Komro Kelli A, Livingston Melvin D, Kominsky Terrence K, Livingston Bethany J, Garrett Brady A, Molina Mildred Maldonado, Boyd Misty L
Institute for Child Health Policy, University of Florida, Gainesville, Florida.
Cherokee Nation Behavioral Health, Tahlequah, Oklahoma.
J Stud Alcohol Drugs. 2015 Jan;76(1):133-42.
American Indians (AIs) suffer from significant alcohol-related health disparities, and increased risk begins early. This study examined the reliability and validity of measures to be used in a preventive intervention trial. Reliability and validity across racial/ethnic subgroups are crucial to evaluate intervention effectiveness and promote culturally appropriate evidence-based practice.
To assess reliability and validity, we used three baseline surveys of high school students participating in a preventive intervention trial within the jurisdictional service area of the Cherokee Nation in northeastern Oklahoma. The 15-minute alcohol risk survey included 16 multi-item scales and one composite score measuring key proximal, primary, and moderating variables. Forty-four percent of the students indicated that they were AI (of whom 82% were Cherokee), including 23% who reported being AI only (n = 435) and 18% both AI and White (n = 352). Forty-seven percent reported being White only (n = 901).
Scales were adequately reliable for the full sample and across race/ethnicity defined by AI, AI/White, and White subgroups. Among the full sample, all scales had acceptable internal consistency, with minor variation across race/ethnicity. All scales had extensive to exemplary test-retest reliability and showed minimal variation across race/ethnicity. The eight proximal and two primary outcome scales were each significantly associated with the frequency of alcohol use during the past month in both the cross-sectional and the longitudinal models, providing support for both criterion validity and predictive validity. For most scales, interpretation of the strength of association and statistical significance did not differ between the racial/ethnic subgroups.
The results support the reliability and validity of scales of a brief questionnaire measuring risk and protective factors for alcohol use among AI adolescents, primarily members of the Cherokee Nation.
美国印第安人（AI）面临与酒精相关的严重健康差异，且风险增加始于早期。本研究检验了将用于预防性干预试验的测量方法的信度和效度。跨种族/族裔亚组的信度和效度对于评估干预效果以及促进符合文化背景的循证实践至关重要。
为评估信度和效度，我们使用了对俄克拉荷马州东北部切罗基族管辖服务区内参与预防性干预试验的高中生进行的三项基线调查。这份15分钟的酒精风险调查问卷包含16个多项目量表和一个综合得分，用于测量关键的近端、主要和调节变量。44%的学生表示他们是美国印第安人（其中82%是切罗基族），包括23%报告仅为美国印第安人的学生（n = 435）以及18%同时为美国印第安人和白人的学生（n = 352）。47%的学生报告仅为白人（n = 901）。
对于整个样本以及由美国印第安人、美国印第安人/白人及白人亚组定义的种族/族裔群体，各量表具有足够的信度。在整个样本中，所有量表都具有可接受的内部一致性，跨种族/族裔群体仅有微小差异。所有量表都具有广泛至典范的重测信度，且跨种族/族裔群体的差异极小。在横断面模型和纵向模型中，八个近端和两个主要结果量表均与过去一个月内的饮酒频率显著相关，为效标效度和预测效度提供了支持。对于大多数量表，种族/族裔亚组之间关联强度和统计显著性的解释并无差异。
结果支持了一份简短问卷量表对于测量美国印第安青少年（主要是切罗基族成员）酒精使用风险和保护因素的信度和效度。
