HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Supplemental data: Appendix In Brief TRACK Discussion: Submit a Comment TRACK Discussion: View Comments Alert me when this article is cited Alert me when TRACK Comments are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Goodyear-Smith, F. Articles by Coupe, N. Search for Related Content PubMed Articles by Goodyear-Smith, F. Articles by Coupe, N. Related Collections Mental health Health promotion Quantitative methods

Asking For Help is Helpful: Validation of a Brief Lifestyle and Mood Assessment Tool in Primary Health Care

¹ Department of General Practice & Primary Health Care, Faculty of Medical and Health Science, The University of Auckland, Auckland, New Zealand
² Nga Pae o te Maramatanga, Whariki, Massey University, Auckland, New Zealand

CORRESPONDING AUTHOR: Felicity Goodyear-Smith, MB, ChB, MGP, FRNZCGP, Department of General Practice and Primary Health Care, School of Population Health Faculty of Medical and Health Sciences, The University of Auckland, PB 92019, Auckland, New Zealand, f.goodyear-smith{at}auckland.ac.nz

PURPOSE The short, validated, self-administered, Case-finding and Help Assessment Tool (CHAT) for lifestyle and mental health assessment of adult patients in primary health care addresses inactivity, tobacco use, alcohol and other drug misuse, problem gambling, depression, anxiety and stress, abuse, and anger problems. For each issue patients are asked whether they would like help, either during the consultation or at a later date. This study aims to assess the value of the help question.

METHODS Validation of the CHAT was conducted according to the STAndards for Reporting of Diagnostic accuracy studies statement for diagnostic tests. The setting was Auckland primary care practices with populations ranging from socioeconomically advantaged to deprived. Participants were 755 consecutive primary care patients who completed the CHAT plus the help question and reference standards. Sensitivity, specificity, and likelihood ratios with and without the addition of help the question were calculated.

RESULTS Sensitivity ranged from 80% to 98% for the more-common conditions (depression, nicotine dependency, anxiety, problematic drinking). For each condition, specificity increased with the addition of the help question: depression increased from 73% to 98%; anxiety 77% to 99%; drinking 85% to 99%; verbal anger 92% to 99%; verbal abuse 97% to 99%; problematic drinking and gambling 98% to 99%.

CONCLUSIONS The help question increased specificity without compromising sensitivity and reduced false positives, thereby increasing the positive predictive value. It allowed patients with comorbidities to prioritize issues they wished to address, indicate their readiness to change, promote self-determination, and give the clinician an indication of which topics to pursue.

Key Words: Sensitivity and specificity • primary health care • mass screening • life style • mental health • risk reduction behavior • validation studies

This article has been cited by other articles:

				R. S. Gotler In this issue: the science, art, and policy of primary care. Ann. Fam. Med, May 1, 2009; 7(3): 194 - 195. [Full Text] [PDF]

TRACK Comments: