The Alcohol Use Disorders Identification Test (AUDIT): Exploring the Factor Structure and Cutoff Thresholds in a Representative Post-Conflict Population in Northern Uganda
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Date
2017
Journal Title
Journal ISSN
Volume Title
Publisher
Alcohol and Alcoholism
Abstract
Despite increased use of the Alcohol Use Disorders Identification Test (AUDIT) in sub-
Saharan Africa, few studies have assessed its underlying conceptual framework, and none have
done so in post-conflict settings. Further, significant inconsistencies exist between definitions
used for problematic consumption. Such is the case in Uganda, facing one of the highest percapita
alcohol consumption levels regionally, which is thought to be hindering rebuilding in the
North after two decades of civil war. This study explores the impact of varying designation cutoff
thresholds in the AUDIT as well as its conceptual factor structure in a representative sample of the
population.
Methods: In all, 1720 Cango Lyec Project participants completed socio-economic and mental
health questionnaires, provided blood samples and took the AUDIT. Participant characteristics
and consumption designations were compared at AUDIT summary score thresholds of ≥3, ≥5 and
≥8. Confirmatory factor analyses (CFA) explored one-, two- and three-factor level models overall
and by sex with relative and absolute fit indicators.
Results: There were no significant differences in participant demographic characteristics between
thresholds. At higher cutoffs, the test increased in specificity to identify those with hazardous
drinking, disordered drinking and suffering from alcohol-related harms. All conceptual models
indicated good fit, with three-factor models superior overall and within both sexes.
Conclusion: In Northern Uganda, a three-factor AUDIT model best explores alcohol use in the
population and is appropriate for use in both sexes. Lower cutoff thresholds are recommended to
identify those with potentially disordered drinking to best plan effective interventions and
treatments.
Description
Keywords
Alcohol Use Disorders Identification Test (AUDIT), Post-Conflict Population
Citation
Blair, A. H., Pearce, M. E., Katamba, A., Malamba, S. S., Muyinda, H., Schechter, M. T., & Spittal, P. M. (2017). The alcohol use disorders identification test (AUDIT): exploring the factor structure and cutoff thresholds in a representative post-conflict population in northern Uganda. Alcohol and Alcoholism, 52(3), 318-327. doi: 10.1093/alcalc/agw090