一种用于指导有物质使用问题的青少年进行简短干预的临床工具。

A clinical instrument to guide brief interventions for adolescents with substance use concerns.

机构信息

a Division of Adolescent Medicine, Department of Pediatrics , University of New Mexico , Albuquerque , New Mexico , USA.

b Department of Family and Community Medicine , University of New Mexico , Albuquerque , New Mexico , USA.

出版信息

Subst Abus. 2018 Jan 2;39(1):110-115. doi: 10.1080/08897077.2017.1371659. Epub 2017 Sep 29.

DOI:10.1080/08897077.2017.1371659

PMID:28850302

Abstract

BACKGROUND

Adolescent substance use is an important public health problem in New Mexico and the United States. The New Mexico Department of Health school-based health centers (SBHCs) universally administer a validated screen, the CRAFFT (Car, Relax, Alone, Forget, Friends, Trouble), for adolescent substance use concerns; however, quality assurance efforts revealed that SBHC providers needed more information at the point of screening to initiate brief interventions for students with positive CRAFFT screens. The CHISPA (Cocaine, Heroin, IV drugs, Synthetic pot, Pot, Alcohol) was developed to gather specific information on recent substance use experience to guide brief interventions. This paper describes the development and initial reliability and validity of data obtained using the CHISPA instrument.

METHODS

In 2015, 99 high school-aged SBHC users in Albuquerque, New Mexico, completed the CRAFFT and CHISPA twice over 2 weeks using standard test-retest methods. Using the CHISPA, students reported for the prior 3 months substances used, frequency of use, and signs of addiction or acute danger (adverse events).

RESULTS

Retest reliability for the CRAFFT score was 0.82. CHISPA retest reliabilities were 0.75 for alcohol use; 0.91 for having used any substances; 0.92 for number of substances used; 0.81 for frequency of substance use; and 0.79 for number of adverse events. CRAFFT scores correlated with CHISPA measures of number of substances used at 0.62; with frequency of substance use at 0.58; and with number of adverse events at 0.64.

CONCLUSIONS

CHISPA measures show preliminary evidence of reliability and validity. SBHC providers and other providers in primary care settings who use the CRAFFT screen may benefit from using the CHISPA to define recent substance use experience to guide brief interventions for adolescents with substance use concerns. The CHISPA instrument is currently being tested in electronic form in selected SBHCs in the state of New Mexico.

摘要

背景

青少年物质使用是新墨西哥州和美国的一个重要公共卫生问题。新墨西哥州卫生署的学校保健中心（SBHC）普遍对青少年物质使用问题进行了经过验证的筛查，即 CRAFFT（汽车、放松、独处、遗忘、朋友、麻烦）；然而，质量保证工作表明，SBHC 提供者在筛查时需要更多信息，以便为 CRAFFT 筛查呈阳性的学生启动简短干预措施。CHISPA（可卡因、海洛因、IV 药物、合成大麻素、大麻、酒精）是为了收集关于最近物质使用经验的具体信息，以指导简短干预措施而开发的。本文描述了使用 CHISPA 仪器获得的数据的开发和初步可靠性和有效性。

方法

2015 年，新墨西哥州阿尔伯克基的 99 名高中生 SBHC 用户使用标准的测试-重测方法，在两周内两次完成 CRAFFT 和 CHISPA。使用 CHISPA，学生报告了过去 3 个月内使用的物质、使用频率以及成瘾或急性危险（不良事件）的迹象。

结果

CRAFFT 评分的重测信度为 0.82。CHISPA 的重测信度分别为：酒精使用 0.75；使用任何物质 0.91；使用的物质数量 0.92；物质使用频率 0.81；以及不良事件数量 0.79。CRAFFT 分数与 CHISPA 物质使用数量的测量值相关系数为 0.62；与物质使用频率相关系数为 0.58；与不良事件数量相关系数为 0.64。

结论

CHISPA 测量方法初步显示出可靠性和有效性的证据。使用 CRAFFT 筛查的 SBHC 提供者和其他初级保健环境中的提供者可能会受益于使用 CHISPA 来定义最近的物质使用经验，以指导有物质使用问题的青少年的简短干预措施。CHISPA 工具目前正在新墨西哥州的选定 SBHC 中以电子形式进行测试。