Skip to main content
Top
Published in: BMC Public Health 1/2013

Open Access 01-12-2013 | Research article

Comparing short versions of the AUDIT in a community-based survey of young people

Authors: Anna L Bowring, Maelenn Gouillou, Margaret Hellard, Paul Dietze

Published in: BMC Public Health | Issue 1/2013

Login to get access

Abstract

Background

The 10-item Alcohol Use Disorders Identification Test (AUDIT-10) is commonly used to monitor harmful alcohol consumption among high-risk groups, including young people. However, time and space constraints have generated interest for shortened versions. Commonly used variations are the AUDIT-C (three questions) and the Fast Alcohol Screening Test (FAST) (four questions), but their utility in screening young people in non-clinical settings has received little attention.

Methods

We examined the performance of established and novel shortened versions of the AUDIT in relation to the full AUDIT-10 in a community-based survey of young people (16–29 years) attending a music festival in Melbourne, Australia (January 2010).
Among those reporting drinking alcohol in the previous 12 months, the following statistics were systematically assessed for all possible combinations of three or four AUDIT items and established AUDIT variations: Cronbach’s alpha (internal consistency), variance explained (R2) and Pearson’s correlation coefficient (concurrent validity). For our purposes, novel shortened AUDIT versions considered were required to represent all three AUDIT domains and include item 9 on alcohol-related injury.

Results

We recruited 640 participants (68% female) reporting drinking in the previous 12 months. Median AUDIT-10 score was 10 in males and 9 in females, and 127 (20%) were classified as having at least high-level alcohol problems according to WHO classification.
The FAST scored consistently high across statistical measures; it explained 85.6% of variance in AUDIT-10, correlation with AUDIT-10 was 0.92, and Cronbach’s alpha was 0.66. A number of novel four-item AUDIT variations scored similarly high. Comparatively, the AUDIT-C scored substantially lower on all measures except internal consistency.

Conclusions

Numerous abbreviated variations of the AUDIT may be a suitable alternative to the AUDIT-10 for classifying high-level alcohol problems in a community-based population of young Australians. Four-item AUDIT variations scored more consistently high across all evaluated statistics compared to three-item combinations. Novel AUDIT versions may be more effective than many established shortened versions as an alternative screening tool to the AUDIT-10 to measure hazardous or harmful alcohol consumption in this population.
Literature
1.
go back to reference Livingston M, Room R: Variations by age and sex in alcohol-related problematic behaviour per drinking volume and heavier drinking occasion. Drug Alcohol Depen. 2009, 101 (3): 169-175. 10.1016/j.drugalcdep.2008.12.014.CrossRef Livingston M, Room R: Variations by age and sex in alcohol-related problematic behaviour per drinking volume and heavier drinking occasion. Drug Alcohol Depen. 2009, 101 (3): 169-175. 10.1016/j.drugalcdep.2008.12.014.CrossRef
2.
go back to reference NHMRC: Australian Guidelines to Reduce Health Risks from Drinking Alcohol. 2009, Canberra: Department of Health and Ageing NHMRC: Australian Guidelines to Reduce Health Risks from Drinking Alcohol. 2009, Canberra: Department of Health and Ageing
3.
go back to reference Bonomo YA, Bowes G, Coffey C, Carlin JB, Patton GC: Teenage drinking and the onset of alcohol dependence: a cohort study over seven years. Addiction. 2004, 99: 1520-1528. 10.1111/j.1360-0443.2004.00846.x.CrossRefPubMed Bonomo YA, Bowes G, Coffey C, Carlin JB, Patton GC: Teenage drinking and the onset of alcohol dependence: a cohort study over seven years. Addiction. 2004, 99: 1520-1528. 10.1111/j.1360-0443.2004.00846.x.CrossRefPubMed
4.
go back to reference Meyers P: Victorian Youth Alcohol and Drug Survey, 2009. Final Report. Commissioned by the Victorian Drug and Alcohol Prevention Council for the Department of Health. 2010, Melbourne: Social Research Centre Meyers P: Victorian Youth Alcohol and Drug Survey, 2009. Final Report. Commissioned by the Victorian Drug and Alcohol Prevention Council for the Department of Health. 2010, Melbourne: Social Research Centre
5.
go back to reference Saunders JB, Aasland OG, Babor TF, De La Fuente JR, Grant M: Development of the Alcohol Use Disorders Identification Test (AUDIT): WHO Collaborative Project on Early Detection of Persons with Harmful Alcohol Consumption-II. Blackwell Publishing Ltd. 1993, 88: 791-804. Saunders JB, Aasland OG, Babor TF, De La Fuente JR, Grant M: Development of the Alcohol Use Disorders Identification Test (AUDIT): WHO Collaborative Project on Early Detection of Persons with Harmful Alcohol Consumption-II. Blackwell Publishing Ltd. 1993, 88: 791-804.
6.
go back to reference Babor T, Higgins-Biddle J, Saunders J, Monteiro M: The Alcohol Use Disorders Identification Test: Guidelines for use in primary care, 2nd edn. 2001, Geneva: World Health Organization, Department of Mental Health and Substance Dependence Babor T, Higgins-Biddle J, Saunders J, Monteiro M: The Alcohol Use Disorders Identification Test: Guidelines for use in primary care, 2nd edn. 2001, Geneva: World Health Organization, Department of Mental Health and Substance Dependence
7.
go back to reference Aalto M, Alho H, Halme JT, Seppa K: AUDIT and its abbreviated versions in detecting heavy and binge drinking in a general population survey. Drug Alcohol Depend. 2009, 103 (1–2): 25-29.CrossRefPubMed Aalto M, Alho H, Halme JT, Seppa K: AUDIT and its abbreviated versions in detecting heavy and binge drinking in a general population survey. Drug Alcohol Depend. 2009, 103 (1–2): 25-29.CrossRefPubMed
8.
go back to reference Rumpf H, Hapke U, Meyer C, John U: Screening for alcohol use disorders and at-risk drinking in the general population: psychometric performance of three questionnaires. Alcohol Alcohol. 2002, 37 (3): 261-10.1093/alcalc/37.3.261.CrossRefPubMed Rumpf H, Hapke U, Meyer C, John U: Screening for alcohol use disorders and at-risk drinking in the general population: psychometric performance of three questionnaires. Alcohol Alcohol. 2002, 37 (3): 261-10.1093/alcalc/37.3.261.CrossRefPubMed
9.
go back to reference Reinert DF, Allen JP: The alcohol use disorders identification test: an update of research findings. Alcohol Clin Exp Re. 2007, 31 (2): 185-199. 10.1111/j.1530-0277.2006.00295.x.CrossRef Reinert DF, Allen JP: The alcohol use disorders identification test: an update of research findings. Alcohol Clin Exp Re. 2007, 31 (2): 185-199. 10.1111/j.1530-0277.2006.00295.x.CrossRef
10.
go back to reference Kriston L, Hölzel L, Weiser A-K, Berner MM, Härter M: Meta-analysis: Are 3 Questions Enough to Detect Unhealthy Alcohol Use?. Ann Intern Med. 2008, 149 (12): 879-888. 10.7326/0003-4819-149-12-200812160-00007.CrossRefPubMed Kriston L, Hölzel L, Weiser A-K, Berner MM, Härter M: Meta-analysis: Are 3 Questions Enough to Detect Unhealthy Alcohol Use?. Ann Intern Med. 2008, 149 (12): 879-888. 10.7326/0003-4819-149-12-200812160-00007.CrossRefPubMed
11.
go back to reference Gordon AJ, Maisto SA, McNeil M, Kraemer KL, Conigliaro RL, Kelley ME, Conigliaro J: Three questions can detect hazardous drinkers. J Fam Pract. 2001, 50 (4): 313-320.PubMed Gordon AJ, Maisto SA, McNeil M, Kraemer KL, Conigliaro RL, Kelley ME, Conigliaro J: Three questions can detect hazardous drinkers. J Fam Pract. 2001, 50 (4): 313-320.PubMed
12.
go back to reference Gual A, Segura L, Contel M, Heather N, Colom J: Audit-3 and audit-4: effectiveness of two short forms of the alcohol use disorders identification test. Alcohol Alcohol. 2002, 37 (6): 591-596. 10.1093/alcalc/37.6.591.CrossRefPubMed Gual A, Segura L, Contel M, Heather N, Colom J: Audit-3 and audit-4: effectiveness of two short forms of the alcohol use disorders identification test. Alcohol Alcohol. 2002, 37 (6): 591-596. 10.1093/alcalc/37.6.591.CrossRefPubMed
13.
go back to reference Hodgson R, Alwyn T, John B, Thom B, Smith A: The FAST alcohol screening test. Alcohol Alcohol. 2002, 37 (1): 61-10.1093/alcalc/37.1.61.CrossRefPubMed Hodgson R, Alwyn T, John B, Thom B, Smith A: The FAST alcohol screening test. Alcohol Alcohol. 2002, 37 (1): 61-10.1093/alcalc/37.1.61.CrossRefPubMed
14.
go back to reference Bush K, Kivlahan DR, McDonell MB, Fihn SD, Bradley KA: The Ambulatory Care Quality Improvement Project: The AUDIT Alcohol Consumption Questions (AUDIT-C): An Effective Brief Screening Test for Problem Drinking. Arch Intern Med. 1998, 158 (16): 1789-1795. 10.1001/archinte.158.16.1789.CrossRefPubMed Bush K, Kivlahan DR, McDonell MB, Fihn SD, Bradley KA: The Ambulatory Care Quality Improvement Project: The AUDIT Alcohol Consumption Questions (AUDIT-C): An Effective Brief Screening Test for Problem Drinking. Arch Intern Med. 1998, 158 (16): 1789-1795. 10.1001/archinte.158.16.1789.CrossRefPubMed
15.
go back to reference Aertgeerts B, Buntinx F, Ansoms S, Fevery J: Screening properties of questionnaires and laboratory tests for the detection of alcohol abuse or dependence in a general practice population. Br J Gen Pract. 2001, 51 (464): 206-217.PubMedPubMedCentral Aertgeerts B, Buntinx F, Ansoms S, Fevery J: Screening properties of questionnaires and laboratory tests for the detection of alcohol abuse or dependence in a general practice population. Br J Gen Pract. 2001, 51 (464): 206-217.PubMedPubMedCentral
16.
go back to reference Bradley KA, Bush KR, Epler AJ, Dobie DJ, Davis TM, Sporleder JL, Maynard C, Burman ML, Kivlahan DR: Two brief alcohol-screening tests From the Alcohol Use Disorders Identification Test (AUDIT): validation in a female Veterans Affairs patient population. Arch Intern Med. 2003, 163 (7): 821-829. 10.1001/archinte.163.7.821.CrossRefPubMed Bradley KA, Bush KR, Epler AJ, Dobie DJ, Davis TM, Sporleder JL, Maynard C, Burman ML, Kivlahan DR: Two brief alcohol-screening tests From the Alcohol Use Disorders Identification Test (AUDIT): validation in a female Veterans Affairs patient population. Arch Intern Med. 2003, 163 (7): 821-829. 10.1001/archinte.163.7.821.CrossRefPubMed
17.
go back to reference Meneses-Gaya C, Zuardi AW, Loureiro SR, Hallak JEC, Trzesniak C, De Azevedo Marques JM, Machado-de-Sousa JP, Chagas MHN, Souza RM, Crippa JAS: Is the Full Version of the AUDIT Really Necessary? Study of the Validity and Internal Construct of Its Abbreviated Versions. Alcohol Clin Exp Re. 2010, 34 (8): 1417-1424. Meneses-Gaya C, Zuardi AW, Loureiro SR, Hallak JEC, Trzesniak C, De Azevedo Marques JM, Machado-de-Sousa JP, Chagas MHN, Souza RM, Crippa JAS: Is the Full Version of the AUDIT Really Necessary? Study of the Validity and Internal Construct of Its Abbreviated Versions. Alcohol Clin Exp Re. 2010, 34 (8): 1417-1424.
18.
go back to reference Chung T, Colby SM, Barnett NP, Rohsenow DJ, Spirito A, Monti PM: Screening Adolescents for Problem Drinking: Performance of Brief Screens against DSM-IV Alcohol Diagnoses(*).(Statistical Data Included). J Stud Alcohol. 2000, 61 (4): 579-CrossRefPubMed Chung T, Colby SM, Barnett NP, Rohsenow DJ, Spirito A, Monti PM: Screening Adolescents for Problem Drinking: Performance of Brief Screens against DSM-IV Alcohol Diagnoses(*).(Statistical Data Included). J Stud Alcohol. 2000, 61 (4): 579-CrossRefPubMed
19.
go back to reference Dawson DA, Grant BF, Stinson FS, Zhou Y: Effectiveness of the Derived Alcohol Use Disorders Identification Test (AUDIT-C) in Screening for Alcohol Use Disorders and Risk Drinking in the US General Population. Alcohol Clin Exp Re. 2005, 29 (5): 844-854. 10.1097/01.ALC.0000164374.32229.A2.CrossRef Dawson DA, Grant BF, Stinson FS, Zhou Y: Effectiveness of the Derived Alcohol Use Disorders Identification Test (AUDIT-C) in Screening for Alcohol Use Disorders and Risk Drinking in the US General Population. Alcohol Clin Exp Re. 2005, 29 (5): 844-854. 10.1097/01.ALC.0000164374.32229.A2.CrossRef
20.
go back to reference Bradley KA, DeBenedetti AF, Volk RJ, Williams EC, Frank D, Kivlahan DR: AUDIT-C as a Brief Screen for Alcohol Misuse in Primary Care. Alcohol Clin Exp Re. 2007, 31 (7): 1208-1217. 10.1111/j.1530-0277.2007.00403.x.CrossRef Bradley KA, DeBenedetti AF, Volk RJ, Williams EC, Frank D, Kivlahan DR: AUDIT-C as a Brief Screen for Alcohol Misuse in Primary Care. Alcohol Clin Exp Re. 2007, 31 (7): 1208-1217. 10.1111/j.1530-0277.2007.00403.x.CrossRef
21.
go back to reference Kelly TM, Donovan JE, Chung T, Bukstein OG, Cornelius JR: Brief screens for detecting alcohol use disorder among 18–20 year old young adults in emergency departments: Comparing AUDIT-C, CRAFFT, RAPS4-QF, FAST, RUFT-Cut, and DSM-IV 2-Item Scale. Addict Behav. 2009, 34 (8): 668-674. 10.1016/j.addbeh.2009.03.038.CrossRefPubMedPubMedCentral Kelly TM, Donovan JE, Chung T, Bukstein OG, Cornelius JR: Brief screens for detecting alcohol use disorder among 18–20 year old young adults in emergency departments: Comparing AUDIT-C, CRAFFT, RAPS4-QF, FAST, RUFT-Cut, and DSM-IV 2-Item Scale. Addict Behav. 2009, 34 (8): 668-674. 10.1016/j.addbeh.2009.03.038.CrossRefPubMedPubMedCentral
22.
go back to reference Aertgeerts B, Buntinx F, Bande-Knops J, Vanderrneulen C, Roelants M, Ansoms S, Fevery J: The Value of CAGE, CUGE, and AUDIT in Screening for Alcohol Abuse and Dependence Among College Freshmen. Alcohol Clin Exp Re. 2000, 24 (1): 53-57. 10.1111/j.1530-0277.2000.tb04553.x.CrossRef Aertgeerts B, Buntinx F, Bande-Knops J, Vanderrneulen C, Roelants M, Ansoms S, Fevery J: The Value of CAGE, CUGE, and AUDIT in Screening for Alcohol Abuse and Dependence Among College Freshmen. Alcohol Clin Exp Re. 2000, 24 (1): 53-57. 10.1111/j.1530-0277.2000.tb04553.x.CrossRef
23.
go back to reference Demartini K, Carey K: Correlates of AUDIT risk status for male and female college students. J Am Coll Health. 2009, 58 (3): 233-239. 10.1080/07448480903295342.CrossRefPubMed Demartini K, Carey K: Correlates of AUDIT risk status for male and female college students. J Am Coll Health. 2009, 58 (3): 233-239. 10.1080/07448480903295342.CrossRefPubMed
24.
go back to reference Fleming MF, Barry KL, Macdonald R: The Alcohol Use Disorders Identification Test (AUDIT) in a College Sample. Subst Use Misuse. 1991, 26 (11): 1173-1185. 10.3109/10826089109062153. Fleming MF, Barry KL, Macdonald R: The Alcohol Use Disorders Identification Test (AUDIT) in a College Sample. Subst Use Misuse. 1991, 26 (11): 1173-1185. 10.3109/10826089109062153.
25.
go back to reference Demartini KS, Carey KB: Optimizing the use of the AUDIT for alcohol screening in college students. Psychol Assess. 2012, 24 (4): 954-963.CrossRefPubMed Demartini KS, Carey KB: Optimizing the use of the AUDIT for alcohol screening in college students. Psychol Assess. 2012, 24 (4): 954-963.CrossRefPubMed
26.
go back to reference Dawson DA, Pulay AJ, Grant BF: A comparison of two single-item screeners for hazardous drinking and alcohol use disorder. Alcohol Clin Exp Res. 2010, 34 (2): 364-374. 10.1111/j.1530-0277.2009.01098.x.CrossRefPubMed Dawson DA, Pulay AJ, Grant BF: A comparison of two single-item screeners for hazardous drinking and alcohol use disorder. Alcohol Clin Exp Res. 2010, 34 (2): 364-374. 10.1111/j.1530-0277.2009.01098.x.CrossRefPubMed
27.
go back to reference Lim MSC, Hellard ME, Aitken CK, Hocking JS: Surveillance of STI risk behaviour among young people attending a music festival in Australia, 2005–08. Aust N Z J Public Health. 2009, 33: 482-484. 10.1111/j.1753-6405.2009.00434.x.CrossRefPubMed Lim MSC, Hellard ME, Aitken CK, Hocking JS: Surveillance of STI risk behaviour among young people attending a music festival in Australia, 2005–08. Aust N Z J Public Health. 2009, 33: 482-484. 10.1111/j.1753-6405.2009.00434.x.CrossRefPubMed
28.
go back to reference Lim MSC, Hellard ME, Hocking JS, Spelman TD, Aitken CK: Surveillance of drug use among young people attending a music festival in Australia, 2005–2008. Drug Alcohol Rev. 2010, 29 (2): 150-156.CrossRefPubMed Lim MSC, Hellard ME, Hocking JS, Spelman TD, Aitken CK: Surveillance of drug use among young people attending a music festival in Australia, 2005–2008. Drug Alcohol Rev. 2010, 29 (2): 150-156.CrossRefPubMed
29.
go back to reference Lim MSC, Hellard ME, Aitken CK, Hocking JS: Sexual-risk behaviour, self-perceived risk and knowledge of sexually transmissible infections among young Australians attending a music festival. Sex Health. 2007, 4 (1): 51-56. 10.1071/SH06031.CrossRefPubMed Lim MSC, Hellard ME, Aitken CK, Hocking JS: Sexual-risk behaviour, self-perceived risk and knowledge of sexually transmissible infections among young Australians attending a music festival. Sex Health. 2007, 4 (1): 51-56. 10.1071/SH06031.CrossRefPubMed
30.
go back to reference Patrick D, Andrew M: Safe, familiar but big crowd still enjoys rocking day out. 2010, Melbourne, Australia: The Age, 5-1 Patrick D, Andrew M: Safe, familiar but big crowd still enjoys rocking day out. 2010, Melbourne, Australia: The Age, 5-1
31.
go back to reference Bowring AL, Gold J, Dietze P, Gouillou M, Van Gemert C, Hellard ME: Know your limits: Awareness of the 2009 Australian alcohol guidelines among young people. Drug Alcohol Rev. 2012, 31 (2): 213-223. 10.1111/j.1465-3362.2011.00409.x.CrossRefPubMed Bowring AL, Gold J, Dietze P, Gouillou M, Van Gemert C, Hellard ME: Know your limits: Awareness of the 2009 Australian alcohol guidelines among young people. Drug Alcohol Rev. 2012, 31 (2): 213-223. 10.1111/j.1465-3362.2011.00409.x.CrossRefPubMed
32.
go back to reference StataCorp: Stata Statistical Software: Release 11. 2009, College Station, TX: StataCorp LP StataCorp: Stata Statistical Software: Release 11. 2009, College Station, TX: StataCorp LP
33.
go back to reference Chikritzhs TN, Pascal R: National Alcohol Indicators: Bulletin No 6. Trends in Youth Alcohol Consumption and Related Harms in Australian Jurisdictions, 1990–2002. 2004, Perth, Australia: National Drug Research Institute Chikritzhs TN, Pascal R: National Alcohol Indicators: Bulletin No 6. Trends in Youth Alcohol Consumption and Related Harms in Australian Jurisdictions, 1990–2002. 2004, Perth, Australia: National Drug Research Institute
34.
go back to reference Australian Bureau of Statistics: Australian Standard Geographical Classification (ASGC) Remoteness Areas (cat. no. 1216.0). 2006, Canberra: Australian Bureau of Statistics Australian Bureau of Statistics: Australian Standard Geographical Classification (ASGC) Remoteness Areas (cat. no. 1216.0). 2006, Canberra: Australian Bureau of Statistics
36.
go back to reference Allen J: Assessing Alcohol Problems: A Guide for Clinicians and Researchers. In. 1995, Bethesda, MD: National Institute on Alcohol Abuse and Alcoholism Allen J: Assessing Alcohol Problems: A Guide for Clinicians and Researchers. In. 1995, Bethesda, MD: National Institute on Alcohol Abuse and Alcoholism
37.
go back to reference McCambridge J, Thomas BA: Short forms of the AUDIT in a Web-based study of young drinkers. Drug Alcohol Rev. 2009, 28 (1): 18-24. 10.1111/j.1465-3362.2008.00010.x.CrossRefPubMed McCambridge J, Thomas BA: Short forms of the AUDIT in a Web-based study of young drinkers. Drug Alcohol Rev. 2009, 28 (1): 18-24. 10.1111/j.1465-3362.2008.00010.x.CrossRefPubMed
38.
go back to reference Mundt MP, Zakletskaia LI: Brown DD. 2011, Fleming MF: Alcohol-induced memory blackouts as an indicator of injury risk among college drinkers. Inj Prev Mundt MP, Zakletskaia LI: Brown DD. 2011, Fleming MF: Alcohol-induced memory blackouts as an indicator of injury risk among college drinkers. Inj Prev
39.
go back to reference Lim MSC, Aitken C, Hocking J, Hellard M: Discrepancies between young people’s self-reported sexual experience and their perceptions of ‘normality’. Sex Health. 2009, 6 (2): 171-172. 10.1071/SH09001.CrossRefPubMed Lim MSC, Aitken C, Hocking J, Hellard M: Discrepancies between young people’s self-reported sexual experience and their perceptions of ‘normality’. Sex Health. 2009, 6 (2): 171-172. 10.1071/SH09001.CrossRefPubMed
40.
go back to reference Lim MSC, Hellard ME, Hocking JS, Aitken CK: A cross-sectional survey of young people attending a music festival: associations between drug use and musical preference. Drug Alcohol Rev. 2008, 27 (4): 439-441. 10.1080/09595230802089719.CrossRefPubMed Lim MSC, Hellard ME, Hocking JS, Aitken CK: A cross-sectional survey of young people attending a music festival: associations between drug use and musical preference. Drug Alcohol Rev. 2008, 27 (4): 439-441. 10.1080/09595230802089719.CrossRefPubMed
Metadata
Title
Comparing short versions of the AUDIT in a community-based survey of young people
Authors
Anna L Bowring
Maelenn Gouillou
Margaret Hellard
Paul Dietze
Publication date
01-12-2013
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2013
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-13-301

Other articles of this Issue 1/2013

BMC Public Health 1/2013 Go to the issue