(WITHDRAWN) Development and Feasibility of a Spanish Language Version of the Tobacco, Alcohol, Prescription Drug, and Illicit Substance Use (TAPS) Tool

Background

Language accessibility and cultural awareness are essential elements of quality healthcare. Limited English Proficiency (LEP) individuals are less likely to self-identify a need for behavioral health services, which results in longer duration of untreated disorders. Accurate identification, diagnosis, and treatment are entirely dependent on a linguistically-accurate screening and assessment, especially for sensitive topics such as substance use.

The Tobacco, Alcohol, Prescription drug, and illicit Substance use (TAPS) Tool is a validated two-stage screening and brief assessment in primary care for unhealthy substance use. This NIH Phase 1 STTR project involved the research-driven adaptation of the TAPS into Spanish using cognitive interviewing methods, its deployment on a self-administered mobile/tablet technology platform, and an empirical study of the platform’s feasibility, acceptability, and preliminary validity in a Spanish-speaking primary care sample.

Methods

Participants were adult primary care patients ages 18 or older with Spanish as their primary language (N=10 for development/refinement using qualitative cognitive interviewing; N=100 for the preliminary validation study). The Spanish language TAPS Tool was administered in both interviewer- and self-administered tablet format (in random order). We examined disclosure of substance use on the TAPS by administration format, and compared it with established measures for identifying substance use and substance use disorders.

Results

The Spanish language TAPS was feasible to use and participants reported high levels of acceptability. The rates of past 12-month substance use were 11% for tobacco, 28% for risky alcohol, 4% for illicit drugs, 1% for non-medical prescription drugs and substance use disorders rates were 7% for tobacco, 2% for alcohol, and 1% for other substances. The self-administered TAPS elicited 1, 3, and 1 additional disclosures of tobacco, risky, alcohol, and marijuana use than the interviewer-administered TAPS, respectively. Rates of disclosure on the TAPS were similar to those on established measures for past 12-month and 3-month time frames.

Conclusions

The current study represents a starting point for expanding the availability of the TAPS Tool beyond its original English language version into Spanish. This Phase 1 study laid the groundwork for a Phase 2 STTR focused on the broader validation and implementation of the TAPS-ESP platform, and its full integration into electronic health records systems. The project could expand access to evidence-based, linguistically-accurate substance use screening and assessment for an underserved health disparity population. The technology could have significant public health impact and commercial viability given the growing Hispanic population in the US and the increasingly prominent role of primary care practices in addressing substance use problems.