Discovering the Hidden Profiles of Employee Drinking Motives: An Application of Integrated Variable- and Person-Centered Latent Profile Analysis

The drinking motives questionnaire (DMQ, Cooper, 1994) has been a very useful measurement tool for understanding why people drink alcohol. Recent attempts to examine drinking motives used the DMQ within a person-centered analysis framework. However, latent profiles identified in previous research largely presented level effects without strong shape effects, which consequently restricted meaningful interpretations and effective applications of drinking-motive profiles. To address this limitation, we applied a new alternative methodology for the study of drinking motives that integrated variable- and person-centered approaches. Our research clearly demonstrated that controlling for an overarching general drinking-motive construct provided a clearer disaggregation of shape and level effects. Four latent profiles were identified that represented a combination of shape and level effects. Each profile predicted different patterns of alcohol use. Theoretical as well as practical implications are discussed.     

Short forms of the AUDIT in a Web‐based study of young drinkers

Introduction. The Alcohol Use Disorders Identification Test (AUDIT) is under‐studied among young drinkers, as are the contributions of individual items to total AUDIT scores, and online performance of the existing briefer versions of this instrument. Design and Methods. This study examined individual items of the AUDIT, and various combinations, including the existing briefer versions, in relation to total AUDIT scores in a Web‐based study of young drinkers. A total of 167 young people aged 16–24 years old who had consumed any alcohol within the previous 7 days were recruited by both offline and online methods. Results. Considered individually, items 3, 4, 5 and 8 were predictive of the majority of the variance in total AUDIT scores in this Web‐based study. Existing briefer versions of the AUDIT do not better predict total scores than possible alternative combinations of items, for which acceptable levels of sensitivity and specificity for screening have been demonstrated. Conclusions. Short forms of the AUDIT, particularly those based only on consumption questions, require further validation study in online applications with young people.[McCambridge J, Thomas BA. Short forms of the AUDIT in a Web‐based study of young drinkers. Drug Alcohol Rev 2009;28:18–24]     

Youth Access to Alcohol: Early Findings From a Community Action Project to Reduce the Supply of Alcohol to Teens

The Youth Access to Alcohol (YATA) project was implemented in 2002 by the Alcohol Advisory Council of New Zealand (ALAC) in thirty communities in New Zealand, with the aim of reducing the harm experienced by young people as a result of alcohol misuse in New Zealand through reducing the supply of alcohol by adults to young people. The communities include a mix of rural and urban from both Islands in New Zealand.

The project uses a community action approach, which has included setting up collaborative partnerships of key agencies, the delivery of key strategies, and multimedia awareness raising campaigns. The communities are encouraged to identify unique issues in their community regarding alcohol abuse and young people and to develop action plans incorporating a range of strategies that include tested strategies as well as innovative ideas. Communities are trained to implement several tools to monitor changes in their community over time. The study's limitations are noted and future needed research is suggested.     

Alcohol-Attributable Calories Consumed as a Result of Binge Drinking: A National Survey of Drinkers in the United States

Aims: Estimate the alcohol-attributed calories associated with respondents' (a) most recent binge drinking episode, and (b) binge drinking across a thirty-day period. Methods: Examined responses to a module of the 2008 Behavioral Risk Factor Surveillance System (BRFSS), completed by a 10-state sample in the United States (n = 7,375), in order to estimate the alcohol-attributed calories consumed among binge drinkers. Alcohol-attributed calories were estimated by multiplying number of drinks consumed for each category (beer, wine, liquor drinks, and pre-mixed flavored drinks) collected in the BRFSS by caloric averages based on two data sources. Results: In the past 30 days, respondents averaged 4.13 (SD = 5.84) binge drinking episodes, and consumed an average of 4.15 (SD = 3.55) beers, .67 (SD = 1.56) glasses of wine, 1.49 (SD = 2.53) shots of liquor, and .15 (SD = .79) pre-mixed flavored beverages during their most recent binge drinking episode. The average amount of alcohol-attributed calories consumed during this binge drinking episode was 991.76 (SD = 578.71), with men consuming significantly more calories than females. Conclusions: Dietary guidelines suggest the calories associated with alcoholic beverages should be considered as part of one's limited allotment of calories associated with solid fats and sugars, yet our results highlight alcohol as a major contributor (approximately 1,000 calories) to the proposed daily caloric needs on binge drinking days.     

Conducting economic evaluations of screening and brief intervention for hazardous drinking: Methods and evidence to date for informing policy

ISSUES: Many policy review articles have concluded that alcohol screening and brief intervention (SBI) is both cost-effective and cost-beneficial. Yet a recent cost-effectiveness review for the United Kingdom's National Institute for Health and Clinical Excellence suggests that these conclusions may be premature. APPROACH: This article offers a brief synopsis of the various types of economic analyses that may be applied to SBI, including cost analysis, cost-effectiveness analysis, cost-utility analysis, cost-benefit analysis and other types of economic evaluation. A brief overview of methodological issues is provided, and examples from the SBI evaluation literature are provided. KEY FINDINGS, IMPLICATIONS AND CONCLUSIONS: The current evidence base is insufficient to draw firm conclusions about the cost, cost-effectiveness or cost-benefit of SBI and about the impact of SBI on health-care utilisation.[Cowell AJ, Bray JW, Mills MJ, Hinde JM. Conducting economic evaluations of screening and brief intervention for hazardous drinking: Methods and evidence to date for informing policy.     

Web‐based screening and advice for hazardous drinkers: Use of a Spanish site

Introduction and Aims. A website for implementing screening and brief intervention on alcohol was launched in Barcelona, Spain, in October 2006. Its aim was to reach hazardous drinkers who probably would not ask for advice. This article describes use of the site, profiles users and discusses limitations concerning screening. Design and Methods. The website included screening, advice and information. Demographic and self‐screening data (typical weekly consumption and the Alcohol Use Disorders Identification Test, AUDIT) were examined. Results. In a 12 month period, 12 138 visitors entered the website, 2574 started self‐assessment, 1342 completed the table and 724 of these participants completed the AUDIT. These users had a mean age of 27.6 years, one‐third of them drank above recommended weekly limits and 84.1% of those who completed the AUDIT (n = 724) scored positive (≥5); a total of 70.3% of identified at‐risk drinkers entered the advice section. Among visitors to the site, risk factors for hazardous drinking were: being male,≥35 years of age, and drinking heavily at weekends. Discussion and conclusions. The percentage of hazardous drinkers accessing the site was high, and visitors reported that they liked the design, that it was easy to use and that it provided relevant information. Most of those who had sought advice considered it to be helpful. The website seems to be an accessible and useful tool for young people and might be used in youth centres as well as in health‐care settings, such as primary care and emergency centres, where it could contribute to health promotion and constitute an easier alternative to screening and brief intervention given by the staff.[Rodríguez‐Martos A, Castellano Y. Web‐based screening and advice for hazardous drinkers: Use of a Spanish site. Drug Alcohol Rev 2009;28:54–59]     

Pregaming: A Field-Based Investigation of Alcohol Quantities Consumed Prior to Visiting a Bar and Restaurant District

Background: Investigations examining the association between pregaming, or the consumption of alcohol prior to attending a social gathering or drinking establishment, and blood alcohol concentrations have primarily relied on estimations (i.e., Widmark equation), rather than objective biologic samples, such as breath alcohol concentration (BrAC). Objectives: The current study assessed: (1) pregaming, using quantity-based measures, among a sample of college and non-college affiliated bar patrons, (2) associations between pregaming intensity/status and participant intoxication (BrAC), and (3) whether participants who pregamed were more likely to identify as a hazardous drinker. Methods: 548?bar patrons provided data on the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) and a single pregaming item assessing quantity of alcohol consumed prior to visiting a bar/restaurant district in 2015. BrAC samples were collected post interview. We used hierarchical linear regression models, respectively, to assess whether pregaming significantly impacted BrAC and whether presence of hazardous drinking predicted pregaming behavior. Results: After controlling for sex, race/ethnicity, age, student status, and Greek affiliation, the linear regression model explained 32.3% (R²?=?.323) of the variance of BrAC levels (F(12)?=?21.162, p?<?.001), with 4.30% of the variance explained solely by pregaming (β?=?0.014; p?<?.001). The linear regression model to assess if harzardous drinking behavior (AUDIT-C) significantly predicted pregaming explained 31.2% (R²?=?.312) of the variance of pregaming behavior (F(18)?=?13.276, p?<?.001), with 4.2% of the variance explained solely by AUDIT-C scores (β?=?0.280; p?<?.001). Conclusion: Findings further highlight pregaming as a harmful risk behavior linked to elevated levels of hazardous drinking and intoxication.     

Validating a Hazardous Drinking Index in a Sample of Sexual Minority Women: Reliability,Validity, and Predictive Accuracy

Background: Although sexual minority women (SMW) are at increased risk of hazardous drinking (HD), efforts to validate HD measures have yet to focus on this population. Objectives: Validation of a 13-item Hazardous Drinking Index (HDI) in a large sample of SMW. Methods: Data were from 700 adult SMW (age 18-82) enrolled in the Chicago Health and Life Experiences of Women study. Criterion measures included counts of depressive symptoms and post-traumatic stress disorder (PTSD) symptoms, average daily and 30-day ethanol consumption, risky sexual behavior, and Diagnostic and Statistical Manual (DSM-IV) measures of alcohol abuse/dependence. Analyses included assessment of internal consistency, construction of receiver operating characteristic (ROC) curves to predict alcohol abuse/dependence, and correlations between HDI and criterion measures. We compared the psychometric properties (diagnostic accuracy and correlates of hazardous drinking) of the HDI to the commonly used CAGE instrument. Results: KR-20 reliability for the HDI was 0.80, compared to 0.74 for the CAGE. Predictive accuracy, as measured by the area under the receiver operating characteristic curve for alcohol abuse/dependence, was HDI: 0.89; CAGE: 0.84. The HDI evidenced the best predictive efficacy and tradeoff between sensitivity and specificity. Results supported the concurrent validity of the HDI measure. Conclusions: The Hazardous Drinking Index is a reliable and valid measure of hazardous drinking for sexual minority women.     

Focus on Secondary Prevention: Implications of a Study on Intervention in Social Networks

Screening and brief intervention (SBI) as a method within secondary prevention of alcohol use–related problems has experienced enormous attention and interest over the past 20 years. Initial results were very promising and great effort was put into designing screening instruments and developing different kinds of interventions. However, at the same time, the approach has generated problems in its own right. Some of these problems relate to standardization of instruments and some to criteria of inclusion into samples; others relate to the focus on the individual drinking style independent from social influences. In light of these problems, it is necessary to elaborate on the theoretical foundation, as well as on the methods used in SBI. This article introduces a method for intervening in social networks with important implications for SBI. By putting emphasis on the motivational part of SBI and including social networks in the field of intervention, it may be assumed that the approach will produce better results than heretofore. The results from a Danish qualitative study on intervening into the social network of social drinkers are presented. This study was carried out between 1991 and 1999 and involved 13 adult Danes between 35 and 45 years of age. They all had a weekly alcohol consumption of 120 to 360 g of pure alcohol and they all considered themselves to be social drinkers. The results of this study show that enhanced awareness of the person's own drinking, as well as that of peers, may influence decisions about specific drinking situations. These findings and the perspectives for SBI are discussed. Recommendations for further research are also presented.     

Reducing sexual risk behaviors: secondary analyses from a randomized controlled trial of a brief web-based alcohol intervention for underage,heavy episodic drinking college women

Background: Alcohol use and sexual risk behaviors (SRBs) are significant problems on college campuses. College women are at particularly high risk for negative consequences associated with sexually transmitted infections (STIs) and unwanted pregnancy.

Methods: The current study (n?=?160) examined the effect of a brief, web-based alcohol intervention (n?=?53) for college women on reducing SRBs compared to an assessment only control (n?=?107) with a randomized controlled trial. Outcome measures included condom use assertiveness and number of vaginal sex partners and data were collected at baseline and three-month follow-up.

Results: Regression analyses revealed that the alcohol intervention was associated with higher levels of condom use assertiveness at a three-month follow-up. Additionally, more alcohol use was associated with less condom use assertiveness for those with more significant sexual assault histories.

Conclusions: These findings suggest that alcohol interventions may impact college women’s beliefs but not behavior, and future interventions should more explicitly target both alcohol and sexual risk to decrease risky behaviors.     

Forcible,drug-facilitated,and incapacitated rape in relation to substance use problems: Results from a national sample of college women

This is the first study to examine the relation between rape and substance use problems in college women as a function of three legally recognized forms of rape: forcible, incapacitated, and substance-facilitated rape. Data were collected via structured telephone interview with a large national sample of college women aged 18–34 years (n = 1980). Lifetime prevalence of any type of rape was 11.3% in the sample. Prevalence estimates for binge drinking and substance abuse were 15.8% and 19.8%, respectively. Lifetime experience of incapacitated rape and drug–alcohol facilitated rape, but not forcible rape, were associated with increased odds of past-year binge drinking and substance abuse. Findings have implications for secondary prevention and call for continued differentiation in assessment of rape type.     

Gamblers Anonymous in Israel: A Participant Observation Study of a Self-Help Group

We have very little research on how substance use impacts employment among welfare mothers. But welfare reform's emphasis on moving aid recipients into the workforce has brought this issue to the fore. Using Cox proportional hazard and logistic regression in a longitudinal study of California welfare mothers in 2001–2003, we examine how substance use impacts the ability to move from welfare to work and to remain economically independent after welfare. While education, work history, and family size consistently predict transitions from welfare to work and back again, substance use-related problems consistently do not. However, the jobs obtained by welfare mothers are short-term and poorly paid regardless of whether they misuse alcohol or use drugs. We argue that, if all that is open to welfare mothers are short-lived work assignments, substance use may have little time to impact job retention. Limitations of the study are noted. This IRB-approved study was supported by a grant from the National Institute on Alcohol Abuse and Alcoholism.     

A confirmatory approach to understanding the four-factor structure of the Adolescent Drinking Index: Evidence for a brief version

The purpose of this study was to examine the psychometric properties of the original version of the Adolescent Drinking Index (ADI), and to examine the fit of a series of confirmatory factor analysis models to arrive at an abbreviated version that can be easily administered in settings with limited time for assessment. These aims were examined in a sample of 740 adolescents (M_age = 15.26; 58.5% males) who completed the ADI during an emergency department visit. Results suggested that the four-domain design did not fit the data adequately. Results, however, demonstrated good fit for an 8-item adapted version with a four-factor structure: interpersonal, social, psychological, and physical indicators. This abbreviated version was also associated with outcomes such as hangover, alcohol withdrawal, and substance use. Findings from this study provide support for the use of an abbreviated version of the ADI for screening adolescents and referring them to appropriate interventions.