Levy Sharon, Dedeoglu Fatma, Gaffin Jonathan M, Garvey Katharine C, Harstad Elizabeth, MacGinnitie Andrew, Rufo Paul A, Huang Qian, Ziemnik Rosemary E, Wisk Lauren E, Weitzman Elissa R
Adolescent Substance Abuse Program, Division of Developmental Behavioral Pediatrics, Boston Children's Hospital, Boston, Massachusetts, United States of America.
Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, United States of America.
PLoS One. 2016 May 26;11(5):e0156240. doi: 10.1371/journal.pone.0156240. eCollection 2016.
In an effort to reduce barriers to screening for alcohol use in pediatric primary care, the National Institute on Alcoholism and Alcohol Abuse (NIAAA) developed a two-question Youth Alcohol Screening Tool derived from population-based survey data. It is unknown whether this screening tool, designed for use with general populations, accurately identifies risk among youth with chronic medical conditions (YCMC). This growing population, which comprises nearly one in four youth in the US, faces a unique constellation of drinking-related risks.
To validate the NIAAA Youth Alcohol Screening Tool in a population of YCMC, we performed a cross-sectional validation study with a sample of 388 youth ages 9-18 years presenting for routine subspecialty care at a large children's hospital for type 1 diabetes, persistent asthma, cystic fibrosis, inflammatory bowel disease, or juvenile idiopathic arthritis. Participants self-administered the NIAAA Youth Alcohol Screening Tool and the Diagnostic Interview Schedule for Children as a criterion standard measure of alcohol use disorders (AUD). Receiver operating curve analysis was used to determine cut points for identifying youth at moderate and highest risk for an AUD.
Nearly one third of participants (n = 118; 30.4%) reported alcohol use in the past year; 86.4% (106) of past year drinkers did not endorse any AUD criteria, 6.8% (n = 8) of drinkers endorsed a single criterion, and 6.8% of drinkers met criteria for an AUD. Using the NIAAA tool, optimal cut points found to identify youth at moderate and highest risk for an AUD were ≥ 6 and ≥12 drinking days in the past year, respectively.
The NIAAA Youth Alcohol Screening Tool is highly efficient for detecting alcohol use and discriminating disordered use among YCMC. This brief screen appears feasible for use in specialty care to ascertain alcohol-related risk that may impact adversely on health status and disease management.
为减少儿科初级保健中酒精使用筛查的障碍，美国国立酒精滥用与酒精中毒研究所（NIAAA）基于人群调查数据开发了一个包含两个问题的青少年酒精筛查工具。尚不清楚这个为普通人群设计的筛查工具能否准确识别患有慢性疾病的青少年（YCMC）中的风险。在美国，这一不断增长的人群占青少年总数的近四分之一，面临着一系列与饮酒相关的独特风险。
为在YCMC人群中验证NIAAA青少年酒精筛查工具，我们进行了一项横断面验证研究，样本为388名9至18岁的青少年，他们因1型糖尿病、持续性哮喘、囊性纤维化、炎症性肠病或青少年特发性关节炎在一家大型儿童医院接受常规专科护理。参与者自行填写NIAAA青少年酒精筛查工具，并使用儿童诊断访谈表作为酒精使用障碍（AUD）的标准测量方法。采用受试者工作特征曲线分析来确定识别AUD中度和高风险青少年的切点。
近三分之一的参与者（n = 118；30.4%）报告在过去一年中有饮酒行为；过去一年饮酒者中86.4%（106人）未认可任何AUD标准，6.8%（n = 8）的饮酒者认可一项标准，6.8%的饮酒者符合AUD标准。使用NIAAA工具，发现识别AUD中度和高风险青少年的最佳切点分别为过去一年中饮酒天数≥6天和≥12天。
NIAAA青少年酒精筛查工具在检测YCMC中的酒精使用和区分紊乱使用方面效率很高。这个简短的筛查在专科护理中用于确定可能对健康状况和疾病管理产生不利影响的酒精相关风险似乎是可行的。
