Development and reliability of items measuring the nonmedical use of prescription drugs for the Youth Risk Behavior Survey: results from an initial pilot test.

BACKGROUND: The purpose of this study was to develop and test the reliability of self-report survey items designed to monitor the nonmedical use of prescription drugs among adolescents. METHODS: Eighteen nonmedical prescription drug items designed to be congruent with the substance abuse items in the US Centers for Disease Control and Prevention's (CDC's) Youth Risk Behavior Survey were constructed, reviewed by a panel of experts, and then examined to assess reliability using a test-retest survey design. RESULTS: Simple kappa (kappa) coefficients for 14 of the 18 items demonstrated "substantial" or "almost perfect" reliability. Three items had coefficients within the "fair" or "moderate" ranges and 1 item fell within in the "poor" range. Of the 10 items for which weighted kappa coefficients were calculated, 6 items fell within the "almost perfect" or "substantial" ranges. Three fell within the "moderate" range and 1 fell within the "poor" range. CONCLUSIONS: Based on the expert panel review and the findings from our study, most of the 18 items developed to measure nonmedical use of prescription drugs among adolescents appear valid and reliable. The nonmedical use of prescription drugs ranks fourth among the most abused class of drugs by adolescents after alcohol, tobacco, and marijuana, respectively. The CDC should consider expanding the surveillance of these specific health-risk behaviors that are assuming new importance by including the items described in this article in future national surveys.