Development, validation, and utility of internet-based, behavioral health screen for adolescents.

TitleDevelopment, validation, and utility of internet-based, behavioral health screen for adolescents.
Publication TypeJournal Article
Year of Publication2010
AuthorsDiamond G, Levy S, Bevans KB, Fein JA, Wintersteen MB, Tien A, Creed T
JournalPediatrics
Volume126
Issue1
Paginatione163-70
Date Published2010 Jul
ISSN1098-4275
KeywordsAdolescent, Adolescent Behavior, Diagnosis, Computer-Assisted, Female, Health Behavior, Health Surveys, Humans, Internet, Male, Mass Screening, Mental Disorders, Primary Health Care, Psychiatric Status Rating Scales, Psychometrics, Sensitivity and Specificity, United States, Young Adult
Abstract

OBJECTIVES: The goals were to develop and to validate the Internet-based, Behavioral Health Screen (BHS) for adolescents and young adults in primary care.

METHODS: Items assessing risk behaviors and psychiatric symptoms were built into a Internet-based platform with broad functionality. Practicality and acceptability were examined with 24 patients. For psychometric validation, 415 adolescents completed the BHS and well-established rating scales. Participants recruited from primary care waiting rooms were 12 to 21 years of age (mean: 15.8 years); 66.5% were female and 77.5% black.

RESULTS: The BHS screens in 13 domains by using 54 required items and 39 follow-up items. The administration time was 8 to 15 minutes (mean: 12.4 minutes). The scales are unidimensional, are internally consistent (Cronbach's alpha = 0.75-0.87), and discriminate among adolescents with a range of diagnostic syndromes. Sensitivity and specificity were high, with overall accuracy ranging from 78% to 85%. Patients with scores above scale cutoff values for depression, suicide risk, anxiety, and posttraumatic stress disorder symptoms were > or =4 times more likely to endorse other risk behaviors or stressors.

CONCLUSIONS: The BHS addresses practical and clinical barriers to behavioral health screening in primary care. It is a brief but comprehensive, self-report, biopsychosocial assessment. The psychiatric scales are valid and predictive of risk behaviors, which facilitates exclusion of false-positive results, as well as assessment and triage.

DOI10.1542/peds.2009-3272
Alternate JournalPediatrics
PubMed ID20566613