Lifestyle History Questionnaire-Youth Version: A Pilot Study
Erica Harvitt, OTS, Ginger Maddox, OTS, Slavica Bjazevic, OTS, Lauren Favorito, OTS & Lynn Jaffe, ScD, OTR/L, FAOTA
Florida Gulf Coast University, Fort Myers, FL
RESULTS / DISCUSSION
PURPOSE
Due to the limited number of participants (n=22) reliability and validity were
unable to be established, nor were the researchers able to establish
domains that could indicate factors of higher incidence rate. The data
analysis of the original LHQ, with adult participants (n=268) produced 7 such
domains. During the re-writing of the LHQ into the LHQ-Y, the 50 response
items were transformed to be applicable to adolescents instead of adults.
Due to the limited number of participants, the factor structure of the LHQ-Y
data was unable to be compared with the factor structure of its predecessor,
the LHQ, which was measured on an adult demographic.
Research results continuously express the importance of environmental factors on
modifying habits, especially habits related to substance use. The family dynamics,
including parent-child relationship (Branstetter & Furman, 2011;Johnson et al.,
2014), can have a significant correlation to substance use. Exposure to
substances through family members or peers has also been found to be correlated
with increased rates of substance use, even when exposed through social groups
in competitive sports (Rüütel et al., 2014; Kothari et al., 2014; Huang et al., 2014;
Lisha & Sussman, 2010). Perhaps the most concerning research result is that the
key transition age when contextual factors start to have an effect on substance use
is believed to be between ages 14-16 years old (Mennis & Mason, 2012).
Therefore, we decided to use the Lifestyle History Questionnaire Youth version
(LHQ-Y) newly developed by Martin et al., (2015) with the adolescent population in
an inpatient rehab unit. The adult version of the LHQ is already used in practice,
with the reliability and validity already established. Specifically, the LHQ-Y
measures the habits and occupational dysfunctions that occur as a result of
substance use in adolescence. The items of the LHQ-Y asses how aforementioned
environmental factors influence or are influenced by the occupational dysfunctions
that occur while using substances, further indicating an individual’s level of
immersion in the culture of addiction as defined by White (1996).
The goals of the current study are to compare the factor structure of the LHQ-Y
with the factor structure of the LHQ adult version, to identify the habits, patterns,
and roles of adolescents while using addictive substances, to establish the
reliability and validity of the LHQ-Y, and to identify the individual level of immersion
in the culture of addiction as defined by White (1996).
METHODS
Subjects: 23 participants (15 males, 8 females) ages ranged from 14-18 were
administered the LHQ-Y in the treatment center.
Instrument: The LHQ-Y, developed by Martin et al., (2015), is a 50 item Likert-scale
self-report assessment designed to measure occupational dysfunction related to
substance abuse. It is used to acquire information about patterns in life to guide
interventions for those affected by substance abuse. The items ask participants to
report how environmental and contextual factors related to their substance use and
lifestyle within 1-2 months before entering treatment. For example, items may ask
about factors such as family or social dynamics. The theoretical basis for the LHQY and LHQ-adult is William White’s work on the culture of addiction, and specifically
the subcultures within the culture of addiction.
PROCEDURE
The researchers obtained approval from Florida Gulf Coast University's Institutional
Review Board before participant recruitment. The researchers obtained parent
consent during a weekly parent meeting at the treatment center, during which the
researchers would present the research study and its purpose to the parents, as
well as provide a copy of the LHQ-Y for them to review. Adolescent assent was
obtained before administering the LHQ-Y to them at the treatment center.
Administration and completion of the 50 item LHQ-Y questionnaire took
approximately 10-15 minutes. Participation in the study was anonymous and
voluntary, having no impact on the treatment the participants received.
REFERENCES
Branstetter, S. A., Low, S., & Furman, W. (2011). The influence of parents and
friends on adolescent substance use: A multidimensional approach. Journal of
Substance Use, 16(2), 150-160. doi: 10.3109/14659891.2010.519421
Denham, B., E. (2014). High school sports participation and substance use:
Differences by sport, race, and gender. Journal of Child & Adolescent
Substance Abuse, 23(3), 145-154. doi: 10.1080/1067828X.2012.750974
Huang, G., Unger, J., Soto, D., Fujimoto, K., Pentz, M., Jordan-Marsh, M., &
Valente, T. (2014). Peer Influences: The impact of online and offline friendship
networks on adolescent smoking and alcohol use. Journal of Adolescent
Health, 54, 508514. Retrieved from:
http://dx.doi.org/10.1016/j.jadohealth.2013.07.001
Johnson, B., McBride, D., Hopkins, G., & Pepper, S. (2014). An examination of
Parent–Child relationships and teen substance use: A brief report. Journal of
Child & Adolescent Substance Abuse, 23(4), 210-216
doi:10.1080/1067828X.2013.786926
Kothari, B. H., Sorenson, P., Bank, L., & Snyder, J. (2014). Alcohol and substance
use in adolescence and young adulthood: the role of siblings. Journal of family
social work, 17(4), 324-343.
Lisha, N., Sussman, S. (2010). Relationship of high school and college sports
participation with alcohol, tobacco, and illicit drug use: A review. Addictive
Behaviors, 35, 399-407. doi:10.1016/j.addbeh.2009.12.032
Martin, L. M., Triscari, R., Boisvert, R., Kipp, K., Gersten, J., West, R. C., ... &
Escobar, P. (2015). Development and evaluation of the lifestyle history
questionnaire (LHQ) for people entering treatment for substance addictions.
American Journal of Occupational Therapy, 69(3).
Mennis, J., & Mason, M. J. (2012). Social and geographic contexts of adolescent
substance use: The moderating effects of age
and gender. Social
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http://dx.doi.org/10.1016/j.socnet.2010.10.003
Neal, D. T., Wood, W., & Quinn, J. M. (2006). Habits—A repeat performance.
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Wasserman, D. (2014). Alcohol consumption patterns among adolescents are
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White, W. L. (1996). Pathways from the culture of addiction to the culture of
recovery: A travel guide for addiction professionals (2nd ed.). Center City, MN:
Hazelden.
Despite its limitations, the study was able to produce useful statistics from
the sample. In addition to the demographics of the youth in this inpatient
treatment facility, several frequency statistics were determined. 74% of
participants reported that they frequently or very often used immediately
after waking up, while 83% reported frequently or very often using
immediately before they went to sleep. 78% reported frequently or very
often obtaining drugs or alcohol from their homes or their friends homes.
22% rarely felt pressure from their family to quit using. 48% reported rarely
to never thinking of finding new activities during or after school. 87%
reported frequently or very often using at the same time each day and 70%
reported frequently or very often having difficulty managing daily activities
because of their use.
It is also important to highlight areas that were found to be non-affected
within this demographic. Hygiene, for example, seems to be in good
standing as 96% report frequently or very often being careful of personal
hygiene. It also appears that keeping their addiction a secret had no trend
as the responses were almost evenly distributed across all 5 response
levels from never to very often.
RECOMMENDATIONS
One of the limitations of this study was that our sample was only drawn from
one treatment center. Few centers provide treatment solely to the
adolescent population in the Southwest Florida region, and those that do
have strict regulations in place to protect those under 18 years of age. The
research team attempted to recruit participants from another treatment
center in the area, yet due to the strict requirements of test administration
set by the university IRB and the policies of this center, we were unable to
collect data from this source.
Another limitation was the low client turnover rate within the facility.
Researchers began administration in March of 2015 and concluded by
August of the same year. The facility remained at capacity (n=20) with an
approximately 3-6 month stay per client for the duration of that time.
Both of these factors contributed to the small sample size in our study. This
challenge created an inability to compare the factor structure of the LHQ-Y
to the original LHQ. It is advised that future researchers take their
geographic accessibility of this specific population into account when
planning further research with the LHQ-Y.