Development of a Screening Tool to Identify Adolescents Engaged in Multiple Problem Behaviors: The Adolescent Risk Behavior Screen (ARBS)

Abstract 

Purpose

To describe the development of a new, brief screening tool to identify teenagers engaged in multiple, co-occurring high-risk behaviors, and to create a screen that bypasses problems associated with assessment of sensitive and potentially stigmatizing behaviors by including questions that are minimally threatening and less transparent than purely face valid items.

Methods

This study utilizes a large, cross-sectional data set consisting of self-report responses to questions about high-risk teen health behaviors such as substance use, sexual risk-taking, and suicidality. Data were collected from 16,664 predominantly Caucasian public high school students, aged 14–18 years, participating in the 2001 New Hampshire Youth Risk Behavior Survey. High-risk status was defined by endorsement of five or more high-risk behaviors. Nine items were chosen for the screen, covering multiple risk domains. The screen’s predictive accuracy was then tested on additional holdout subsets of the total sample and separately by gender using receiver operating characteristic (ROC) curves.

Results

Approximately 10% of the sample met criteria for “high-risk” status. High ROC areas were found for the initial sample and subsequent holdout samples. The screen was found to be accurate for both girls and boys in identifying multi-problem, high-risk adolescents.

Conclusions

The Adolescent Risk Behavior Screen (ARBS) holds promise as a useful clinical tool for adolescent health care providers. It can quickly and accurately identify multi-problem teens, engaged in dangerous high-risk activities, who are likely in need of more comprehensive evaluation and intervention.

Keywords: High-risk behaviors, Adolescents, Assessment, Substance use, Youth