Validity of the CRAFFT in American-Indian and Alaska-Native adolescents: screening for drug and alcohol risk.
OBJECTIVE
Native-American adolescents are reported to be at high risk for drug and alcohol use and related negative consequences. A brief screening instrument that is culturally and developmentally appropriate can aid clinicians who work with Native youth in determining whether more extensive assessment of substance use is necessary. The CRAFFT has been shown to be a valid and reliable screen among general adolescent outpatient clinic samples.


METHODS
Data were collected as part of the Journeys of the Circle project, a collaborative effort between the Seattle Indian Health Board (SIHB) and the University of Washington's Addictive Behaviors Research Center. Psychometric properties of the CRAFFT were examined in 70 American-Indian and Alaska-Native youths ages 13 to 19 recruited from public schools and SIHBs outpatient clinics.


RESULTS
The CRAFFT demonstrated good internal consistency (alpha = 0.81). A score of 2 or higher on the CRAFFT was found to be optimal for capturing youths with high alcohol-related problems (sensitivity, 0.95; specificity, 0.86), frequent alcohol use (sensitivity, 1.00; specificity, 0.72) and frequent marijuana use (sensitivity, 1.00; specificity, 0.75). A cut-point of 3 was appropriate for identifying adolescents with frequent other drug use (sensitivity, 0.86; specificity, 0.76).


CONCLUSIONS
The CRAFFT may be a valid instrument for identifying Native youths at risk for alcohol and other drug problems. This brief screen can be effective in helping providers determine the need for further assessment and treatment or prevention services for Native-American adolescents.
Department of Psychology, University of Washington, Seattle, Washington, USA. lcummins@alliant.edu
Lillian Huang
LH
Cummins
Karen K
KK
Chan
Kelly M
KM
Burns
Arthur W
AW
Blume
Mary
M
Larimer
G Alan
GA
Marlatt
D000293:Adolescent; D000413:Alaska / Q000453:epidemiology; D000437:Alcoholism / Q000453:epidemiology* / Q000208:ethnology / Q000517:prevention & control; D005260:Female; D006801:Humans; D007198:Indians, North American / Q000706:statistics & numerical data*; D004930:Inuit / Q000706:statistics & numerical data*; D008297:Male; D008403:Mass Screening; D010552:Personality Assessment / Q000706:statistics & numerical data*; D011594:Psychometrics; D015203:Reproducibility of Results; D012307:Risk Factors; D013334:Students / Q000523:psychology / Q000706:statistics & numerical data; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000208:ethnology / Q000517:prevention & control; D014481:United States / Q000453:epidemiology