The Alcohol, Smoking and Substance Involvement Screening Test (ASSIST): development, reliability and feasibility

Group, WHO ASSIST Working

doi:10.1046/j.1360-0443.2002.00185.x

Cited by 1,982Substance Abuse Treatment and OutcomesPsychometric Methodologies and TestingHistorical and Modern Theater Studies

The Alcohol, Smoking and Substance Involvement Screening Test (ASSIST): development, reliability and feasibility

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Group, WHO ASSIST Working·2002·Addiction

DOI 10.1046/j.1360-0443.2002.00185.x

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Aims: The Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) was developed for the World Health Organization (WHO) by an international group of substance abuse researchers to detect psychoactive substance use and related problems in primary care patients. This report describes the new instrument as well as a study of its reliability and feasibility. Setting: The study was conducted at participating sites in Australia, Brazil, Ireland, India, Israel, the Palestinian Territories, Puerto Rico, the United Kingdom and Zimbabwe. Sixty per cent of the sample was recruited from alcohol and drug abuse treatment facilities; the remainder was drawn from general medical settings and psychiatric facilities. Methods: The study was concerned primarily with test item reliability, using a simple test–retest procedure to determine whether subjects would respond consistently to the same items when presented in an interview format on two different occasions. Qualitative and quantitative data were also collected to evaluate the feasibility of the screening items and rating format. Participants: A total of 236 volunteer participants completed test and retest interviews at nine collaborating sites. Slightly over half of the sample (53.6%) was male. The mean age of the sample was 34 years and they had completed, on average, 10 years of education. Results: The average test–retest reliability coefficients (kappas) ranged from a high of 0.90 (consistency of reporting ‘ever’ use of substance) to a low of 0.58 (regretted what was done under influence of substance). The average kappas for substance classes ranged from 0.61 for sedatives to 0.78 for opioids. In general, the reliabilities were in the range of good to excellent, with the following items demonstrating the highest kappas across all drug classes: use in the last 3 months, preoccupied with drug use, concern expressed by others, troubled by problems related to drug use, intravenous drug use. Qualitative data collected at the end of the retest interview suggested that the questions were not difficult to answer and were consistent with patients’ expectations for a health interview. The data were used to guide the selection of a smaller set of items that can serve as the basis for more extensive validation research. Conclusion: The ASSIST items are reliable and feasible to use as part of an international screening test. Further evaluation of the screening test should be conducted.

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The WHO ASSIST V3 was developed and validated in primary care public clinics in high-, middle- and low-income countries including in Southern Africa.
“We used this instrument for assessment because it was designed for medical settings, and because it was developed and validated in primary care public clinics in high-, middle- and low-income countries including in Southern Africa (WHO ASSIST Working Group, 2002).”
From Effectiveness of Nurse-Practitioner-Delivered Brief Motivational Intervention for Young Adult Alcohol and Drug Use in Primary Care in South Africa: A Randomized Clinical Trial (2014) · cites this paper as WHO ASSIST Working Group, 2002
The Abstract (page unavailable) says ASSIST was developed for primary-care patients and studied at international sites including Zimbabwe. But the Discussion (page unavailable) says this study tested ASSIST 1.0 and 2.0, did not assess their concurrent or predictive validity, and did not evaluate the preliminary instrument under typical primary-care conditions. The paper therefore does not support the claim that ASSIST V3 was validated in primary-care public clinics across the stated income groups. (LLM, conf=0.90)
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Development of the Alcohol Use Disorders Identification Test (AUDIT): WHO Collaborative Project on Early Detection of Persons with Harmful Alcohol Consumption‐II
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Authors: Group, W. A. W.
Affiliations: UConn Health (US)
Corresponding author: Group, WHO ASSIST Working
Venue: Addiction
Publisher: Wiley
Published: 2002-08-30
Volume: 97
Issue: 9
Pages: 1183-1194
ISSN: 0965-2140 (ISSN-L)
1360-0443
DOI: 10.1046/j.1360-0443.2002.00185.x
OpenAlex: W2617126691
Cited by: 1,982
References: 2
Citations by year: 2026: 132 · 2025: 176 · 2024: 187 · 2023: 168 · 2022: 184 · 2021: 191 · 2020: 135 · 2019: 119 · 2018: 105 · 2017: 117 · 2016: 91 · 2015: 89 · 2014: 68 · 2013: 43 · 2012: 49
FWCI: 2.51
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations: Addiction (publishedVersion)
PubMed (publishedVersion)
HRB National Drugs Library (Health Research Board) (acceptedVersion)
Adelaide Research & Scholarship (AR&S) (University of Adelaide) (submittedVersion)
UNIFESP Institutional Repository (Universidade Federal de São Paulo) (submittedVersion)
Funders: World Health Organization
University of Connecticut
National Institute on Alcohol Abuse and Alcoholism (AA03510-24, AA-03510)
Topics: Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
Social Sciences › Decision Sciences › Management Science and Operations Research › Psychometric Methodologies and Testing
Social Sciences › Psychology › Clinical Psychology › Historical and Modern Theater Studies
Keywords: ASSIST, substance use screening, alcohol consumption, smoking, drug use, test-retest reliability, screening tool development, primary care, international validation
MeSH terms: Adult, Alcohol Drinking, Feasibility Studies, Female, Humans, Male, Research Design, Sensitivity and Specificity, Smoking, Substance Abuse Detection

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