Survey Design for TANF Caseload Project: Summary Report and Recommendations. Common Measures Used, Pros and Cons

08/28/2002

The CIDI-SF provides separate diagnostic assessments for abuse and dependence of both drugs and alcohol.(5) The CalWORKS Prevalence Project, the WES, and SPD used the alcohol and drug modules of the CIDI-SF to assess dependence. The modules are relatively short for a diagnostic assessment (the alcohol component has eight items, and the drug module has nine). Thus, the modules suggest a diagnosis, they are brief, and scores can be compared to national norms from the NCS. These measures have the additional advantage of having been previously OMB-approved for use in a nationally representative survey (the SPD).

The Nebraska survey of welfare recipients used a four-item screener for drug and alcohol use, known as the Drug-CAGE. Adapted from the original CAGE, which is an alcoholism screener used primarily by clinicians, the Drug-CAGE includes alcohol or drug use in each item. The measure was supplemented with a small number of other questions asking whether drug or alcohol use interfered with the respondents ability to work or attend training activities, as well as questions about service receipt. Though brief, these items do not permit disaggregation of alcohol from drug use; more important for our purposes, the Drug-CAGE does not result in a probable diagnosis of drug or alcohol dependence. Furthermore, although the CAGE has been widely used, it has been found not to be equally sensitive across ethnic and racial groups, and its items are not equally discriminating (Cherpitel 1998; and Volk et al. 1997).

The Alameda study administered numerous lengthy measures for alcohol and drug use and dependence, making them largely unsuitable for our purposes. The Healthcare for Communities Survey employed a screener for alcoholism (the AUDIT) and included a modified version of the CIDI for drug abuse and dependency.

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