Transdermal monitors to assess alcohol consumption in real-time and real-life – a qualitative study on user-experience

Abstract

Introduction: Transdermal alcohol monitors, such as Secure Continuous Remote Alcohol Monitors (SCRAMs), enable continuous measurement of alcohol consumption in participants' natural environments free from recall bias and response burden. This paper explores young research participants' experience of wearing SCRAMs to provide insights into the potential of the devices to be used for research on a larger scale. Method:In south-east Australia, participants were recruited among festival attendees (n=12) and college students (n=18). Participants wore the SCRAMs over three to four days, and upon returning the devices participated in a semi-structured qualitative interview about their experiences of the devices.Results: Most participants reported becoming unaware of the device after initial adjustment and did not believe their drinking patterns had been altered by wearing the SCRAM.Perceived similarities with correctional monitoring equipment led to a number of social interactions with onlookers, but participants generally felt at ease with this. Common issues reported by participants related to the physical discomfort and restrictions caused by the devices, citing problems with sleeping, exercising, and irritation with the clamping mechanism as impediments.Conclusions: Although SCRAMs have not been designed with research purposes in mind, this study highlights their utility in measuring alcohol consumption in real-life and real-time.Most participants suggested that their drinking patterns were unaffected and that any physical discomfort was manageable; however, comfort is a critical consideration in terms of improving the user experience. Adequately controlled validation studies are needed to determine if and how wearing SCRAMs affects retention, behaviour and drinking patterns.

Ecological Momentary Assessment of Alcohol Consumption and Its Concordance with Transdermal Alcohol Detection and Timeline Follow‐Back Self‐report Among Adults Experiencing Homelessness

“…Furthermore, some participants complained about the size and physical discomfort of wearing the SCRAM, which has been discussed in previous studies (Alessi et al, 2017;Caluzzi et al, 2019). When the 29 participants who did not complete the study were compared with those who did complete the study, 2 statistically significant differences were found (Table 1).…”

Validating transdermal alcohol biosensors: a meta‐analysis of associations between blood/breath‐based measures and transdermal alcohol sensor output

“…1a [13]). SCRAM is a relatively bulky ankle bracelet intended primarily for use with criminal justice-involved populations [18,37,38]. SCRAM devices have demonstrated discriminative validity in detecting drinking episodes [12], albeit with limited ability to detect low level drinking [39][40][41][42], and thus appear well suited to their primary intended purpose as abstinence monitors in forensic settings [12,43].…”

“…Thus, transdermal sensors have the potential to assess drinking continuously, passively and unobtrusively by measuring the concentration of alcohol in sweat and insensible perspiration. In addition to their existing application as abstinence monitors in the criminal justice system [12,13], a range of additional uses have been proposed for transdermal sensors, including as relapse-detecting monitors capable of prompting 'just-in-time' addiction intervention [14,15], as drinking risk-level indicators to inform the advisability of driving [14,16,17] and as continuous trackers capable of unobtrusively assessing drinking during the course of months and even years for implementation in research studies [5,[18][19][20].…”

Drinking and Driving

“…Given the low number of persons who receive interlock devices, the study provided no evidence on effects of interlock devices on motor vehicle crashes. Evaluations of SCRAM devices have been based on small samples, limiting conclusions that can be made about their effectiveness (see e.g., Marques and McKnight 2009;Caluzzi et al 2019).…”