ASSIST in Pitjantjatjara: Protocol for a randomised crossover validation study among Aboriginal and Torres Strait...

Substance use significantly contributes to disease burden among Australians, with harms exacerbated among Aboriginal and Torres Strait Islander peoples by colonisation-related factors like stigma and trauma. Addressing this gap requires culturally acceptable, valid and reliable screening tools, available in a familiar language to the participant, to identify and provide support for those at-risk. This protocol describes a study aimed at validating a culturally-adapted screening tool - the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) - into Pitjantjatjara, to detect risk of substance-related harm.

Recruitment will occur at a variety of Aboriginal health and welfare settings across remote, rural and urban South Australia. Eligible participants (aged 18-65) will be briefed and, upon consent, randomly complete the ASSIST app on an iPad and a semi-structured, yarning-style diagnostic interview (see endnote 1) with a health professional and Pitjantjatjara interpreter. The interview will assess for a range of clinically-defined substance use disorders (based on DSM-5-TR and ICD-11 criteria). All participants will be asked to complete the app a second time (between 7 and 28 days) to assess reliability, while a subset of participants at highest-risk will also undergo specialist evaluation from an independent clinician, as a second check for validity.

Valid and reliable assessment tools are essential for detecting risky and harmful substance use. If valid, this app has the potential to contribute to community-led efforts to bridge the health gap by addressing modifiable health risk factors.

ANZCTR: ACTRN12625000413426. Open Science Framework pre-registration: https://doi.org/10.17605/OSF.IO/GNZAY.

Protocol version 1.1, June 23, 2025.