Validation of a Substance Use Disorder Screening Instrument for Use in Vocational Rehabilitation Settings

Objective: The study objectives were to develop and validate a substance use disorder screening instrument for vocational rehabilitation customers. Beginning with the Substance Abuse Subtle Screening Inventory-3 (SASSI-3), the authors developed items pertaining to prescription medication misuse and modified other items. Research Method/Design: Data were collected for the cross-sectional cohort study through interviews with a random subsample reinterviewed 14 days later. Complete data sets were collected from 948 customers recruited in Ohio, Illinois, and West Virginia; 128 completed a second interview. Women composed 52% of the sample and 58% were African American; the mean age was 40 years (±12 years). Customers completed a preliminary version of the new instrument, called the Substance Abuse in Vocational Rehabilitation Screener (SAVR-S), and the Diagnostic Interview Schedule. The authors used Rasch analyses to reduce the instrument to 43 items then divided the sample into a development subsample (used to formulate a scoring routine) and a validation subsample. Results: Sensitivity in detecting substance use disorders was 82% and specificity was 85% in the validation subsample. Conclusions/Implications: The SAVR-S appears to be a valid instrument and minimizes respondent burden while maximizing sensitivity and specificity to substance use disorders. It can assist vocational rehabilitation staff in identifying customers who need professional assessment and help support efforts toward self-sufficiency.