation

A Multi-Site Case Study Evaluation of Mandated SBIRT Policy in Massachusetts Public Schools

Detecting Youth Drinking and Associations with Alcohol Policies via Social Media

In this study, we developed and tested an innovative approach to public health monitoring of alcohol use and binge drinking using public social media posts. Using natural language processing, we mined large amounts of Twitter data to produce estimates of state-level prevalence of alcohol consumption, comparing this to estimates produced from existing “gold standard” monitoring systems (the Behavioral Risk Factor Surveillance System and the Youth Risk Behavior Surveillance System). We also tested the relationship between social media metrics of alcohol use and the alcohol policy environment by assessing variations related to state level alcohol policy controls.

Project PI: Dr. Elissa Weitzman, ScD, MSc

Funder: NIH/NIAAA

Publications:
Chunara R, Wisk LE, Weitzman ER. Denominator Issues for Personally Generated Data in Population Health Monitoring. Am J Prev Med. 2017;52(4):549-553. doi:10.1016/j.amepre.2016.10.038

Liu J, Weitzman ER, Chunara R. Assessing Behavioral Stages From Social Media Data. CSCW Conf Comput Support Coop Work. 2017;2017:1320-1333. doi:10.1145/2998181.2998336

Salimian PK, Chunara R, Weitzman ER. Averting the perfect storm: addressing youth substance use risk from social media use. Pediatr Ann. 2014;43(10):411. doi:10.3928/00904481-20140924-08

Weitzman ER, Magane KM, Chen PH, Amiri H, Naimi TS, Wisk LE. Online Searching and Social Media to Detect Alcohol Use Risk at Population Scale. Am J Prev Med. 2020;58(1):79-88. doi:10.1016/j.amepre.2019.08.027

Adolescent and Young Adult Research Network

The leading causes of morbidity and mortality during adolescence and emerging adulthood may be preventable and often mediated by health behaviors established during this time, such as alcohol use. The individual and societal burdens, financial and otherwise, of these preventable health problems and risk behaviors during emerging adulthood likely contribute substantially to the long-term costs of chronic disease in the US. As such, there is increasing interest in improving access to care for adolescents and young adults (AYA) and providing prevention-oriented activities to aid the adoption of healthy behaviors in order to ensure healthy and productive life course trajectories for this growing population. In order to address vulnerabilities in access to care, particularly preventive care, it is first necessary to quantify care seeking patterns during childhood, adolescence and young adulthood and to determine if and to what extent risk behaviors and chronic conditions modify these profiles.

Principal Investigator: Elizabeth Ozer, PhD

Project PI: Dr. Elissa Weitzman, ScD, MSc

Publications:
Harris, S. K., Aalsma, M. C., Weitzman, E. R., Garcia-Huidobro, D., Wong, C., Hadland, S. E., Santelli, J., Park, M. J., & Ozer, E. M. (2017). Research on clinical preventive services for adolescents and young adults: Where are we and where do we need to go? Journal of Adolescent Health, 60(3), 249–260. https://doi.org/10.1016/j.jadohealth.2016.10.005

Wong CA, Madanay F, Ozer EM, et al. Digital Health Technology to Enhance Adolescent and Young Adult Clinical Preventive Services: Affordances and Challenges. J Adolesc Health. 2020;67(2S):S24-S33. doi:10.1016/j.jadohealth.2019.10.018

Adolescent Views and Experiences with Vaping

This project aimed to conduct key informant interviews with current patients being treated for nicotine vaping in the Adolescent Substance Use and Addiction Program (ASAP), in order to inform the development of a vaping group therapy curriculum, a training manual, and protocol for counseling professionals and a companion manual for primary care providers.

Project PI: Dr. Sharon Levy, MD, MPH

Project Investigator: Dr. Elissa Weitzman, ScD, MSc

Funder: Harvard Pilgrim Healthcare

Publication: Levy S, Evins AE, Schuster RM, et al. Virtual Group Therapy Programs-The Wave of the Future. J Adolesc Health. 2021;69(3):527. doi:10.1016/j.jadohealth.2021.05.018

Predictive Measures

Validating Adolescent Substance Use Measures

This project aimed to define and disseminate a set of brief and easy to administer measures to accurately detect substance use frequency and substance-specific patient centered outcomes among adolescent populations. We developed novel questions and validated them against criterion standard measures using self-administered electronic surveys.

Project Co-PIs: Dr. Elissa Weitzman, ScD, MSc; Dr. Sharon Levy, MD, MPH

Funder: Conrad N. Hilton Foundation

Publications:
Oliver AL, Kossowsky J, Minegishi M, Levy S, Weitzman ER. The Association of Vaping With Social/Emotional Health and Attitudes Toward COVID-19 Mitigation Measures in Adolescent and Young Adult Cohorts During the COVID-19 Pandemic. https://doi.org/101177/08897077231165860. Published online April 26, 2023. doi:10.1177/08897077231165860

Levy S, Weitzman ER, Marin AC, Magane KM, Wisk LE, Shrier LA. Sensitivity and specificity of S2BI for identifying alcohol and cannabis use disorders among adolescents presenting for primary care. Subst Abus. 2021;42(3):388-395. doi:10.1080/08897077.2020.1803180

Levy S, Weitzman ER. Building a Learning Marijuana Surveillance System. JAMA Pediatr. 2016;170(3):193-194. doi:10.1001/jamapediatrics.2015.3489

Presentations 

 

Marijuana-related beliefs in adolescents: Moving beyond perceived riskiness of marijuana use

  • Authors: Nicholas Chadi, MD, MPH; Sharon Levy, MD, MPH; Elissa Weitzman, ScD, MSc
  • Presented at: CPPD 2019

Associations among adolescent and young adult binge alcohol use and COVID-19 related exposures, impacts, and distress

  • Authors: Machiko Minegishi, MD, MPH; Sharon Levy, MD, MPH; Elissa R. Weitzman, ScD, MSc
  • Presented at: PAS 2022

Impact of the Coronavirus Disease 2019 Pandemic on Adolescent Alcohol Use Behaviors

  • Authors: Machiko Minegishi, MD, MPH; Alexandra Chretien, BA, MPH; Rachele Cox, BA, MPH; Sharon Levy, MD, MPH; Elissa R. Weitzman, ScD, MSc
  • Presented at:  SAHM 2022

Relationship between Covid-19 Impact and Instrumental Use of Marijuana in Youth with Chronic Medical Conditions

  • Authors: Joe Kossowsky, PhD, MMSc; Machiko Minegishi MD, MPH; Sharon Levy, MD, MPH; Elissa R. Weitzman, ScD, MSc
  • Presented at: SAHM 2022

Chronic Illness in Youth

Trial of a Novel Brief Intervention for Substance Use Among Youth with Chronic Medical Conditions

In this project, we developed and tested (in a set of randomized controlled trials) a set of measures of adolescent substance use and patient-centered intermediary outcomes and a brief, electronic self-administered intervention to reduce alcohol use among youth with chronic medical conditions. The intervention is patient-centered and draws on epidemiological and ethnographic research. The project rests on a framework that posits “four legs” of influence shaping youth outcomes – patient, parent, provider and policy.

Funder: Conrad N. Hilton Foundation

Project Co-PIs: Dr. Elissa Weitzman, ScD, MSc, Dr. Sharon Levy, MD, MPH

Publications:
Levy S, Wisk LE, Minegishi M, Lunstead J, Weitzman ER. Pediatric Subspecialist Alcohol Screening Rates and Concerns About Alcohol and Cannabis Use Among Their Adolescent Patients. J Adolesc Health. 2022;71(4S):S34-S40. doi:10.1016/j.jadohealth.2022.03.001

Weitzman ER, Wisk LE, Minegishi M, et al. Effects of a Patient-Centered Intervention to Reduce Alcohol Use Among Youth With Chronic Medical Conditions. J Adolesc Health. 2022;71(4S):S24-S33. doi:10.1016/j.jadohealth.2021.10.017

Kossowsky, J. Weitzman, ER. Instrumental Substance Use Among Youth with Rheumatic Disease—A Biopsychosocial Model. Rheum Dis Clin N Am. 2022;48(1):51-65.doi:10.1016/j.rdc.2021.08.003.

Kossowsky J, Magane KM, Levy S, Weitzman ER. Marijuana Use to Address Symptoms and Side Effects by Youth With Chronic Medical Conditions. Pediatrics. 2021 Mar;147(3):e2020021352. PMID: 33542147.

Weitzman ER, Salimian PK, Rabinow L, Levy S. Perspectives on substance use among youth with chronic medical conditions and implications for clinical guidance and prevention: A qualitative study. PLoS One. 2019;14(1):e0209963. Published 2019 Jan 23. doi:10.1371/journal.pone.0209963

Weitzman ER, Ziemnik RE, Huang Q, Levy S. Alcohol and Marijuana Use and Treatment Nonadherence Among Medically Vulnerable Youth. Pediatrics. 2015;136(3):450-457. doi:10.1542/peds.2015-0722

Weitzman ER, Magane KM, Wisk LE, Allario J, Harstad E, Levy S. Alcohol Use and Alcohol-Interactive Medications Among Medically Vulnerable Youth. Pediatrics. 2018;142(4):e20174026. doi:10.1542/peds.2017-4026

Wisk, L, Magane K, Levy S, Weitzman ER. Alcohol Use Behaviors and Reasons to Abstain From or Limit Drinking Among Medically Vulnerable Youth. J Addict Med. .Jul/Aug 2020;14(4):311-318. doi: 10.1097/ADM.0000000000000603.

Chadi N, Schizer M, Mountain-Ray S, Thakur A, Weitzman ER, Levy S. Co-occurring Substance Use Disorders in Youth With Chronic Medical Conditions: The Need for Integration of Addiction Treatment into Mainstream Medical Facilities. J Addict Med. 2020 May/Jun;14(3):261-263. doi: 10.1097/ADM.0000000000000557. PMID: 31403520.

Chadi N, Li G, Cerda N, Weitzman ER. Depressive Symptoms and Suicidality in Adolescents Using e-Cigarettes and Marijuana: A Secondary Data Analysis From the Youth Risk Behavior Survey. J Addict Med. 2019;13(5):362-365. doi:10.1097/ADM.0000000000000506

Presentations

Barriers and Beliefs Associated with Alcohol Use Screening Frequency by Pediatric Specialists

  • Authors: Kara M. Magane, MS, Lauren E. Wisk, PhD, Sharon Levy, MD, MPH, Elissa R. Weitzman, ScD, MSc
  • Presented at: PAS 2017

Pediatric specialists’ concerns regarding marijuana use among adolescent patients

  • Authors: Dylan Kaye, BA, Kara M. Magane, MS, Lauren E. Wisk, PhD, Sharon Levy, MD, MPH, Elissa R. Weitzman, ScD, MSc
  • Presented at: AMERSA 2017

Substance Use Screening and Brief Intervention: Tools for healthy and medically vulnerable teens

Alcohol use beliefs and behaviors of parents of medically vulnerable youth

  • Authors: Kara M. Magane, MS, Lauren E. Wisk, PhD, Adna Glusac, BA, Elissa R. Weitzman, ScD, MSc
  • Presented at: ICBM 2018

A randomized trial of a novel patient-centered preventive intervention to reduce alcohol use among medically vulnerable youth – confirming a theory of change

  • Authors: Elissa Weitzman, ScD, MSc, Lauren Wisk, PhD, Kara Magane, MS, Julie Lunstead, MS, Sharon Levy, MD, MPH
  • Presented at: ICBM 2018

Health Promotion in Transition: Effects of Web-Based Health Information on Disease Management and Alcohol Use for Youth with Type 1 Diabetes in College

In this project, we developed and tested (in a set of randomized controlled trials) a brief, electronic self-administered intervention to reduce alcohol use among youth with chronic medical conditions. The intervention is patient-centered, draws on epidemiological and ethnographic research, and clinical trials evaluated the impacts and effects of the intervention among college students with Type 1 diabetes.

Project Co-PIs: Dr. Elissa Weitzman, ScD, MSc; Dr. Lauren Wisk, PhD

Funder: Boston Children’s Hospital Research Faculty Council Pilot Award

Publications:
Tsevat RK, Weitzman ER, Wisk LE. Indicators of Healthcare Transitions Progress among College Youth with Type 1 Diabetes. Academic Pediatrics, 2022 Sep 3;(22)00423-5. PMID: 26067922.

Wisk LE, Magane KM, Nelson EB, Tsevat RK, Levy S, Weitzman ER. Psychoeducational Messaging to Reduce Alcohol Use for College Students with Type 1 diabetes: Results from an Internet-Delivered Pilot Trial. Journal of Medical Internet Research, 2021, Sep 30; 23(9):e26418. PMID: 34591022. 

Presentation

Substance Use, Self-Management, and HbA1c among College Students with Type 1 Diabetes

  • Authors: Lauren E. Wisk, PhD, Eliza B. Nelson, MPH, Kara M. Magane, MS, Elissa R. Weitzman, ScD, MSc
  • Presented at: PAS 2018

Developing Patient and Family Centered Approaches for Measuring and Improving Transition Readiness and Self-Efficacy

18 million U.S. adolescents, ages 18–21, are moving into adulthood and will need to transition from pediatric to adult-centered healthcare. Despite the recognized importance of a planned healthcare transition (HCT), particularly for youth with chronic medical conditions (YCMC), many youth are ill-prepared and/or unsuccessful in achieving a timely, high-quality HCT and there is no consensus on best practices for improving HCT. This lack of evidence-based models to support HCT subjects YCMC to gaps in medical care and adverse health outcomes as a result. To address this gap, this study’s overarching goal is to establish patient preferences for HCT models that can guide selection of effective HCT interventions. Identifying patient-centered interventions that address the most prominent HCT needs for YCMC stands to improving both clinical and patient-centered HCT outcomes.

Project PI: Dr. Elissa Weitzman, ScD, MSc

Funders: Academic Pediatric Association and Agency for Healthcare Research & Quality

Publications:
Sawicki GS, Kelemen S, Weitzman ER. Ready, Set, Stop: Mismatch Between Self-Care Beliefs, Transition Readiness Skills, and Transition Planning Among Adolescents, Young Adults, and Parents. Clinical Pediatrics. 2014;53(11):1062-1068. doi:10.1177/0009922814541169

Weitzman ER, Kaci L, Quinn M, Mandl KD. Helping high-risk youth move through high-risk periods: personally controlled health records for improving social and health care transitions. J Diabetes Sci Technol. 2011;5(1):47-54. Published 2011 Jan 1. doi:10.1177/193229681100500107

Weitzman ER, Kelemen S, Quinn M, Eggleston EM, Mandl KD. Participatory Surveillance of Hypoglycemia and Harms in an Online Social Network. JAMA Intern Med. 2013;173(5):345–351. doi:10.1001/jamainternmed.2013.2512

Secondary Data Analyses of Panel Study of Income Dynamics

This project involves retrospective analysis of an un-identifiable claims database from a nationwide US health insurance plan inclusive of at least 22.5 million youth members to measure their healthcare service utilization, substance use, psychosocial status, and health outcomes. We investigated trends in prevalence of substance use disorders and related problems among adolescents and young adults from 2008-2016, including examining these trends by gender. Furthermore, we estimated the odds that adolescents/young adults will experience alcohol- or other substance use-related events/problems, comparing risk for youth with and without a chronic medical condition. The project aimed to generate evidence of the prevalence, correlates and consequences for disease outcomes, health harms and healthcare cost of alcohol and other substance use problems among chronically ill adolescents/young adults. Results will provide a roadmap for clinical and system level interventions with potential to improve the health status of young people at risk from both substance use and chronic illness.

Project PI: Elissa Weitzman, ScD, MSc

Funder: None

Publications:
Wisk LE, Weitzman ER. Expectancy and Achievement Gaps in Educational Attainment and Subsequent Adverse Health Effects Among Adolescents With and Without Chronic Medical Conditions. J Adolesc Health. 2017;61(4):461-470. doi:10.1016/j.jadohealth.2017.04.006

Wisk LE, Weitzman ER. Substance use patterns through early adulthood: Results for youth with and without chronic conditions. Am J Prev Med. 2016;51(1):33-45. doi:10.1016/j.amepre.2016.01.029

Patient-Reported Outcomes: Quality of Life for Youth with Chronic Illness

The Learning Cohort: Collecting Patient Reported Outcomes from CARRA Registry Participants

This project engaged at least 400 CARRA Registry participants/caregivers (at least 100 patients at each of the 4 sites) in providing structured electronic patient-reported outcomes (PROs) on their health condition(s) including information needs, symptoms, medications, quality of life, and physical/social/emotional function around the time of a clinic visit. In a later phase of the study (estimated in study year 2) we provided participants with access to their own self-reported health data as well as summary data from the registry, in order to provide contextualizing information pertinent to a family’s healthcare experience.

Boston Children's Hospital was the coordinating center for this study. The four sites where patients of patient enrollment were Boston Children's Hospital, Hackensack University Medical Center, Seattle Children's Hospital, and University Hospital of Salt Lake City, Utah.

Project PI: Dr. Elissa Weitzman, ScD, MSc

Funder: National Library of Medicine

Publications:
Weitzman ER, Magane KM, Wisk LE. How Returning Aggregate Research Results Impacts Interest in Research Engagement and Planned Actions Relevant to Health Care Decision Making: Cohort Study. J Med Internet Res. 2018;20(12):e10647. Published 2018 Dec 21. doi:10.2196/10647

Weitzman ER, Wisk LE, Salimian PK, et al. Adding patient-reported outcomes to a multisite registry to quantify quality of life and experiences of disease and treatment for youth with juvenile idiopathic arthritis. J Patient Rep Outcomes. 2018;2:1. doi:10.1186/s41687-017-0025-2