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Alcohol Alcohol. 2017 May 1;52(3):318-327. doi: 10.1093/alcalc/agw090.

The Alcohol Use Disorders Identification Test (AUDIT): Exploring the Factor Structure and Cutoff Thresholds in a Representative Post-Conflict Population in Northern Uganda.

Author information

1
School of Population and Public Health, University of British Columbia, 2206 East Mall Drive, Vancouver, British Columbia, V6T 1Z9 Canada.
2
Global Health Sciences Program, University of California San Francisco, 550 16th Street, Third Floor, San Francisco, CA 94158, USA.
3
School of Population and Public Health, University of British Columbia, 2206 East Mall Drive, Vancouver, British Columbia, V6T 1Z9Canada.
4
Makerere University School of Public Health, New Mulago Hill Road, Kampala, Uganda.
5
HIV Reference Laboratory Program, Uganda Virus Research Institute (UVRI), Plot 51-59 Nakiwongo Road, Entebbe, Uganda.
6
Makerere University Child Health Development Center, Upper Mulago Hospital Complex, Kampala, Uganda.

Abstract

Aims:

Despite increased use of the Alcohol Use Disorders Identification Test (AUDIT) in sub-Saharan Africa, few studies have assessed its underlying conceptual framework, and none have done so in post-conflict settings. Further, significant inconsistencies exist between definitions used for problematic consumption. Such is the case in Uganda, facing one of the highest per-capita alcohol consumption levels regionally, which is thought to be hindering rebuilding in the North after two decades of civil war. This study explores the impact of varying designation cutoff thresholds in the AUDIT as well as its conceptual factor structure in a representative sample of the population.

Methods:

In all, 1720 Cango Lyec Project participants completed socio-economic and mental health questionnaires, provided blood samples and took the AUDIT. Participant characteristics and consumption designations were compared at AUDIT summary score thresholds of ≥3, ≥5 and ≥8. Confirmatory factor analyses (CFA) explored one-, two- and three-factor level models overall and by sex with relative and absolute fit indicators.

Results:

There were no significant differences in participant demographic characteristics between thresholds. At higher cutoffs, the test increased in specificity to identify those with hazardous drinking, disordered drinking and suffering from alcohol-related harms. All conceptual models indicated good fit, with three-factor models superior overall and within both sexes.

Conclusion:

In Northern Uganda, a three-factor AUDIT model best explores alcohol use in the population and is appropriate for use in both sexes. Lower cutoff thresholds are recommended to identify those with potentially disordered drinking to best plan effective interventions and treatments.

Short summary:

A CFA of the AUDIT showed good fit for one-, two, and three-factor models overall and by sex in a representative sample in post-conflict Northern Uganda. A three-plus total AUDIT cutoff score is suggested to screen for hazardous drinking in this or similar populations.

PMID:
28003244
DOI:
10.1093/alcalc/agw090
[Indexed for MEDLINE]

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