Ridenour Ty A, Willis David, Bogen Debra L, Novak Scott, Scherer Jennifer, Reynolds Maureen D, Zhai Zu Wei, Tarter Ralph E
Research Triangle Institute, Research Triangle Park, NC, United States; University of Pittsburgh, Pittsburgh, PA, United States.
Health Resources and Services Administration, Rockville, MD, United States.
Drug Alcohol Depend. 2015 May 1;150:54-62. doi: 10.1016/j.drugalcdep.2015.02.013. Epub 2015 Mar 2.
Youth substance use (SU) is prevalent and costly, affecting mental and physical health. American Academy of Pediatrics and Affordable Care Act call for SU screening and prevention. The Youth Risk Index(©) (YRI) was tested as a screening tool for having initiated and propensity to initiate SU before high school (which forecasts SU disorder). YRI was hypothesized to have good to excellent psychometrics, feasibility and stakeholder acceptability for use during well-child check-ups.
A high-risk longitudinal design with two cross-sectional replication samples, ages 9-13 was used. Analyses included receiver operating characteristics and regression analyses.
A one-year longitudinal sample (N=640) was used for YRI derivation. Replication samples were a cross-sectional sample (N=345) and well-child check-up patients (N=105) for testing feasibility, validity and acceptability as a screening tool.
YRI has excellent test-retest reliability and good sensitivity and specificity for concurrent and one-year-later SU (odds ratios=7.44, CI=4.3-13.0) and conduct problems (odds ratios=7.33, CI=3.9-13.7). Results were replicated in both cross-sectional samples. Well-child patients, parents and pediatric staff rated YRI screening as important, acceptable, and a needed service.
Identifying at-risk youth prior to age 13 could reap years of opportunity to intervene before onset of SU disorder. Most results pertained to YRI's association with concurrent or recent past risky behaviors; further replication ought to specify its predictive validity, especially adolescent-onset risky behaviors. YRI well identifies youth at risk for SU and conduct problems prior to high school, is feasible and valid for screening during well-child check-ups, and is acceptable to stakeholders.
青少年物质使用（SU）普遍存在且代价高昂，会影响身心健康。美国儿科学会和《平价医疗法案》呼吁进行SU筛查和预防。青少年风险指数（©）（YRI）被作为一种筛查工具进行测试，用于筛查高中前开始使用物质的情况以及开始使用物质的倾向（这可预测物质使用障碍）。假设YRI在儿童健康检查期间具有良好至优异的心理测量学特性、可行性和利益相关者可接受性。
采用了一项针对9至13岁儿童的高风险纵向设计，并设有两个横断面重复样本。分析包括受试者工作特征分析和回归分析。
一个为期一年的纵向样本（N = 640）用于推导YRI。重复样本包括一个横断面样本（N = 345）和儿童健康检查患者（N = 105），用于测试作为筛查工具的可行性、有效性和可接受性。
YRI具有出色的重测信度，对于同时期和一年后的SU（优势比 = 7.44，CI = 4.3 - 13.0）以及行为问题（优势比 = 7.33，CI = ）具有良好的敏感性和特异性。结果在两个横断面样本中均得到重复。儿童健康检查患者、家长和儿科工作人员将YRI筛查评为重要、可接受且是一项必要的服务。
在13岁之前识别出有风险的青少年，可能会赢得在物质使用障碍发作之前进行多年干预的机会。大多数结果涉及YRI与同时期或近期危险行为的关联；进一步的重复研究应明确其预测效度，尤其是青少年期开始的危险行为。YRI能够很好地识别高中前有物质使用和行为问题风险的青少年，在儿童健康检查期间进行筛查是可行且有效的，并且为利益相关者所接受。
