Date of Award

August 2019

Degree Type


Degree Name

Doctor of Philosophy (PhD)




Stephen A. Maisto


AUDIT-C, College Students, Primary Care, Screening, SUBS, Substance Use

Subject Categories

Social and Behavioral Sciences


Harmful substance use is a prevalent and under-treated public health problem, with use of alcohol, tobacco, and illicit drugs among the top preventable causes of death in the United States. The unmet need for treatment is particularly pronounced among young adults, for whom university primary care is an important venue for early detection and intervention. Although a number of different multi-substance use screens have been developed for primary care settings, none have been validated in university primary care. Other behavioral health concerns are also highly prevalent among college students, although little is known regarding how behavioral risk factors co-occur in this setting. Accordingly, this study aimed to extend research on the validity of the 4-item Substance Use Brief Screen (SUBS) in a university primary care setting. The diagnostic utility of the SUBS was also compared to an established screen for at-risk drinking, the Alcohol Use Disorder Identification Test – Consumption (AUDIT-C). Finally, this study described prevalence rates and identified cluster profiles of multiple risk factors, including at-risk substance use, behavioral health concerns, and body mass index. Participants (n = 100) were recruited from Syracuse University Health Services to complete self-report screens and a structured interview. Results support the construct validity and utility of the SUBS in university primary care, with cut-off scores of 1 for tobacco and nonmedical prescription drug use, and 2 for at-risk alcohol and illicit drug use. Results also suggest that behavioral health risk factors commonly co-occur, thereby supporting the development of brief, combined interventions targeting multiple risk factors in university primary care.


Open Access