Cultural adaptation and validation of the DEP-ADO: an alcohol and drugs screening test for indigenous teenagers

Abstract

Background. In order to improve interventions efficiency among Indigenous teenagers, adapting questionnaires to their cultural reality is paramount. In fact, without this cultural adaptation, the results obtained with these questionnaires could minimize or exaggerate the extent of youth’s difficulties. The Detection of Alcohol and Drug Problems (DEP-ADO; Landry and al., 2004) is a screening test that allows assessment of the severity of alcohol or drug consumption among adolescents. Comprising 25 questions, this questionnaire dress a portrait of the alcohol and cannabis use, drugs use, consequences of alcohol and drug use and problem substance use. The present study adapted and validated the DEP-ADO among Indigenous Teenagers.

Method. Crees (anglophones) and Attikamekws (francophones) have collaborated to the validation of this screening test. At first, a co-building process, allowing for the development of an initial version of the DEP-ADO adapted to Indigenous’ cultural reality, was conducted with the workplaces (professionals, educators, band council members) of communities. During a second part, 50 youth have filled the adapted version and have taken part in focus groups aimed to give them the opportunity to comment their understanding and usefulness of such a grid for Indigenous Youth. Finally, a second adapted version of the test was administered to Youth from three communities (N=421, average age 14.75) for a final validation. To confirm the interne structure and to measure the reliability, confirmatory factor analysis and Chronbach’s and polychoric’s alphas were run. Chi-squared test were also perform to test the breakpoint (red, yellow and green lights).

Results and conclusion. The main challenge was to make sure that the wording and the examples were easily understandable and make sense for Indigenous Youth. For examples: changing the questionnaire response options, give examples to help understand the issues at stake, review the phrasing of the questions. During the focus groups, youth reported that many questions or concepts were difficult to understand and needed to be reworded or clarified. Also, as some questions are more sensitive, participants reported experiencing shame and hesitating to answer accurately. Regarding the reliability, the DEP-ADO (adapted) scales indicated that alcohol scale (α tet=0.91), drugs scale (α tet=0.86), risk factors scale (α tet=0.88) and global score (α tet=0.93) had adequate reliability for Indigenous Youth. The one-factor latent structure was confirmed for all scales. Our results confirm that DEP-ADO (adapted) is validated for Indigenous teenagers.

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