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Title: The alcohol, smoking and substance involvement screening test (ASSIST): development, reliability and feasibility
Authors: Ali, Robert
Awwad, Elia
Babor, Thomas
Bradley, Fiona
Butau, Tecla
Farrell, Michael
Souza-Formigoni, Maria Lucia Oliveira de [UNIFESP]
Isralowitz, Richard
Lacerda, Roseli Boerngen de [UNIFESP]
Marsden, John
McRee, Bonnie
Monteiro, Maristela
Pal, Hemraj
Rubio-Stipec, Maritza
Vendetti, Janice
WHO ASSIST Working Grp
Univ Connecticut
Drug & Alcohol Addict Serv Council
Univ Fed Parana
Univ Dublin Trinity Coll
Univ Zimbabwe
Natl Addict Ctr
Universidade Federal de São Paulo (UNIFESP)
Ben Gurion Univ Negev
All India Inst Med Sci
Univ Puerto Rico
Keywords: alcohol
screening test
Issue Date: 1-Sep-2002
Publisher: Blackwell Publishing Ltd
Citation: Addiction. Oxford: Blackwell Publishing Ltd, v. 97, n. 9, p. 1183-1194, 2002.
Abstract: Aims The Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) was developed for the World Health Organization (WHO) by an international group of substance abuse researchers to detect psychoactive substance use and related problems in primary care patients. This report describes the new instrument as well as a study of its reliability and feasibility.Setting The study was conducted at participating sites in Australia, Brazil, Ireland, India, Israel, the Palestinian Territories, Puerto Rico, the United Kingdom and Zimbabwe. Sixty per cent of the sample was recruited from alcohol and drug abuse treatment facilities: the remainder was drawn from general medical settings and psychiatric facilities.Methods The study was concerned primarily with test item reliability, using a simple test-retest procedure to determine whether subjects would respond consistently to the same items when presented in an interview format on two different occasions. Qualitative and quantitative data were also collected to evaluate the feasibility of the screening items and rating format.Participants A total of 236 volunteer participants completed test and retest interviews at nine collaborating sites. Slightly over half of the sample (53.6%) was male. The mean age of the sample was 34 years and they had completed, on average, 10 years of education.Results The average test-retest reliability coefficients (kappas) ranged from a high of 0.90 (consistency of reporting 'ever' use of substance) to a low of 0.58 (regretted what was done under influence of substance). The average kappas for substance classes ranged from 0.61 for sedatives to 0.78 for opioids. In general, the reliabilities were in the range of good to excellent, with the following items demonstrating the highest kappas across all drug classes: use in the last 3 months, preoccupied with drug use, concern expressed by others, troubled by problems related to drug use, intravenous drug use. Qualitative data collected at the end of the retest interview suggested that the questions were not difficult to answer and were consistent with patients' expectations for a health interview. The data were used to guide the selection of a smaller set of items that can serve as the basis for more extensive validation research.Conclusion The ASSIST items are reliable and feasible to use as part of an international screening test. Further evaluation of the screening test should be conducted.
ISSN: 0965-2140
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