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Introduction: Underage drinking is a significant problem that is often overlooked. In the United States, alcohol is the most common form of drug/substance used and abused by adolescents. In 2014, the National Survey on Drug Use and Health reported that 2.9 million adolescents with ages between 12 and 17 years were current alcohol users, 1.5 million past month binge alcohol users, and nearly 300,000 heavy alcohol users. The magnitude of underage alcohol use in the United States, and the associated costs, support the broad implementation of a validated, age appropriate alcohol screening tool. While several brief alcohol screening tools have been validated, these screeners disproportionately focus on heavy, episodic drinking or severe alcohol problems, and fail to address early signs of alcohol use and related problems. Addressing this limitation, NIAAA and the American Association of Pediatrics (AAP) collaboratively developed a brief two-item underage alcohol use screening tool that is empirically derived and developmentally appropriate for early, middle, and late adolescents. Although this measure has been evaluated in clinical settings, it has yet to be evaluated in school-based samples.
Methods: The purpose of the present study was to evaluate the predictive validity of the NIAAA/AAP brief screening measure in a school-based sample by examining differences across the screeners’ risk profiles (i.e., No, Low, Moderate, and High Risk) on recent alcohol use (i.e., number of days drinking, largest number of drinks, and number of days drunk) on six-month follow up, controlling for baseline levels. The present study drew on baseline and six-month follow-up data of 809 6th, 8th, and 10th graders (52.4% female; Mage = 13.60 years, 11-18, SD=1.65) from an ongoing multisite (Miami and DC) accelerated longitudinal school-based study. Because the total scores on measures of recent alcohol use were heavily and positively skewed, analyses were conducted using Poisson regression. The NIAAA/AAP brief screening was dummy coded based on the level of risk, with no risk set as the reference point.
Results: After controlling for age, gender, and baseline scores, relative to the no risk group, participants in the Low, Moderate and High Risk drank more often, had larger number of drinks, and were drunk more often relative to the no risk group. Additionally, odds ratio relative to the no risk progressively increased alongside the level of risk.
Conclusions: The current findings provide preliminary support for the predictive validity of the NIAAA/AAP brief screener in school setting.