The validity of the Alcohol Use Disorders Identification Test (AUDIT) among Australian nurses

The Alcohol Use Disorders Identification Test (AUDIT) has been used in various global settings as a rapid, reliable screening instrument to detect risky and hazardous alcohol consumption. However, there remain populations where the AUDIT has not been validated. Nurses make up a substantial proportion of healthcare workers globally, and their experiences during the recent pandemic response have indicated that risky and hazardous alcohol consumption has occurred among this occupational group. The objective of this study was to validate the AUDIT amongst a cohort of nurses.

This paper uses a dataset of Australian nurses (n = 1,159) who completed the AUDIT as part of a nationwide survey on alcohol consumption conducted between July and October 2021. A three-step factor analysis method was used to determine the validity and reliability of the AUDIT as a screen for risky and hazardous alcohol consumption among Australian nurses.

Initial confirmatory factor analysis found poor performance on items 5, 6 and 9 of the AUDIT. Further exploratory factor analysis confirmed these results, additionally finding other items (1 and 10) that contributed marginally to the AUDIT performance among nurses. A final Goodness-of-Fit test on the remaining five items in the AUDIT was significant ([Formula: see text]= 59.871(5), p < 0.001), suggesting that a five-item AUDIT scale is reliable amongst nurses.

The factor analysis process confirmed that that original 10-item AUDIT was not valid and reliable to screen for risky and hazardous alcohol consumption among nurses in Australian settings. A modified, five item version of the AUDIT tool (the AUDIT-N) was a substantially better fit for use in a cohort of Australian nurses, although further testing for construct validity is required prior to deployment. Our findings have applicability for the use of the AUDIT in future workforce surveys of alcohol consumption among not only nurses, but the wider population of healthcare workers.