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

Article Figures & Data

Table 1.

Case Prevalence by CHAT and Reference Standards

Condition	CHAT- Positive Cases	Reference Standard	Case Criteria	Reference Standard–Positive Cases % (n/N)^a
A=anxiety score; CHAT=Case-finding and Help Assessment Tool; PA = physical aggression scale; VA = verbal aggression scale.
^a No. of cases/No. responding.
Nicotine dependency	38	Heavy Smoking Index (HSI)⁹	>2	6.8 (51/755)
Problematic drinking	67	Alcohol Use Disorders Identification Test (AUDIT)¹⁰	>7	11.3 (84/746)
Problematic drug use	9	Drug Abuse Screening Test (DAST)¹¹	>5	1.9 (14/750)
Problematic gambling	4	South Oaks Gambling Screen (SOGS)¹²	≥4	0.7 (5/688)
Major depression	30	Patient Health Questionnaire – Depression (PHQ-9)¹³	≥15	4.1 (30/737)
Anxiety	58	Hospital Anxiety & Depression Scale (HADS)¹⁴	A >10	9.3 (68/728)
Being verbally abused	8	Conflict Tactic Scale 1 (CTS-1)¹⁵	VA ≥15	2 (12/688)
Being physically abused	1	Conflict Tactic Scale 1 (CTS-1)¹⁵	PA ≥24	0.3 (2/594)
Being verbally angry	10	Conflict Tactic Scale 1 (CTS-1)¹⁵	VA ≥15	2.2 (13/594)
Being physically angry	1	Conflict Tactic Scale 1 (CTS-1)¹⁵	PA ≥24	0.3 (2/594)

Table 2.

Percentage of CHAT-Positive Patients Wanting Help

Condition	Positive Cases No.	Wanting Help No. (%)	Wanting Help Not Today No. (%)	Wanting Help Today No. (%)
CHAT=Case-finding and Help Assessment Tool.
Nicotine dependency	51	23 (45)	18 (35)	5 (10)
Problematic drinking	84	9 (11)	5 (6)	4 (5)
Problematic drug use	14	3 (21)	2 (14)	1 (7)
Problematic gambling	5	1 (20)	1 (20)	0 (0)
Major depression	30	17 (57)	11 (37)	6 (20)
Anxiety	68	27 (40)	12 (18)	15 (26)
Being verbally abused	14	2 (14)	1 (7)	1 (7)
Being verbally angry	13	4 (31)	3 (23)	1 (8)

Table 3.

Comparison of CHAT With Reference Standards: Sensitivity and Specificity

Condition	% Sensitivity (95% CI)	Positive CHAT Responses/ Positive Reference Standard	% Specificity (95% CI)	Negative CHAT Responses/ Negative Reference Standard
CHAT=Case-finding and Help Assessment Tool; CI = confidence interval.
Nicotine dependency	88 (77–95)	38/51	91 (89–93)	61/704
Problematic drinking	80 (70–87)	67/84	85 (82–87)	101/662
Problematic drug use	64 (39–84)	9/14	98 (97–99)	3/736
Problematic gambling	80 (38–99)	4/5	98 (97–99)	13/683
Major depression	98 (86–100)	30/30	73 (70–76)	191/707
Anxiety	85 (75–92)	58/68	77 (73–80)	155/660
Being verbally abused	57 (33–79)	8/14	97 (96–98)	16/580
Being verbally angry	77 (50–92)	10/13	92 (89–94)	47/581

Table 4.

CHAT Specificity With and Without the Help Questions

Condition	Specificity No Help Question % (95% CI)	Specificity With Help Question % (95% CI)
CHAT=Case-finding and Help Assessment Tool; CI = confidence interval.
Nicotine dependency	91 (89–93)	99 (98–99)
Problematic drinking	85 (82–87)	99 (99–100)
Problematic drug use	98 (97–99)	99 (99–100)
Problematic gambling	98 (97–99)	99 (99–100)
Major depression	73 (70–76)	98 (97–99)
Anxiety	77 (73–80)	99 (98–100)
Being verbally abused	97 (96–98)	99 (98–100)
Being physically abused	94 (92–95)	99 (98–100)
Being verbally angry	92 (89–94)	99 (98–100)
Being physically angry	91 (88–93)	99 (98–100)

Table 5.

Effect of Help Question on Likelihood Ratio of Being CHAT Positive for Common Conditions

Positive Condition	Help Today LR (95% CI)	Help But Not Today LR (95% CI)	Not Requesting Help LR (95% CI)	Help Requested (Either Today or Later) LR (95% CI)
CHAT=Case-finding and Help Assessment Tool; CI = confidence interval; LR = likelihood ratio.
Nicotine dependency	11.5 (3.6–36.4)	10.4 (6.0–17.4)	0.6 (0.5–0.7)	10.6 (6.7–16.8)
Problematic drinking	70.2 (3.8–1,292.6)	6.6 (2.0–21.0)	0.9 (0.8–1.0)	11.8 (4.3–32.4)
Major depression	21.6 (10.4–45.0)	5.2 (2.3–11.7)	0.5 (0.3–0.7)	10.3 (6.6–15.9)
Anxiety	18.2 (8.0–41.0)	5.8 (3.0–11.4)	0.6 (0.5–0.8)	9.4 (5.9–14.9)