The development, reliability, and validity of a risk factor screening survey for urban minority junior high school students.

PURPOSE To develop and evaluate a risk factor screening survey as a mechanism to identify inner-city junior high school students who may benefit from medical or mental health services available in school-based clinics. METHODS A 36-item health risk factor screening survey was developed and administered to 3,787 predominantly Hispanic students from 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 activity, parental or guardian substance use, personal substance use, or having run away) were scheduled to visit the clinic for services, and to have their survey responses validated by clinic interview. RESULTS The development of the screening tool resulted in a short, easy to read and understand survey instrument that was feasible to administer within a classroom setting. The reliability of the instrument was excellent, and the results of the validity study indicated that it was successful in identifying students who did not need clinic services. The screening tool produced mixed results in identifying those truly in need through 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 screening tool can be used to effectively focus limited clinical resources on those in need. Outreach surveys of this type should be considered as a valuable component of a school-based clinic service delivery strategy.