Assessment of Alcohol Use and Consequences: Comparison of Data Collected Via Timeline Followback Interview and Daily Reports.

OBJECTIVE: The aim of this study was to compare data on both alcohol use and alcohol-related consequences between intensive longitudinal data collection and the retrospective Timeline Followback (TLFB) interview. METHOD: Heavy drinking college students (n = 96; 52% women) completed daily reports across a 28-day period to assess alcohol use and positive and negative consequences of drinking. They returned to the lab at the end of this period to complete a TLFB assessing behavior over those same 28 days. First, t tests were used to compare variables aggregated across the full 28 days at the between-person level. Next, hierarchical linear modeling was used to examine within-person differences between methods for each variable in weekly and daily increments. RESULTS: Many alcohol use and consequence variables were significantly different when derived from self-reports during TLFB versus daily reports. In contrast to prior work, we found that higher estimates of drinking were reported retrospectively on the TLFB than on the daily reports. In addition, discrepancies were greater on some variables for heavier drinkers and when more time had elapsed between the end of the daily reporting period and TLFB collection. CONCLUSIONS: Recall of drinking behavior during TLFB and daily reports may differ in systematic ways, with discrepancies varying based on participant and methodological characteristics.

Using the Internet to access key populations in ecological momentary assessment research: Comparing adherence, reactivity, and erratic responding across those enrolled remotely versus in-person.

Ecological momentary assessment (EMA) is a set of longitudinal methods that researchers can use to understand complex processes (e.g., health, behavior, emotion) in "high resolution." Although technology has made EMA data collection easier, concerns remain about the consistency and quality of data collected from participants who are enrolled and followed online. In this study, we used EMA data from a larger study on HIV-risk behavior among men who have sex with men (MSM) to explore whether several indicators of data consistency/quality differed across those who elected to enroll in-person and those enrolled online. One hundred MSM (age 18-54) completed a 30-day EMA study. Forty-five of these participants chose to enroll online. There were no statistically significant differences in response rates for any survey type (e.g., daily diary [DD], experience sampling [ES], event-contingent [EC]) across participants who enrolled in-person versus online. DD and ES survey response rates were consistent across the study and did not differ between groups. EC response rates fell sharply across the study, but this pattern was also consistent across groups. Participants' responses on the DD were generally consistent with a poststudy follow-up Timeline Followback (TLFB) with some underreporting on the TLFB, but this pattern was consistent across both groups. In this sample of well-educated, mostly White MSM recruited from urban areas, EMA data collected from participants followed online was as consistent, reliable, and valid as data collected from participants followed in-person. These findings yield important insights about best practices for EMA studies with cautions regarding generalizability. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Using ecological momentary assessment (EMA) to explore mechanisms of alcohol-involved HIV risk behavior among men who have sex with men (MSM).

BACKGROUND AND AIMS: Heavy drinking is associated with increased risk of incident HIV infection among men who have sex with men (MSM). Past studies suggest that this association may be due to the tendency for intoxication to interfere with condom use. However, research on potential causal mechanisms explaining this relationship has been limited primarily to laboratory studies. In this study, we tested several potential mediators of the relationship between alcohol use level and HIV risk behavior. DESIGN: Ecological momentary assessment (EMA) methods conducted over a 30-day period. SETTING AND PARTICIPANTS/CASES: MSM (n = 100) in the northeastern United States. MEASUREMENTS: Participants completed daily diary surveys and up to six experience sampling surveys randomly prompted throughout the day. FINDINGS: Very heavy levels of drinking (12+ drinks) increased the odds of engaging in any sex [odds ratio (OR) = 1.87, P < 0.001]. Coefficient products and 95% confidence intervals indicated that both subjective sexual arousal (OR = 1.52, P < 0.001) and sex intentions (OR = 1.74, P < 0.001) significantly mediated the association between very heavy drinking and the odds of sex. When participants reported sex, the odds of engaging in high-risk condomless anal sex (CAS) increased incrementally after drinking heavily (five to 11 drinks; OR = 3.27, P = 0.006) and very heavily (12+ drinks; OR = 4.42, P < 0.001). Only subjective sexual arousal significantly mediated the association between alcohol use level and high-risk CAS (OR = 1.16, P = 0.040). CONCLUSIONS: Increases in subjective sexual arousal after drinking heavily appear to partly account for alcohol-related HIV risk behaviors in the daily lives of men who have sex with men. Alcohol's role in strengthening motivationally consistent emotional states may therefore play a more important role in facilitating alcohol-involved HIV risk than explicit sexual motivation.

Using Ecological Momentary Assessment (EMA) to Study Sex Events Among Very High-Risk Men Who Have Sex with Men (MSM).

MSM continue to represent the largest share of new HIV infections in the United States each year due to high infectivity associated with unprotected anal sex. Ecological momentary assessment (EMA) has the potential to provide a unique view of how high-risk sexual events occur in the real world and can impart detailed information about aspects of decision-making, antecedents, and consequences that accompany these events. EMA may also produce more accurate data on sexual behavior by assessing it soon after its occurrence. We conducted a study involving 12 high-risk MSM to explore the acceptability and feasibility of a 30 day, intensive EMA procedure. Results suggest this intensive assessment strategy was both acceptable and feasible to participants. All participants provided response rates to various assessments that approached or were in excess of their targets: 81.0 % of experience sampling assessments and 93.1 % of daily diary assessments were completed. However, comparing EMA reports with a Timeline Followback (TLFB) of the same 30 day period suggested that participants reported fewer sexual risk events on the TLFB compared to EMA, and reported a number of discrepancies about specific behaviors and partner characteristics across the two methods. Overall, results support the acceptability, feasibility, and utility of using EMA to understand sexual risk events among high-risk MSM. Findings also suggest that EMA and other intensive longitudinal assessment approaches could yield more accurate data about sex events.

Systematic review of interventions to reduce problematic alcohol use in men who have sex with men.

ISSUES: Rates of heavy drinking, alcohol problems and alcohol-related disorders are high among men who have sex with men (MSM) and are an important public health issue. Associations between heavy drinking and human immunodeficiency virus (HIV) acquisition among MSM also suggest that drinking may have more severe and chronic consequences for this population relative to others. Consequently, effective interventions to reduce heavy drinking and alcohol-related risk factors among MSM are needed. APPROACH: We conducted a systematic review of randomised controlled trials of interventions to reduce heavy drinking and/or alcohol-related problems among MSM. We searched five electronic databases, screened 3722 records and identified 5 studies involving 1022 participants that satisfied inclusion criteria, which included having: (i) incorporated a comparison condition; (ii) randomised participants to groups; and (iii) reported quantitative outcomes. KEY FINDINGS: The methodological quality of studies varied, and meta-analysis was not conducted because of heterogeneity in intervention approaches and outcomes. Studies provided preliminary support for the use of motivational interviewing/motivational enhancement-based interventions (MI) and hybrid MI and cognitive behavioural therapy treatments for heavy drinking among MSM over no treatment. Perhaps the most important conclusion of this review, however, is that well-designed, theoretically informed research focused on establishing the efficacy of interventions for hazardous drinking and alcohol use disorders among MSM is alarmingly scarce. CONCLUSIONS: Effective interventions to reduce hazardous drinking among MSM and prevent key alcohol-related outcomes, including risk for HIV transmission and health problems among HIV-positive MSM, are needed to mitigate health disparities in this population.

Using Ecological Momentary Assessment (EMA) to Assess Situation-Level Predictors of Alcohol Use and Alcohol-Related Consequences.

Ecological momentary assessment (EMA) has afforded several important advances in the field of alcohol research, including testing prominent models of alcohol abuse etiology in "high resolution." Using high-tech methods for signaling and/or assessment, such as mobile electronic diaries, personal data assistants, and smartphones, EMA approaches potentially can improve understanding of precipitants of drinking, drinking patterns, and consequences. For example, EMA has been used to study complex drinking patterns and dynamic predictors of drinking in near-real time. Compared with other methods, EMA can better sample and capture changes in these phenomena that occur in relatively short time frames. EMA also has several potential applications in studying the consequences of alcohol use, including physical, interpersonal, behavioral, and legal problems. However, even with all these potential capabilities, EMA research in the alcohol field still is associated with some limitations, including the potential for measurement reactivity and problems with acceptability and compliance. Despite these limitations, electronically based EMA methods are versatile and are capable of capturing data relevant to a variety of momentary influences on both alcohol use and consequences. Therefore, it will be exciting to fully realize the potential of future applications of EMA technologies, particularly if the associated costs can be reduced.

Demographic and economic predictors of mental health problems and contact with treatment resources among adults in a low-income primary care setting.

The purpose of this study was to examine the prevalence of mental health-related problems in a low-income primary care setting, as well as the demographic and economic variables associated with these problems and contact with treatment resources. A total of 346 patient records were randomly selected among patients at an urban Iowa primary care clinic serving lower-income and uninsured individuals. Logistic models examined relationships among demographic factors, poverty level, and insurance status and three outcomes: Lifetime mental health problems, receipt of pharmacological intervention, and contact with psychosocial services. Female gender was associated with reporting mental health problems, and age and ethnicity interacted to predict reported mental health problems. Among those reporting mental health problems, female gender was predictive of contact with psychosocial services, while female gender with Caucasian ethnicity was predictive of receiving pharmacological intervention. Results support the need for primary care providers working with lower-income individuals to be active in discussing mental health issues with patients.