THE DEVELOPMENT, RELIABILITY, AND VALIDITY OF A RISK FACTOR SCREENINGSURVEY FOR URBAN MINORITY JUNIOR-HIGH-SCHOOL STUDENTS

Purpose: To develop and evaluate a risk factor screening survey as a m echanism to identify inner-city junior high school students who may be nefit from medical or mental health services available in school-based clinics. Methods: A 36-item health risk factor screening survey was d eveloped and administered to 3,787 predominantly Hispanic students fro m four schools in an economically disadvantaged, medically underserved New York City school district. Students who indicated that they were experiencing one of five major risk factors (suicidality, sexual activ ity, parental or guardian substance use, personal substance use, or ha ving run away) were scheduled to visit the clinic for services, and to have their survey responses validated by clinic interview. Results: T he development of the screening tool resulted in a short, easy to read and understand survey instrument that was feasible to administer with in a classroom setting. The reliability of the instrument was excellen t, and the results of the validity study indicated that it was success ful in identifying students who did not need clinic services. The scre ening tool produced mixed results in identifying those truly in need t hrough single item identification (e.g., produced a moderate number of ''false positives''), although combining items on the screening tool produced much higher positive predictive values. Conclusions: This scr eening tool can be used to effectively focus limited clinical resource s on those in need. Outreach surveys of this type should be considered as a valuable component of a school-based clinic service delivery str ategy.