UConn Health School of Medicine, Farmington, CT, United States.
UConn Health School of Medicine, Farmington, CT, United States.
Alcohol. 2019 Dec;81:139-147. doi: 10.1016/j.alcohol.2018.10.001. Epub 2018 Oct 8.
Rates of heavy alcohol use in soup kitchen attendees range from 30% to 38%, but these data are based entirely on self-reported drinking. Little is known about the intensity or frequency of drinking in this population. We assessed alcohol use transdermally every 30 min over a 3-week period among heavy drinkers who attended local soup kitchens. In addition to transdermal alcohol monitoring, participants were randomly assigned to daily breath alcohol monitoring with or without reinforcement for alcohol-negative breath samples (BrAC). Analyses assessed feasibility of transdermal monitoring and examined alcohol use based on BrAC, transdermal, and self-report data, as well as effect sizes for these metrics based on group assignment. Nineteen participants completed the 21-day monitoring period in full; three persons removed the anklet 3-16 days early due to hospitalization, impending hospitalization, or incarceration. Participants reported minimal impacts of the monitors, and severity ratings of side effects were mild. When using BrAC, transdermal, and self-report data, the percentage of non-drinking days was 93%, 58%, and 57%, and the longest duration of consecutive non-drinking days averaged 10.3, 7.2, and 5.7 days, respectively. About half of drinking days involved heavy drinking (5 + drinks). Self-report and transdermal drinking days correlated significantly, p < .001, but neither index was associated with BrAC. Group comparisons indicate small-to-moderate sized effects of reinforcement compared to no reinforcement for increasing the proportion of alcohol-negative breath samples and durations of consecutive non-drinking samples during the study when BrAC was the metric. Transdermal data and self-report data indicated a more complex pattern. Reinforcement participants drank more often but at lower quantities than monitoring (control) participants per both transdermal and self-report data. These data suggest that transdermal monitors are well tolerated and document substantial heavy drinking in this population. Soup kitchens users are in need of alcohol interventions, and soup kitchens may represent a novel opportunistic setting for intervention delivery for an important and growing health disparities population.
收容所食客中重度饮酒的比例为 30%至 38%，但这些数据完全基于自我报告的饮酒情况。对于该人群的饮酒强度或频率知之甚少。我们评估了当地收容所的重度饮酒者在 3 周内每 30 分钟通过皮肤监测的酒精使用情况。除了皮肤酒精监测外，参与者还被随机分配到每日呼吸酒精监测，其中包括有或没有对阴性呼吸样本（BrAC）进行强化的监测。分析评估了皮肤监测的可行性，并根据 BrAC、皮肤和自我报告的数据检查了饮酒情况，以及根据组分配的这些指标的效应大小。19 名参与者完整完成了 21 天的监测期；3 人因住院、即将住院或监禁而提前 3-16 天取下踝带。参与者报告说监测器的影响很小，副作用的严重程度评级为轻度。当使用 BrAC、皮肤和自我报告数据时，非饮酒日的百分比分别为 93%、58%和 57%，最长连续非饮酒日的平均天数分别为 10.3、7.2 和 5.7 天。大约一半的饮酒日涉及重度饮酒（5 杯以上）。自我报告和皮肤数据的饮酒天数显著相关，p<0.001，但两者均与 BrAC 无关。组间比较表明，在 BrAC 作为指标时，与无强化相比，强化可使研究期间的阴性呼吸样本比例和连续非饮酒样本的持续时间增加，这具有较小至中等大小的效果。皮肤数据和自我报告数据表明了更为复杂的模式。与监测（对照）参与者相比，强化参与者通过皮肤和自我报告数据的饮酒频率更高，但每次饮酒的量更低。这些数据表明，皮肤监测器具有良好的耐受性，并记录了该人群中大量的重度饮酒情况。收容所使用者需要接受酒精干预，而收容所可能代表一个为重要且不断增长的健康差异人群提供干预的新的机会性环境。
