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Natural History Interview (NHI)
Overview
The Natural History Interview (NHI) protocol is designed to be
used in face-to-face interviews to collect detailed information
on substance abuse history and behaviors as well as other potentially
related information. The NHI was originally adapted in part from
procedures developed by Nurco and colleagues (1975) and has been
used in many longitudinal studies since 1977 (McGlothlin et al.,
1977).
The interview protocol is composed of several numbered Forms,
each targeting a different domain and organized into two major
parts of the interview. Part I, collectively called the "Static" segment,
collects general background information plus current and summary
data on alcohol and drug use and other selected behaviors and characteristics.
Component forms can include sections on personal and family background,
acculturation, physical and mental health, substance use, criminal
history, HIV risk behaviors, employment, income, and characteristics
related to a specific treatment episode. Forms can be expanded
or condensed to meet the objectives of the particular study. For
example, if a study targets a treatment population, then forms
can be added to identify treatment services received and satisfaction
with treatment. If a study targets methamphetamine users, a form
with items adapted from Pennell et al., (1999) can be added.
Part II, collectively called the "Dynamic" segment,
is used to collect a continuous history of substance abuse and
related behaviors, co-occurring characteristics, and events from
a specified starting point (e.g. first substance use) until the
interview. Different component forms target historical use of alcohol
and specific drugs (e.g. narcotics, marijuana, cocaine/crack, amphetamines/methamphetamine),
periods of incarceration (and non-incarceration), criminal behavior,
in-patient health and mental health treatment, substance abuse
treatment, and employment. Component forms can be expanded or condensed
according to study objectives. For this part of the interview,
the interviewer and respondent first construct a time line, noting
major events for respondent reference (e.g. marriages, births,
incarcerations, as well as major contextual events) to facilitate
recall of substance use and other behaviors and events. Then the
respondent identifies time periods associated with specific behaviors
(from questions on the component forms), with periods delineated
by changes in behavior. The respondent answers the sets of questions
about each type of behavior or event for each delineated period.
These data can be translated to month-by-month time series-type
data for each type of behavior/event targeted by the study (Anglin & Hser,
1988).
The NHI typically averages about two to three hours to administer,
depending on the number of forms included, the length of time covered,
and the number of periods of behavior change (e.g. number of incarcerated
and non-incarcerated intervals from the starting date until the
interview or the number of periods delineated by major changes
in use of a specific drug or the number of substance use treatment
episodes). No specific interviewer licensure is required for conducting
interviews. However, interviewer training is required and on-going
quality assurance procedures are strongly recommended (see NHI-related
videos). Training typically includes instruction, observation of
NHI administration, mock interviews with trainers and other project
staff and critique, and practice interviews with individuals similar
to intended subjects.
Information on reliability and validity is presented in Anglin
et al., (1993), Chou et al. (1996), Hser et al. (1992), and Murphy
et al. (under review).
Specific examples of the NHI are available from this web site.
Other versions of the NHI and NHI – Short Form are available
from the PIs listed in the selected studies below.
- A version of the NHI Static segment forms
(numbered 1-5A, 12A, 23, 30A) covering background, physical health,
mental health, crime/deviant behavior, drug history, methamphetamine/
amphetamine, drug treatment components, past year income, and
other behaviors was used in the Methamphetamine Abuse – Natural
History, Treatment Effects (Meth) study (Brecht, PI) for the
first interview during 1998-2000.
- A version of the NHI Dynamic segment forms
(numbered 6, 9-11, and 13-19) was used in the Therapeutic Community
Treatment for Prisoners (Amity; Prendergast, PI) study, 1999-2000. The
forms covered incarcerations, medical/psychiatric treatment,
legal status, drug treatment, cocaine/crack use, narcotics use,
amphetamine/speed/crystal/ methamphetamine use, marijuana use,
alcohol use, legal employment, crime and dealing. This
example also includes additional detail on the administration
of these forms within the Amity study.
- A third example is a version of the NHI – Short
Form also known as (aka) the Life Experience Timeline
(LET) Interview from the Treatment System Impact and Outcomes
of Proposition 36 (TSI) study (Hser, Ph.D., PI), which was
used during 2005-2007. The forms covered
criminal justice, drug treatment, medical/psychiatric treatments,
and drug use.
References:
Anglin, M. D., & Hser, Y. (1988). Addict career
histories: Processes and patterns. Unpublished
report, University of California, Los Angeles, Drug Abuse Research
Center.
Anglin, M. D., Hser, Y., & Chou, C. P. (1993). Reliability
and validity of retrospective behavioral self-report by narcotics
addicts. Evaluation Review, 17(1), 90-107.
Chou, C. -P., Hser, Y., and Anglin, M. D. (1996). Pattern reliability
of narcotics addicts' self-reported data: A confirmatory assessment
of construct validity and consistency. Substance Use & Misuse,
31(9), 1189-1216.
Hser, Y., Anglin, M. D., & Chou, C. (1992). Reliability of
retrospective self-report by narcotics addicts. Psychological
Assessment, 4(2), 207-213.
McGlothlin, W. H., Anglin, M. D., & Wilson, B. D. (1977). An
evaluation of the California civil addicts program. NIDA Services
Research Monograph ADM 78-558. Washington, DC: US Government Printing
Office.
Murphy, D. A., Hser, Y., Huang, D., Brecht, M.-L., & Herbeck,
D. (under review). Self-report of longitudinal substance
use: A comparison of the UCLA Natural History Interview and
the Addiction Severity Index.
Nurco, D. N., Bonito, A. J., Lerner, M., & Balter, M. B. (1975). Studying
addicts over time: Methodology and preliminary findings. American
Journal of Drug and Alcohol Abuse, 2(2),183-96.
Pennell, S., Ellet, J., Rienick, C., & Grimes, J. (1999). Meth
matters: Report on methamphetamine users in five western cities. (NIJ
Publication No. NCJ 176331). Washington, DC: U.S. Department
of Justice.
NHI
Introduction to the NHI (video) [coming soon]
Part I: “Static” Segment - Example
from the Methamphetamine Abuse – Natural History Treatment
Effect (Meth) study (Brecht, PI)
Part II: “Dynamic” Segment - Example
from the Therapeutic Community Treatment for Prisoners (Amity)
study (Prendergast, PI)
Selected studies that have used the NHI
NHI – Short Form aka the Life Experience Timeline (LET)
Interview
Example from the Treatment System Impact and Outcomes of Proposition
36 (TSI) study (Hser, PI)
Selected studies that have used the NHI – Short
Form aka the Life Experience Timeline (LET)
Selected studies that have used the NHI
- Methamphetamine Abuse: Natural History, Treatment Effects (Brecht,
PI)
- Context and Effectiveness of Two Models of Service Delivery
(SAMI) (Grella, PI)
- Gender Differences in a Long-term Follow-up Study of Opiate
Users in California (Grella, PI)
- A 12-Year Follow-up of a Cocaine Dependent Sample (Hser, PI)
- Treatment Utilization and Effectiveness (TUE) Project (Hser,
PI)
- Drug Treatment Process (Hser, PI)
- Natural History of Narcotics Addiction - 33 Yr Follow Up (Hser,
PI)
- Therapeutic Community Treatment for Prisoners (Amity Project)
(Prendergast, PI)
Selected studies that have used the NHI – Short Form
aka the Life Experience Timeline (LET)
- Methamphetamine Abuse Treatment – Special Studies (MAT-SS)
(Marinelli-Casey, PI)
- Treatment System Impact and Outcomes of Proposition 36 (Hser,
PI)
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