生态瞬时评估饮酒及其与酒精透皮检测和时间线回溯自我报告在经历无家可归的成年人中的一致性。
Ecological Momentary Assessment of Alcohol Consumption and Its Concordance with Transdermal Alcohol Detection and Timeline Follow-Back Self-report Among Adults Experiencing Homelessness.
机构信息
Department of Health Behavior and Health Systems, University of North Texas Health Science Center, Fort Worth, TX, USA.
Health Promotion Research Center, Stephenson Cancer Center, Oklahoma City, OK, USA.
出版信息
Alcohol Clin Exp Res. 2021 Apr;45(4):864-876. doi: 10.1111/acer.14571. Epub 2021 Mar 3.
BACKGROUND
Studies of alcohol use presume valid assessment measures. To evaluate this presumption, we examined the concordance of alcohol use as measured by ecological momentary assessment (EMA) self-reports, transdermal alcohol concentration readings via the Secure Continuous Remote Alcohol Monitor (SCRAM), and retrospective self-reports via the Timeline Follow-Back (TLFB) among adults experiencing homelessness.
METHODS
Forty-nine adults who reported alcohol misuse (mean age = 47, SD = 9; 57% Black; 82% men) were recruited from a homeless shelter. For 4 weeks, alcohol use was assessed: (i) 5 times or more per day by EMA, (ii) every 30 minutes by a SCRAM device worn on the ankle, and (iii) by TLFB for the past month at the end of the study period. There were 1,389 days of observations of alcohol use and alcohol use intensity for 49 participants.
RESULTS
EMA and SCRAM alcohol use data agreed on 73% of days, with an interrater agreement Kappa = 0.46. A multilevel analysis of concordance of 3 measures for alcohol use yielded statistically significant correlations of 0.40 (day level) and 0.63 (person level) between EMA and SCRAM. Alcohol use was detected on 49, 38, and 33% of days by EMA, SCRAM, and TLFB, respectively. For alcohol use intensity, EMA and SCRAM resulted in statistically significant correlations of 0.46 (day level) and 0.78 (person level). The concordance of TLFB with either EMA or SCRAM was weak, especially at the day level.
CONCLUSIONS
This is the first study to examine concordance of alcohol use estimates using EMA, SCRAM, and TLFB methods in adults experiencing homelessness. EMA is a valid approach to quantifying alcohol use, especially given its relatively low cost, low participant burden, and ease of use. Furthermore, any stigma associated with wearing the SCRAM or reporting alcohol use in person may be attenuated by using EMA, which may be appealing for use in studies of stigmatized and underserved populations.
背景
对酒精使用的研究假设了有效的评估措施。为了评估这一假设，我们检查了通过生态瞬间评估（EMA）自我报告、通过Secure Continuous Remote Alcohol Monitor（SCRAM）进行的透皮酒精浓度读数以及通过Timeline Follow-Back（TLFB）进行的回溯性自我报告在经历无家可归的成年人中测量的酒精使用情况之间的一致性。
方法
从一个收容所招募了 49 名报告有酒精滥用问题的成年人（平均年龄为 47 岁，标准差为 9；57%为黑人；82%为男性）。在 4 周的时间里，通过 EMA 评估酒精使用情况：（i）每天 5 次或更多次，（ii）通过戴在脚踝上的 SCRAM 设备每 30 分钟评估一次，（iii）在研究期间结束时通过 TLFB 评估过去一个月的情况。有 1389 天的观察记录了 49 名参与者的酒精使用情况和酒精使用强度。
结果
EMA 和 SCRAM 酒精使用数据在 73%的天数上一致，评分者间一致性 Kappa 为 0.46。对 3 种酒精使用测量方法的一致性进行的多层次分析得出，EMA 和 SCRAM 之间在天水平和人水平上的相关性分别为 0.40 和 0.63。通过 EMA、SCRAM 和 TLFB 分别检测到 49%、38%和 33%的天数有酒精使用情况。对于酒精使用强度，EMA 和 SCRAM 在天水平和人水平上的相关性分别为 0.46 和 0.78。TLFB 与 EMA 或 SCRAM 的一致性较弱，尤其是在天水平上。
结论
这是第一项使用 EMA、SCRAM 和 TLFB 方法在经历无家可归的成年人中检查酒精使用估计一致性的研究。EMA 是一种量化酒精使用的有效方法，尤其是考虑到其相对较低的成本、较低的参与者负担和易用性。此外，使用 EMA 可能会减轻佩戴 SCRAM 或亲自报告酒精使用所带来的任何耻辱感，这对于研究受污名化和服务不足的人群可能具有吸引力。
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