Outcome ascertainment for the ARYS cohort will involve blood testing, clinical evaluation of needle tracks, and self-reported behavioral data obtained through the interviewer-administered questionnaire. In addition, the local setting is unique because of the availability of confidential record linkages made possible through Canada's universal healthcare system. Specifically, administrative databases create an opportunity for the accurate ascertainment of key measures, including emergency room and hospital use, medication use, and contact with various harm reduction services, including the city's supervised injecting facility. These linkages have several advantages, since self-reported health service use has been shown to be subject to socially desirable responding [40 (link)].
Although many youth-specific indicators have had to be developed, the survey instrument for the ARYS cohort is largely based on the scales that have been developed as part of the Vancouver Injection Drug Users Study (VIDUS), a prospective cohort study of IDU that has been described in detail previously [13 (link),41 (link)-43 (link)]. The survey instruments have been intentionally coordinated to facilitate the examination of the natural history of injection drug use through to adulthood. Both surveys include sections on sources of income, non-injection and injection drug use (including overdose and binging), interactions with police, incarceration, sexual activity, drug and alcohol treatment, violence, and nutritional needs. Both surveys also include standardized measures for depression (Centre for Epidemiologic Studies Depression Scale [44 ]) and childhood trauma (Childhood Trauma Questionnaire [45 ,46 (link)]), as well as HIV knowledge scales [47 (link)] and a non-standardized self-efficacy scale to evaluate self-efficacy to avoid injection drug use. The youth survey also includes sections on educational background and exposure to injection drug use. The coordination of survey instruments allows us to seek to explore the relationship between established injectors and new initiates into injection drug use.
Although many youth-specific indicators have had to be developed, the survey instrument for the ARYS cohort is largely based on the scales that have been developed as part of the Vancouver Injection Drug Users Study (VIDUS), a prospective cohort study of IDU that has been described in detail previously [13 (link),41 (link)-43 (link)]. The survey instruments have been intentionally coordinated to facilitate the examination of the natural history of injection drug use through to adulthood. Both surveys include sections on sources of income, non-injection and injection drug use (including overdose and binging), interactions with police, incarceration, sexual activity, drug and alcohol treatment, violence, and nutritional needs. Both surveys also include standardized measures for depression (Centre for Epidemiologic Studies Depression Scale [44 ]) and childhood trauma (Childhood Trauma Questionnaire [45 ,46 (link)]), as well as HIV knowledge scales [47 (link)] and a non-standardized self-efficacy scale to evaluate self-efficacy to avoid injection drug use. The youth survey also includes sections on educational background and exposure to injection drug use. The coordination of survey instruments allows us to seek to explore the relationship between established injectors and new initiates into injection drug use.
Free full text: Click here
