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GAIN-Q3

GAIN-Q3

Description
The Global Appraisal of Individual Needs Q3 (GAIN-Q3) is a brief, 20-45 minute assessment used to identify and address a wide range of problems among adolescents and adults in clinical and general populations. As a clinical tool, the GAIN-Q3 is designed for use by personnel in diverse settings that include employee assistance programs, student assistance programs, health clinics, juvenile justice, criminal justice, child welfare, mental health, and substance abuse treatment programs.

Instruments
There are several versions of the GAIN-Q3 available for use:

The GAIN-Q3-Lite is the most basic form of the assessment. It consists of nine screeners that estimate the severity of problems and the recency of treatment participation in each life area represented. The GAIN-Q3-Lite also computes a measure of participants' quality of life. The average time to administer the GAIN-Q3-Lite is about 25 minutes.

The GAIN-Q3-Standard contains the same nine screeners as the GAIN-Q3-Lite, plus additional items that record information on the frequency of participants' service utilization and behaviors during the preceding 90 days. The GAIN-Q3-Standard provides more detailed outcome measures than the GAIN-Q3-Lite. In addition to the quality of life measure, the GAIN-Q3-Standard computes indices on the participant's prevalence of problems and quarterly costs to society. A six-item measure on current life satisfaction is also included in the GAIN-Q3-Standard. The average time to administer the GAIN-Q3-Standard is about 25 to 35 minutes.

The GAIN-Q3-MI is best suited to participants who may be in need of brief intervention. It contains the same nine screeners as the GAIN-Q3-Lite and Standard, the past-90-day items, and the measure of life satisfaction from the Q3-Standard, as well as reasons and readiness items to facilitate a motivational-interviewing session. The time to conduct the screening and brief intervention varies, depending on the number of life areas the participant reports as problematic. On average, the GAIN-Q3-MI takes about 35 to 45 minutes to administer. Following up the assessment with a motivational-interviewing intervention can take another 15 to 30 minutes, depending on how many life areas are covered

Since the GAIN-Q3-Standard provides more detailed outcome measures than the GAIN-Q3-Lite, and motiviational interviewing items are typically only asked at baseline, the Q3 Standard is recommended for use as a follow-up assessment to all versions of the Q3. 

Clinical Reports
Once the Q3 interview is completed, there are a number of reports that can be generated to support your clinical decision making and referral process. The following reports have been generated using the Q3-Standard (with the exception of the Q3PFR). Report availability and detail may vary based on which instrument version you are using.

Q3 Individual Clinical Profile (Q3ICP) - This report allows clinicians a quick visual on areas of clinical significance. The Q3ICP contains information related to service utilization in every section of the GAIN-Q3, and it allows clinicians to compare these scores with the problem rating and impact of services scores. You can also view this report as generated with the GAIN-Q3-Lite and the GAIN-Q3-MI.

Q3 Personalized Feedback Report (Q3PFR) - This report is a summary of the life problems reported by the participant along with their reasons for wanting to change. The Q3PFR can be used to support motivational interviewing or brief intervention. The Q3PFR is designed for use with the GAIN-Q3-MI. You can also view this report as generated with the GAIN-Q3-Lite or GAIN-Q3-Standard, but the results will contain sections of missing information that have to be collected from the participant during a subsequent session or during motivational interviewing.

Q3 Recommendation Referral Summary (Q3RRS) - This report summarizes information from the GAIN-Q3 in narrative format. Unlike the Q3ICP, the Q3RRS is fully editable and designed to be shared with participants, referral sources, clinicians, etc. It is used to enhance and support decision making, but is not designed to replace clinical judgment. The amount of information summarized in the Q3RRS depends on the version and items reported by the participant.
You can also view this report as generated with the GAIN-Q3-Lite and the GAIN-Q3-MI.

Validity Report - This report summarizes possible and definite validity errors found during the course of GAIN-Q3 administration. Issues identified in the validity reports should be addressed with the participant during or immediately after the interview. Identification of validity errors helps increase the overall strength of the participant's self-report and helps ensure proper intervention and referral. You can also view this report as generated with the GAIN-Q3-MI.

Manual
Please click to download a watermarked copy of the GAIN-Q3 manual.

Psychometrics
Psychometrics for the GAIN-Q3 screeners (9 individual and 1 total), including internal consistency, construct validity, efficiency, and validity of the interpretative cut-points, have been established for both adolescent and adult samples. The Total Disorder Screener has excellent internal consistency for both adolescents and adults (.90). For most of the individual GAIN-Q3 screeners, internal consistency is good to excellent (Cronbach's alpha > .7) for both adolescents and adults; exceptions include screeners with a potentially restricted range of problems (e.g., lower alpha on the Sources of Stress Screener given stress can result from any number of experiences, not all of which may be captured by the screener). Correlations of the GAIN-Q3 screeners with their corresponding full length GAIN-I scales are at or above 0.82 for all screeners across both samples, supporting concurrent validity; correlations of the GAIN-Q3 screeners with their non-corresponding full-length GAIN-I scales are at or below 0.40, supporting discriminant validity. The efficiency of a GAIN-Q3 screener as defined by Dennis et al (2006) is a measure of how well it can obtain the same or similar measurement information as its full-length GAIN-I counterpart, but with fewer items. The efficiency measure can be interpreted as the adjusted percent of items required to get virtually the same measuring information as that obtained using the full-length scales. Efficiency improves (lower values) the fewer the items that are used in the screeners and declines (higher values) the less the screener is correlated with its corresponding full scale. Efficiency scores less than 1 are ideal. Adolescents' efficiency scores range from 0.15 to .55 while adults' range from .15 to .54, demonstrating capability for quick measurement without any significant loss of information. Analyses on each GAIN-Q3 screener's sensitivity (the percent of people with disorders on a full GAIN-I scale correctly identified by its corresponding GAIN-Q3 screener), specificity (percent of people without a disorder on a full GAIN-I scale correctly excluded by its corresponding GAIN-Q3 screener) provide interpretive support for the cut-points. GAIN-Q3 screener scores allow the clinician to triage clients into three groups: unlikely diagnosis (0), possible diagnosis (1-2), and probable diagnosis (3-5). These cut-points reflect 90% sensitivity for most GAIN-Q3 screeners and 90% specificity for all GAIN-Q3 screeners for both adults and adolescents; thus, across all age groups, predicting diagnoses using the GAIN-Q3 screeners is nearly as accurate as using an assessment four times longer.

You can download the most recent GAIN-Q3 Norms, calculated using GAIN-I data.

For more information, see Resources for Evaluators and Researchers.

GAIN ABS
Learn more about how the GAIN ABS Web Application can enhance your use of the GAIN-Q3.