Measuring Exposure to Cannabis use and other Substance use in Remote Aboriginal Populations in Northern Australia: Evaluation of A ‘Community Epidemiology’ Approach using Proxy Respondents

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Abstract
We evaluate a method to describe changing substance use patterns in northern Australia's remote Aboriginal communities (Arnhem Land, Northern Territory). Substance use was assessed in random samples in two communities A (n = 194) and B (n = 176). Five Aboriginal health workers made assessments independently of each other in community A. A different group of three health workers made independent assessments in community B. Sub-samples were opportunistically recruited for interview (community A, n = 77; community B, n = 55). In community C, 101 people were interviewed and were also assessed by four local health workers working together. Proportional agreements (kappa-κ statistic) among health workers for a history of substance use and current use, varied from κ = 0.207 for petrol sniffing (P = 0.006) up to κ = 0.749 for cannabis use (PPP<0.001). Aboriginal health worker consensus classification clarified equivocal self-report data.