A systematic review of event-level measures of risk-taking behaviors and harms during alcohol intoxication

Brooks, Michael; Nguyen, Rebecca; Bruno, Raimondo; Peacock, Amy

doi:10.1016/j.addbeh.2019.106101

Cited by 7 publications

(3 citation statements)

References 57 publications

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“…Several studies in high-income countries have shown EMA can be used to effectively collect behavioral data including dietary [3,4], substance use [5][6][7], and sexual risk behaviors [8]. One small study among women in South Africa showed it feasible to collect daily sexual risk data over mobile phones [9].…”

Section: Introductionmentioning

confidence: 99%

Acceptability and feasibility of mobile phone-based ecological momentary assessment and intervention in Uganda: A pilot randomized controlled trial

et al. 2022

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Valid, reliable behavioral data and contextually meaningful interventions are necessary for improved health outcomes. Ecological Momentary Assessment and Intervention (EMAI), which collects data as behaviors occur to deliver real-time interventions, may be more accurate and reliable than retrospective methods. The rapid expansion of mobile technologies in low-and-middle-income countries allows for unprecedented remote data collection and intervention opportunities. However, no previous studies have trialed EMAI in sub-Saharan Africa. We assessed EMAI acceptability and feasibility, including participant retention and response rate, in a prospective, parallel group, randomized pilot trial in Rakai, Uganda comparing behavioral outcomes among adults submitting ecological momentary assessments (EMA) versus EMAI. After training, participants submitted EMA data on five nutrition and health risk behaviors over a 90-day period using a smartphone-based application utilizing prompt-based, participant-initiated, and geospatial coordinate data collection, with study coordinator support and incentives for >50% completion. Included behaviors and associated EMAI-arm intervention messages were selected to pilot a range of EMAI applications. Acceptability was measured on questionnaires. We estimated the association between high response rate and participant characteristics and conducted thematic analysis characterizing participant experiences. Study completion was 48/50 participants. Median prompt response rate was 66.5% (IQR: 60.0%-78.6%). Prior smartphone app use at baseline (aPR 3.76, 95%CI: 1.16–12.17, p = 0.03) and being in the intervention arm (aPR 2.55, 95% CI: 1.01–6.44, p = 0.05) were significantly associated with the top response rate quartile (response to >78.6% of prompts). All participants submitted self-initiated reports, covering all behaviors of interest, including potentially sensitive behaviors. Inconsistent phone charging was the most reported feasibility challenge. In this pilot, EMAI was acceptable and feasible. Response rates were good; additional strategies to improve compliance should be investigated. EMAI using mobile technologies may support improved behavioral data collection and intervention approaches in low and middle-income settings. This approach should be tested in larger studies.

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Section: Introductionmentioning

confidence: 99%

Acceptability and feasibility of mobile phone-based ecological momentary assessment and intervention in Uganda: A pilot randomized controlled trial

et al. 2022

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“…It is also possible that the disinhibiting effect of alcohol, in concert with attentional focus, contributed to the results. Alcohol intoxication is associated with deficits in cognitive functioning and decision making, including lower perceptions of personal risk related to sexual risk-taking (Brooks et al, 2019; Fromme et al, 1999). Future researchers could test these suppositions.…”

Section: Discussionmentioning

confidence: 99%

Alcohol intoxication, condom use rationale, and men’s coercive condom use resistance: The role of past unintended partner pregnancy.

Neilson,

Marcantonio,

Woerner

et al. 2024

Psychology of Addictive Behaviors

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Objective: Cisgender men's condom use resistance (CUR), deliberate attempts to avoid using a condom with a partner who wishes to use one, may include coercive strategies, such as deception and force, and places their partners at risk for unintended pregnancy and sexually transitted infections (STIs). This investigation used an alcohol administration design to examine one distal (history of unintended partner pregnancy) and two proximal (acute alcohol intoxication, condom use rationale) contributors to men's intentions to engage in coercive CUR. Method: Nonproblem drinking, cisgender men (N = 313) completed questionnaires, then were randomized to a beverage condition (control, placebo, low dose [.04%gm], and high dose [.08%gm]). Participants completed a sexual risk analog and reported their coercive CUR intentions after a hypothetical, female partner provided a condom use rationale (STI avoidance or pregnancy avoidance). Results: Men who received the pregnancy condom use rationale reported higher intentions to engage in coercive CUR when they received a high alcohol dose relative to sober men. For men who had a history of unintended partner pregnancy, receiving a pregnancy condom use rationale was associated with greater intentions to have forced, condomless sex if they received a high alcohol dose relative to sober men. Conclusions: Intoxicated men may be more likely to engage in coercive CUR; this may indicate that when intoxicated, pregnancy risks are less salient relative to STI-related outcomes. As reproductive rights are being decimated, effective interventions targeting CUR, particularly when intoxicated, are needed in tandem with policies that affirm one's ability to prevent and terminate pregnancy. Public Health Significance StatementThe present study examined three contributors to men's intentions to use coercive strategies to avoid using a condom: (a) a history of having a partner have an unintended pregnancy; (b) alcohol intoxication; and (c) whether a partner wants to use a condom to prevent STIs or pregnancy. Results indicate that a history of unintended partner pregnancy is associated with intentions to have forced, condomless sex, when men are intoxicated and are asked to use a condom to prevent pregnancy. The results suggest that past unintended pregnancy may not deter intoxicated men from engaging in aggressive strategies to avoid condom use, even when there is a possibility of unintended pregnancy.

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“…There is an abundance of evidence from outside the laboratory that alcohol causes a range of maladaptive risktaking behaviours (e.g. Brooks et al, 2019); and corroborating evidence from within the laboratory has recently been reviewed by Harmon et al (2021). While the laboratory evidence for risk-taking and related behaviors at low BACs is not plentiful, the available evidence was reviewed by Weafer and Fillmore (2016), who defined a 'low BAC' as below 0.08the general driving limit in the U.S.…”

Section: The One-dimensional Approach Particularly Fails To Explain L...mentioning

confidence: 99%

How to read a paper on the short-term impairing effects of cannabis: A selective and critical review of the literature

White

Burns

2022

Drug Science, Policy and Law

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The prosecution of cannabis-presence driving offences (in the absence of any behavioural evidence of impairment) is ultimately based on the assumption that there is a tight causal relationship between positive toxicology for cannabis and impairment. The main purpose of this review is to examine the evidence for that relationship. We show that most experimental studies have failed to elicit statistically-significant cannabis-induced impairments for many of their possible outcomes. And many studies failed to demonstrate any impairment at all in regular users of cannabis (because of the development of tolerance). We argue that selective reporting by researchers, editors and the media has created the false impression that the evidence for cannabis-induced impairment is strong and consistent. Human beings are ‘over-engineered’ for the psychomotor skills required to drive safely. A benchmark level of cannabis-induced impairment is therefore required to distinguish unproblematic from ‘real-world’ impairment. The conventional benchmarks of statistical significance, effect size and BAC-equivalence are shown to be inadequate. However, a benchmark in terms of 30 years of normal cognitive aging has good face validity. The recent use of cannabis is indicated toxicologically by the presence of delta-9-tetrahydrocannabinol (THC) in blood or oral fluid. Evidence is provided that most THC-positive drivers are not impaired, and certainly not meaningfully impaired. It follows that the justice of stand-alone cannabis-presence driving offences must be questioned.

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A systematic review of event-level measures of risk-taking behaviors and harms during alcohol intoxication

Cited by 7 publications

References 57 publications

Acceptability and feasibility of mobile phone-based ecological momentary assessment and intervention in Uganda: A pilot randomized controlled trial

Acceptability and feasibility of mobile phone-based ecological momentary assessment and intervention in Uganda: A pilot randomized controlled trial

Alcohol intoxication, condom use rationale, and men’s coercive condom use resistance: The role of past unintended partner pregnancy.

How to read a paper on the short-term impairing effects of cannabis: A selective and critical review of the literature

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