Psychometric Evaluation of a Scale That Assesses Systems-Level Barriers to Uptake of Youth Substance Use Assessment in Community Behavioral Health Settings.

Substance use disorders among youth are a significant public health problem. Implementation of evidence-based practices in community settings, such as evidence-based assessment, is needed for early identification of youth with substance use. Yet systemic barriers (e.g., poor resources and unsupportive organizational culture) impede these efforts. This study examined the psychometric properties of a newly developed quantitative measure, the Systems-Level Barriers Scale for Adolescent Substance Assessment (SBS-ASA), which assesses clinician perceptions of systemic barriers to adopting evidence-based screening and diagnostic assessment of adolescent substance, including opioid, use in organizational settings. Scale construction was based on prior qualitative work. Participants were 78 community-based behavioral health clinicians who attended a 7-hr training in evidence-based practices for addressing adolescent opioid use. Clinicians completed a survey before training and subsequently completed the SBS-ASA and additional measures used for validation during the 12-month survey. Exploratory factor analysis was conducted using Principal Axis Factoring with Promax rotation. Results supported two factors accounting for 64% of total variance: (a) resource-related barriers (e.g., funding) and (b) perceptual barriers (e.g., staff attitudes). Internal consistency was excellent (alpha = .95). Support was found for divergent but not convergent validity. Psychometric analyses support the initial factor structure and reliability of the measure. The SBS-ASA is a tool that may aid in identifying systems-level barriers to implementing evidence-based assessment for adolescent substance use. Future research should examine psychometric properties of the SBS-ASA in larger samples using gold-standard measures for validity.