Alcohol screening and assessment measures for young people: A systematic review and meta-analysis of validation studies

Toner, Paul; Böhnke, Jan R.; Andersen, Phil; McCambridge, Jim

doi:10.1016/j.drugalcdep.2019.01.030

Cited by 31 publications

(38 citation statements)

References 55 publications

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“…This is lower than the only other UK validation study of the instrument (Khadjesari et al, 2017), but that study was of a younger average age sample of people seeking help for their drinking and used the previous UK recommended weekly consumption limits as a reference category (21 units for men and 14 for women). Findings for the sensitivity and specificity of the AUDIT-C are broadly comparable with those reported in systematic reviews of non-UK validation studies in young people (Toner et al, 2019), in primary care patients and in other clinical settings (Kriston et al, 2008;Reinert and Allen, 2007). However, these studies using a variety of reference categories have found lower optimal AUDIT-C cut-offs and greater differences for men and women than reported here (Kriston et al, 2008;Reinert and Allen, 2007).…”

Section: Discussionsupporting

confidence: 78%

Exploratory Validation Study of the Individual AUDIT-C Items among Older People

Stewart

Hewitt

McCambridge

2020

Alcohol and Alcoholism

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Aims The AUDIT-C is a brief and commonly used alcohol screening tool, with few data available on the relative validity of the three individual items in older adult populations. The aim of this study was to explore the validity of the AUDIT-C items in identifying unhealthy drinking among older people, with a view to developing a single-item screener. Methods A sample of 143 older adults (mean age = 71) were recruited from non-clinical settings in the UK. AUDIT-C scores were compared to an unhealthy drinking reference category of consuming more than the UK recommended weekly units of alcohol. Standard analyses were conducted for men and women, and for those prescribed medications for long term conditions. Results The AUDIT-C items performed well in identifying unhealthy drinking in this sample of older people, with generally high sensitivity, specificity and area under the ROC curve. No significant differences were found in the validity of the three items, though the combined sensitivity and specificity scores and ROC values for item 3 were consistently slightly lower than for items 1 and 2. The findings were similar for men and women, and for participants prescribed medications for long-term conditions. Conclusions AUDIT-C items 1 and 2 performed as well as item 3 in identifying unhealthy drinking among older people in this study. Both are reasonable single-item screener candidates, especially given relative ease of administration, with further validation study needed to examine psychometrics and how alcohol screening for older people can best be implemented in clinical settings.

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Section: Discussionsupporting

confidence: 78%

Exploratory Validation Study of the Individual AUDIT-C Items among Older People

Stewart

Hewitt

McCambridge

2020

Alcohol and Alcoholism

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“…The Cronbach alpha for the AUDIT-C has been reported to be 0.75 in the present setting, with a high test-retest reliability of 0.93 [26]. Toner and co-workers recently summarized studies assessing the AUDIT-C (and other instruments related to alcohol consumption) in young people, with an average sensitivity of 0.83, an average specificity of 0.70, and an average reliability of 0.92, and described this instrument as being at least promising as a brief screening tool for alcohol problems [27]. Other questions included gender, age, daily smoking and the number of days of exercise per week (3-7 days) for a typical week.…”

Section: Methodsmentioning

confidence: 80%

Problem Gambling in the Fitness World—A General Population Web Survey

Håkansson

Entezarjou

Kenttä

et al. 2020

IJERPH

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The world of sports has a complex association to problem gambling, and the sparse research examining problem gambling in athletes has suggested an increased prevalence and particularly high male predominance. The present study aimed to study frequency and correlates of problem gambling in populations with moderate to high involvement in fitness or physical exercise. This is a self-selective online survey focusing on addictive behaviors in physical exercise distributed by ‘fitness influencers’ on social media and other online fitness forums to their followers. Respondents were included if they reported exercise at least thrice weekly, were above 15 years of age, and provided informed consent (N = 3088). Problem gambling, measured with the Lie/Bet, was studied in association with demographic data, substance use, and mental health variables. The occurrence of lifetime problem gambling was 8 percent (12 percent in men, one percent in women). In logistic regression, problem gambling was associated with male gender, younger age, risky alcohol drinking, obsessive-compulsive disorder, and less frequent exercise habits. In conclusion, in this self-recruited population with moderate to high fitness involvement, problem gambling was moderately elevated. As shown previously in elite athletes, the male predominance was larger than in the general population. The findings strengthen the link between problem gambling and the world of sports.

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“…Further studies are needed to validate screening tools for ALHIV in low-and middle-income countries [53][54][55] and to develop evidence-based interventions for improving mental health and adherence in ALHIV affected by mental health problems.…”

Section: Discussionmentioning

confidence: 99%

“…We defined viral load at screening as the measurement taken closest to the date of screening, within hundred days before and one day after the screening. [44,45,47,[49][50][51][52][53][54][55][56][57][58][59]. However, none of the tools has been validated in South African ALHIV.…”

Section: Methodsmentioning

confidence: 99%

Mental health, substance use and viral suppression in adolescents receiving ART at a paediatric HIV clinic in South Africa

Haas

Technau

Pahad

et al. 2020

J. Intern. AIDS Soc.

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Introduction Mental health problems are prevalent in adolescents living with HIV (ALHIV), often remain untreated, and may negatively affect antiretroviral therapy (ART) adherence and viral suppression. We implemented routine mental health screening at a paediatric ART clinic to improve the identification and management of mental health problems in ALHIV. In this report, we examine screening outcomes, associated patient characteristics and the odds of unsuppressed viral load in ALHIV screening positive for mental disorders. Methods Adolescents aged 10 to 19 years attending Rahima Moosa Hospital in Johannesburg, South Africa between February 1, 2018, and January 1, 2020, were offered mental health screening at each routine HIV care visit. The screening included four pre‐screening questions followed by full screening (conditional on positive pre‐screening) for depression (Patient Health Questionnaire‐9 [PHQ‐9]), suicide (Adolescent Innovations Project [AIP]‐handbook), anxiety (Generalized Anxiety Disorder‐7 [GAD‐7]), post‐traumatic stress disorder (PTSD) (Primary Care PTSD Screen [PC‐PTSD‐5]) and substance use (CAGE Adapted to Include Drugs [CAGE‐AID]). We assessed screening outcomes and calculated adjusted odds ratios for associations between positive screening tests at the first screen and unsuppressed viral load (>400 copies/mL) at the measurement taken closest to the date of screening, within hundred days before and one day after screening. Results Out of 1203 adolescents who attended the clinic, 1088 (90.4%) were pre‐screened of whom 381 (35.0%) underwent full screening, 48 (4.4%) screened positive for depression (PHQ‐9 ≥10), 29 (2.8%) for suicidal concern, 24 (2.2%) for anxiety (GAD‐7 ≥10), 38 (3.2%) for PTSD (PC‐PTSD‐5 ≥3), 18 (1.7%) for substance use (CAGE‐AID ≥2) and 97 (8.9%) for any of these conditions. Positive screening for depression (aOR 2.39, 95% CI 1.02 to 5.62), PTSD (aOR 3.18, 95% CI 1.11 to 9.07), substance use (aOR 7.13, 95% CI 1.60 to 31.86), or any condition (aOR 2.17, 95% CI 1.17 to 4.02) were strongly associated with unsuppressed viral load. Conclusions ALHIV affected by mental health problems have increased rates of unsuppressed viral load and need specific clinical attention. The integration of routine mental health screening in paediatric ART programmes is a feasible approach for identifying and referring adolescents with mental health and adherence problems to counselling and psychosocial support services and if needed to psychiatric care.

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Alcohol screening and assessment measures for young people: A systematic review and meta-analysis of validation studies

Cited by 31 publications

References 55 publications

Exploratory Validation Study of the Individual AUDIT-C Items among Older People

Exploratory Validation Study of the Individual AUDIT-C Items among Older People

Problem Gambling in the Fitness World—A General Population Web Survey

Mental health, substance use and viral suppression in adolescents receiving ART at a paediatric HIV clinic in South Africa

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