The Pitjantjatjara ASSIST: A project aimed at assessing the validity, reliability and cultural appropriateness of the digital, translated and culturally-adapted Alcohol, Smoking and Substance Involvement Screening Test (ASSIST), for use in Aboriginal and Torres Strait Islander populations.

Participant Involvement and Procedure: Participants will complete the Pitjantjatjara ASSIST app, a culturally-adapted and translated 8-item questionnaire that assesses risk of harm from substance use disorders [1,2]. The app focuses on five substances of concern in Pitjantjatjara communities (alcohol, tobacco, cannabis, methamphetamine, and inhalants). Participants step through the instrument sequentially for each substance, with the ability to modify responses throughout the assessment until the final question is completed. After completion, participants receive personalized feedback on substance-specific risk levels and general health advice about reducing or stopping use. Following the receipt of feedback, participants are then asked to answer three user experience questions using a 5-point Likert Scale with emoji faces to evaluate cultural acceptability. Time Requirement: Based on internal pilot testing, the app takes approximately 10 minutes to complete, not including the variable time participants spend reviewing their feedback, which is not time-limited. Administration: The app is self-administered on an iPad tablet. Before beginning, participants receive a guided visual and tactile demonstration from a research team member (either a health worker or interpreter). Research team members remain nearby to address any questions or technical issues, but participants complete the assessment independently. Frequency: Participants will complete the app twice during the study period: once on the initial day (either before or after the diagnostic interview, depending on randomization) and again during a follow-up session 6-14 days later. Fidelity and Adherence Monitoring: The app's digital format ensures standardisation of the assessment process. All participants receive the same questions in the same sequence, with built-in controls that prevent modification of responses after completion. Randomisation and follow-up Participants will first be randomised to complete either the Pitjantjatjara ASSIST app or the diagnostic interview first. Those assigned to the app-first condition will complete the app as outlined, then be provided a 30-minute break before completing the diagnostic interview. Those assigned to the interview-first condition will complete the diagnostic interview first, then be given a 30-minute break before completing the app. Both groups of participants will then be followed up 7-14 days later to complete the Pitjantjatjara ASSIST app a second time. References: 1. World Health Organization Working Group. The Alcohol, Smoking and Substance Involvement Screening Test (ASSIST): development, reliability and feasibility. Addiction. 2002 Sep;97(9):1183-94. 2. Stevens MW, Barry D, Bertossa S, Thompson M, Ali R. First-Stage Development of the Pitjantjatjara Translation of the World Health Organization’s Alcohol, Smoking and Substance Involvement Screening Test (ASSIST). Journal of the Australian Indigenous HealthInfoNet. 2022;3(4):2.