Development, validation, and utility of internet-based, behavioral health screen for adolescents

Guy Diamond, Suzanne Levy, Katherine B. Bevans, Joel A. Fein, Matthew B. Wintersteen, Allen Tien, Torrey Creed

Research output: Contribution to journalArticlepeer-review

52 Scopus citations


OBJECTIVES: The goals were to develop and to validate the Internetbased, Behavioral Health Screen (BHS) for adolescents and young adults in primary care. METHODS: Items assessing risk behaviors and psychiatric symptoms were built into a Internet-based platform with broad functionality. Practicality and acceptability were examined with 24 patients. For psychometric validation, 415 adolescents completed the BHS and wellestablished rating scales. Participants recruited from primary care waiting rooms were 12 to 21 years of age (mean: 15.8 years); 66.5% were female and 77.5% black. RESULTS: The BHS screens in 13 domains by using 54 required items and 39 follow-up items. The administration time was 8 to 15 minutes (mean: 12.4 minutes). The scales are unidimensional, are internally consistent (Cronbach's α = 0.75-0.87), and discriminate among adolescents with a range of diagnostic syndromes. Sensitivity and speci-ficity were high, with overall accuracy ranging from 78% to 85%. Patients with scores above scale cutoff values for depression, suicide risk, anxiety, and posttraumatic stress disorder symptoms were ≥4 times more likely to endorse other risk behaviors or stressors. CONCLUSIONS: The BHS addresses practical and clinical barriers to behavioral health screening in primary care. It is a brief but comprehensive, self-report, biopsychosocial assessment. The psychiatric scales are valid and predictive of risk behaviors, which facilitates exclusion of false-positive results, as well as assessment and triage.

Original languageEnglish (US)
Issue number1
StatePublished - Jul 2010
Externally publishedYes


  • Adolescents
  • Behavioral health screening
  • Depression
  • Primary care
  • Suicide

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health


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