Blair Alden Hooper, Pearce Margo Ellen, Katamba Achilles, Malamba Samuel S, Muyinda Herbert, Schechter Martin T, Spittal Patricia M
School of Population and Public Health, University of British Columbia, 2206 East Mall Drive, Vancouver, British Columbia, V6T 1Z9 Canada.
Global Health Sciences Program, University of California San Francisco, 550 16th Street, Third Floor, San Francisco, CA 94158, USA.
Alcohol Alcohol. 2017 May 1;52(3):318-327. doi: 10.1093/alcalc/agw090.
Despite increased use of the Alcohol Use Disorders Identification Test (AUDIT) in sub-Saharan Africa, few studies have assessed its underlying conceptual framework, and none have done so in post-conflict settings. Further, significant inconsistencies exist between definitions used for problematic consumption. Such is the case in Uganda, facing one of the highest per-capita alcohol consumption levels regionally, which is thought to be hindering rebuilding in the North after two decades of civil war. This study explores the impact of varying designation cutoff thresholds in the AUDIT as well as its conceptual factor structure in a representative sample of the population.
In all, 1720 Cango Lyec Project participants completed socio-economic and mental health questionnaires, provided blood samples and took the AUDIT. Participant characteristics and consumption designations were compared at AUDIT summary score thresholds of ≥3, ≥5 and ≥8. Confirmatory factor analyses (CFA) explored one-, two- and three-factor level models overall and by sex with relative and absolute fit indicators.
There were no significant differences in participant demographic characteristics between thresholds. At higher cutoffs, the test increased in specificity to identify those with hazardous drinking, disordered drinking and suffering from alcohol-related harms. All conceptual models indicated good fit, with three-factor models superior overall and within both sexes.
In Northern Uganda, a three-factor AUDIT model best explores alcohol use in the population and is appropriate for use in both sexes. Lower cutoff thresholds are recommended to identify those with potentially disordered drinking to best plan effective interventions and treatments.
A CFA of the AUDIT showed good fit for one-, two, and three-factor models overall and by sex in a representative sample in post-conflict Northern Uganda. A three-plus total AUDIT cutoff score is suggested to screen for hazardous drinking in this or similar populations.
尽管在撒哈拉以南非洲地区，酒精使用障碍识别测试（AUDIT）的使用有所增加，但很少有研究评估其潜在的概念框架，且在冲突后环境中尚无此类研究。此外，对于问题饮酒的定义存在显著不一致。乌干达就是如此，该国面临着该地区人均酒精消费水平最高的情况之一，这被认为阻碍了北部地区在内战二十年之后的重建。本研究探讨了在AUDIT中不同指定临界值的影响及其在具有代表性的人群样本中的概念性因素结构。
共有1720名坎戈·莱克项目参与者完成了社会经济和心理健康问卷，提供了血样并进行了AUDIT测试。在AUDIT总分阈值≥3、≥5和≥8时，比较了参与者特征和饮酒指定情况。验证性因素分析（CFA）总体上以及按性别通过相对和绝对拟合指标探索了单因素、双因素和三因素水平模型。
各阈值之间参与者的人口统计学特征无显著差异。在较高的临界值时，该测试识别有害饮酒、紊乱饮酒和遭受酒精相关危害者的特异性增加。所有概念模型均显示拟合良好，三因素模型总体上以及在男女两性中均表现更优。
在乌干达北部，三因素AUDIT模型最能探究人群中的酒精使用情况，且适用于男女两性。建议采用较低的临界值来识别那些可能存在紊乱饮酒的人，以便更好地规划有效的干预措施和治疗方法。
对AUDIT进行的验证性因素分析表明，在冲突后的乌干达北部代表性样本中，单因素、双因素和三因素模型总体上以及按性别均拟合良好。建议采用AUDIT总分≥3的临界值来筛查此类或类似人群中的有害饮酒情况。
