The Reliability and Validity of the Self-Reported Drinking Measures in the Army's Health Risk Appraisal Survey
Background: The reliability and validity of self‐reported drinking behaviors from the Army Health Risk Appraisal (HRA) survey are unknown. Methods: We compared demographics and health experiences of those who completed the HRA with those who did not (1991–1998). We also evaluated the reliability and...
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| Veröffentlicht in: | Alcoholism, clinical and experimental research clinical and experimental research, 2003-05, Vol.27 (5), p.826-834 |
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| creator | Bell, Nicole S. Williams, Jeffrey O. Senier, Laura Strowman, Shelley R. Amoroso, Paul J. |
| description | Background: The reliability and validity of self‐reported drinking behaviors from the Army Health Risk Appraisal (HRA) survey are unknown.
Methods: We compared demographics and health experiences of those who completed the HRA with those who did not (1991–1998). We also evaluated the reliability and validity of eight HRA alcohol‐related items, including the CAGE, weekly drinking quantity, and drinking and driving measures. We used Cohen's κ and Pearson's r to assess reliability and convergent validity. To assess criterion (predictive) validity, we used proportional hazards and logistical regression models predicting alcohol‐related hospitalizations and alcohol‐related separations from the Army, respectively.
Results: A total of 404,966 soldiers completed an HRA. No particular demographic group seems to be over‐ or underrepresented. Although few respondents skipped alcohol items, those who did tended to be older and of minority race. The alcohol items demonstrate a reasonable degree of reliability, with Cronbach's α= 0.69 and test‐retest reliability associations in the 0.75–0.80 range for most items over 2‐ to 30‐day interims between surveys. The alcohol measures showed good criterion‐related validity: those consuming more than 21 drinks per week were at 6 times the risk for subsequent alcohol‐related hospitalization versus those who abstained from drinking (hazard ratio, 6.36; 95% confidence interval=5.79, 6.99). Those who said their friends worried about their drinking were almost 5 times more likely to be discharged due to alcoholism (risk ratio, 4.9; 95% confidence interval=4.00, 6.04) and 6 times more likely to experience an alcohol‐related hospitalization (hazard ratio, 6.24; 95% confidence interval=5.74, 6.77).
Conclusions: The Army's HRA alcohol items seem to elicit reliable and valid responses. Because HRAs contain identifiers, alcohol use can be linked with subsequent health and occupational outcomes, making the HRA a useful epidemiological research tool. Associations between perceived peer opinions of drinking and subsequent problems deserve further exploration. |
| doi_str_mv | 10.1097/01.ALC.0000067978.27660.73 |
| format | Article |
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Methods: We compared demographics and health experiences of those who completed the HRA with those who did not (1991–1998). We also evaluated the reliability and validity of eight HRA alcohol‐related items, including the CAGE, weekly drinking quantity, and drinking and driving measures. We used Cohen's κ and Pearson's r to assess reliability and convergent validity. To assess criterion (predictive) validity, we used proportional hazards and logistical regression models predicting alcohol‐related hospitalizations and alcohol‐related separations from the Army, respectively.
Results: A total of 404,966 soldiers completed an HRA. No particular demographic group seems to be over‐ or underrepresented. Although few respondents skipped alcohol items, those who did tended to be older and of minority race. The alcohol items demonstrate a reasonable degree of reliability, with Cronbach's α= 0.69 and test‐retest reliability associations in the 0.75–0.80 range for most items over 2‐ to 30‐day interims between surveys. The alcohol measures showed good criterion‐related validity: those consuming more than 21 drinks per week were at 6 times the risk for subsequent alcohol‐related hospitalization versus those who abstained from drinking (hazard ratio, 6.36; 95% confidence interval=5.79, 6.99). Those who said their friends worried about their drinking were almost 5 times more likely to be discharged due to alcoholism (risk ratio, 4.9; 95% confidence interval=4.00, 6.04) and 6 times more likely to experience an alcohol‐related hospitalization (hazard ratio, 6.24; 95% confidence interval=5.74, 6.77).
Conclusions: The Army's HRA alcohol items seem to elicit reliable and valid responses. Because HRAs contain identifiers, alcohol use can be linked with subsequent health and occupational outcomes, making the HRA a useful epidemiological research tool. Associations between perceived peer opinions of drinking and subsequent problems deserve further exploration.</description><identifier>ISSN: 0145-6008</identifier><identifier>EISSN: 1530-0277</identifier><identifier>DOI: 10.1097/01.ALC.0000067978.27660.73</identifier><identifier>PMID: 12766628</identifier><identifier>CODEN: ACRSDM</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Publishing Ltd</publisher><subject>Addictive behaviors ; Adult ; Adult and adolescent clinical studies ; Alcohol ; Alcohol Drinking ; Alcoholism ; Alcoholism - complications ; Alcoholism - epidemiology ; Biological and medical sciences ; Female ; Health Status Indicators ; Health Surveys ; Hospitalization - statistics & numerical data ; Humans ; Male ; Medical sciences ; Military ; Military Personnel ; Psychology. Psychoanalysis. Psychiatry ; Psychopathology. Psychiatry ; Reliability ; Survey ; Surveys and Questionnaires ; Validity</subject><ispartof>Alcoholism, clinical and experimental research, 2003-05, Vol.27 (5), p.826-834</ispartof><rights>2003 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5466-d98e4401b64a6e450e9c968d698e13335228eb9ca4ef7cf4ab3100f01f93f1403</citedby><cites>FETCH-LOGICAL-c5466-d98e4401b64a6e450e9c968d698e13335228eb9ca4ef7cf4ab3100f01f93f1403</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1097%2F01.ALC.0000067978.27660.73$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1097%2F01.ALC.0000067978.27660.73$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>230,314,776,780,881,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=14802400$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/12766628$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bell, Nicole S.</creatorcontrib><creatorcontrib>Williams, Jeffrey O.</creatorcontrib><creatorcontrib>Senier, Laura</creatorcontrib><creatorcontrib>Strowman, Shelley R.</creatorcontrib><creatorcontrib>Amoroso, Paul J.</creatorcontrib><title>The Reliability and Validity of the Self-Reported Drinking Measures in the Army's Health Risk Appraisal Survey</title><title>Alcoholism, clinical and experimental research</title><addtitle>Alcohol Clin Exp Res</addtitle><description>Background: The reliability and validity of self‐reported drinking behaviors from the Army Health Risk Appraisal (HRA) survey are unknown.
Methods: We compared demographics and health experiences of those who completed the HRA with those who did not (1991–1998). We also evaluated the reliability and validity of eight HRA alcohol‐related items, including the CAGE, weekly drinking quantity, and drinking and driving measures. We used Cohen's κ and Pearson's r to assess reliability and convergent validity. To assess criterion (predictive) validity, we used proportional hazards and logistical regression models predicting alcohol‐related hospitalizations and alcohol‐related separations from the Army, respectively.
Results: A total of 404,966 soldiers completed an HRA. No particular demographic group seems to be over‐ or underrepresented. Although few respondents skipped alcohol items, those who did tended to be older and of minority race. The alcohol items demonstrate a reasonable degree of reliability, with Cronbach's α= 0.69 and test‐retest reliability associations in the 0.75–0.80 range for most items over 2‐ to 30‐day interims between surveys. The alcohol measures showed good criterion‐related validity: those consuming more than 21 drinks per week were at 6 times the risk for subsequent alcohol‐related hospitalization versus those who abstained from drinking (hazard ratio, 6.36; 95% confidence interval=5.79, 6.99). Those who said their friends worried about their drinking were almost 5 times more likely to be discharged due to alcoholism (risk ratio, 4.9; 95% confidence interval=4.00, 6.04) and 6 times more likely to experience an alcohol‐related hospitalization (hazard ratio, 6.24; 95% confidence interval=5.74, 6.77).
Conclusions: The Army's HRA alcohol items seem to elicit reliable and valid responses. Because HRAs contain identifiers, alcohol use can be linked with subsequent health and occupational outcomes, making the HRA a useful epidemiological research tool. Associations between perceived peer opinions of drinking and subsequent problems deserve further exploration.</description><subject>Addictive behaviors</subject><subject>Adult</subject><subject>Adult and adolescent clinical studies</subject><subject>Alcohol</subject><subject>Alcohol Drinking</subject><subject>Alcoholism</subject><subject>Alcoholism - complications</subject><subject>Alcoholism - epidemiology</subject><subject>Biological and medical sciences</subject><subject>Female</subject><subject>Health Status Indicators</subject><subject>Health Surveys</subject><subject>Hospitalization - statistics & numerical data</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Military</subject><subject>Military Personnel</subject><subject>Psychology. Psychoanalysis. Psychiatry</subject><subject>Psychopathology. Psychiatry</subject><subject>Reliability</subject><subject>Survey</subject><subject>Surveys and Questionnaires</subject><subject>Validity</subject><issn>0145-6008</issn><issn>1530-0277</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2003</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqVkVFv0zAUhSMEYmXwF5CFhHhKuI4dO-GBKcq2FqkbqBvwaDmJvZq6SWSng_z7JWu1wiN-sex7zud7fYLgHYYIQ8Y_Ao7yZRHBtBjPeBrFnDGIOHkWzHBCIISY8-fBDDBNQgaQngSvvP81ymnK2MvgBE8GFqezoLldK7RS1sjSWNMPSDY1-iGtqadDq1E_1m-U1eFKda3rVY3OnWk2prlDV0r6nVMemeZRlrvt8MGjhZK2X6OV8RuUd52TxkuLbnbuXg2vgxdaWq_eHPbT4PvlxW2xCJdf51-KfBlWCWUsrLNUUQq4ZFQyRRNQWZWxtGbjPSaEJHGcqjKrJFWaV5rKkmAADVhnRGMK5DT4vOd2u3Kr6ko1vZNWdM5spRtEK434t9KYtbhr70WMKWZZMgI-7QGVa713Sj95MYgpBQFYjCmIYwriMQXByWh--_frR-vh20fB-4NA-kpa7WRTGX_U0RRiCtMYZ3vdb2PV8B8tiLy4WKUxGwnhnmB8r_48EaTbCMYJT8TP67kosnNyffVtIebkASw9svk</recordid><startdate>200305</startdate><enddate>200305</enddate><creator>Bell, Nicole S.</creator><creator>Williams, Jeffrey O.</creator><creator>Senier, Laura</creator><creator>Strowman, Shelley R.</creator><creator>Amoroso, Paul J.</creator><general>Blackwell Publishing Ltd</general><general>Lippincott Williams & Wilkins</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>5PM</scope></search><sort><creationdate>200305</creationdate><title>The Reliability and Validity of the Self-Reported Drinking Measures in the Army's Health Risk Appraisal Survey</title><author>Bell, Nicole S. ; Williams, Jeffrey O. ; Senier, Laura ; Strowman, Shelley R. ; Amoroso, Paul J.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5466-d98e4401b64a6e450e9c968d698e13335228eb9ca4ef7cf4ab3100f01f93f1403</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2003</creationdate><topic>Addictive behaviors</topic><topic>Adult</topic><topic>Adult and adolescent clinical studies</topic><topic>Alcohol</topic><topic>Alcohol Drinking</topic><topic>Alcoholism</topic><topic>Alcoholism - complications</topic><topic>Alcoholism - epidemiology</topic><topic>Biological and medical sciences</topic><topic>Female</topic><topic>Health Status Indicators</topic><topic>Health Surveys</topic><topic>Hospitalization - statistics & numerical data</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Military</topic><topic>Military Personnel</topic><topic>Psychology. Psychoanalysis. Psychiatry</topic><topic>Psychopathology. Psychiatry</topic><topic>Reliability</topic><topic>Survey</topic><topic>Surveys and Questionnaires</topic><topic>Validity</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bell, Nicole S.</creatorcontrib><creatorcontrib>Williams, Jeffrey O.</creatorcontrib><creatorcontrib>Senier, Laura</creatorcontrib><creatorcontrib>Strowman, Shelley R.</creatorcontrib><creatorcontrib>Amoroso, Paul J.</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Alcoholism, clinical and experimental research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bell, Nicole S.</au><au>Williams, Jeffrey O.</au><au>Senier, Laura</au><au>Strowman, Shelley R.</au><au>Amoroso, Paul J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The Reliability and Validity of the Self-Reported Drinking Measures in the Army's Health Risk Appraisal Survey</atitle><jtitle>Alcoholism, clinical and experimental research</jtitle><addtitle>Alcohol Clin Exp Res</addtitle><date>2003-05</date><risdate>2003</risdate><volume>27</volume><issue>5</issue><spage>826</spage><epage>834</epage><pages>826-834</pages><issn>0145-6008</issn><eissn>1530-0277</eissn><coden>ACRSDM</coden><abstract>Background: The reliability and validity of self‐reported drinking behaviors from the Army Health Risk Appraisal (HRA) survey are unknown.
Methods: We compared demographics and health experiences of those who completed the HRA with those who did not (1991–1998). We also evaluated the reliability and validity of eight HRA alcohol‐related items, including the CAGE, weekly drinking quantity, and drinking and driving measures. We used Cohen's κ and Pearson's r to assess reliability and convergent validity. To assess criterion (predictive) validity, we used proportional hazards and logistical regression models predicting alcohol‐related hospitalizations and alcohol‐related separations from the Army, respectively.
Results: A total of 404,966 soldiers completed an HRA. No particular demographic group seems to be over‐ or underrepresented. Although few respondents skipped alcohol items, those who did tended to be older and of minority race. The alcohol items demonstrate a reasonable degree of reliability, with Cronbach's α= 0.69 and test‐retest reliability associations in the 0.75–0.80 range for most items over 2‐ to 30‐day interims between surveys. The alcohol measures showed good criterion‐related validity: those consuming more than 21 drinks per week were at 6 times the risk for subsequent alcohol‐related hospitalization versus those who abstained from drinking (hazard ratio, 6.36; 95% confidence interval=5.79, 6.99). Those who said their friends worried about their drinking were almost 5 times more likely to be discharged due to alcoholism (risk ratio, 4.9; 95% confidence interval=4.00, 6.04) and 6 times more likely to experience an alcohol‐related hospitalization (hazard ratio, 6.24; 95% confidence interval=5.74, 6.77).
Conclusions: The Army's HRA alcohol items seem to elicit reliable and valid responses. Because HRAs contain identifiers, alcohol use can be linked with subsequent health and occupational outcomes, making the HRA a useful epidemiological research tool. Associations between perceived peer opinions of drinking and subsequent problems deserve further exploration.</abstract><cop>Oxford, UK</cop><pub>Blackwell Publishing Ltd</pub><pmid>12766628</pmid><doi>10.1097/01.ALC.0000067978.27660.73</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Addictive behaviors Adult Adult and adolescent clinical studies Alcohol Alcohol Drinking Alcoholism Alcoholism - complications Alcoholism - epidemiology Biological and medical sciences Female Health Status Indicators Health Surveys Hospitalization - statistics & numerical data Humans Male Medical sciences Military Military Personnel Psychology. Psychoanalysis. Psychiatry Psychopathology. Psychiatry Reliability Survey Surveys and Questionnaires Validity |
| title | The Reliability and Validity of the Self-Reported Drinking Measures in the Army's Health Risk Appraisal Survey |
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