Perceptions Of Alcohol Use Research Articles

Alcohol Consumption Among Persons Living with HIV: Perceptions, Messages and Interventions-A Qualitative Study at an HIV Treatment Clinic in South Western Uganda.

In Sub-Saharan Africa, efficacy trials of brief interventions to reduce unhealthy drinking among persons living with HIV (PLWH) have yielded mixed results. A better understanding of the perceptions of drinking, especially by PLWH, and how drinking is talked about at HIV treatment clinics in this setting, may guide more optimal designs for future trials. We conducted a qualitative study at an HIV treatment clinic in South Western Uganda to better understand perceptions of drinking, how drinking is talked about, and perceptions of interventions, especially a protocolled screening and brief intervention (SBI) for unhealthy drinking among PLWH. We conducted in-depth interviews with 17 PLWH who engaged in unhealthy drinking and 6 health workers, and one focus group discussion with 3 community advisory-board members. We performed manual preliminary data analysis and computer-assisted detailed thematic analysis to identify emergent themes. Four themes emerged: perceptions of alcohol use in the general population; perceptions of alcohol use in PLWH; interaction between PLWH and health workers about alcohol use; perceptions of interventions for unhealthy drinking including SBI. Unhealthy drinking was seen as a problem in the general population and among those with HIV, where it was negatively perceived. Communication about drinking was done by counselors, but doctors participated in screening for unhealthy alcohol use. Messages about drinking covered reduction and abstinence. Participants expressed positive attitudes towards SBI and preference for person-delivered SBI over technological alternatives. A protocolled SBI for unhealthy alcohol use among PLWH would be well-received but successful implementation may depend on mode of delivery.

An Updated Narrative Review on the Role of Alcohol Among Indigenous Communities.

The role of alcohol varies considerably among Indigenous Peoples and is the backdrop of persistent stereotypes despite decades of research. This paper provides an updated narrative review on the alcohol literature among Indigenous communities, highlighting recent studies published since 2017. We examined published literature involving alcohol use rates, including abstinence; risk and protective factors; treatment; and recovery, as well as future directions for alcohol prevention and intervention efforts with Indigenous communities. Evidence-based alcohol use prevention, intervention, and recovery strategies with Indigenous communities are outlined. Recommendations are provided for researchers, health providers, and public policy advocates to address and better understand alcohol use, treatment, prevention, and recovery among Indigenous Peoples. Specific recommendations include using community-based participatory research strategies and harm reduction approaches to prevent and treat alcohol use problems with Indigenous communities. Future research is needed to elucidate mechanisms of resilience and recovery from Alcohol Use Disorder and possible shifts in perceptions of alcohol use for Indigenous Peoples.

Perception of Alcohol Use and Alcohol Use Disorder among Persons Involved in Road Accidents at an Emergency Department: A Cross-Sectional Study.

Alcohol plays a significant role in road traffic accidents in Ghana. However, little is known about the perspectives of victims who suffer road traffic accidents, RTAs, and the extent to which alcohol use disorder is involved. We conducted a three-month cross-sectional study in a teaching hospital involving 102 patients involved in a road accident and presented to the hospital's emergency. The Alcohol Use Disorder Identification Test, AUDIT, was used to assess for Alcohol Use Disorder, AUD, at a score of 8. In addition, we used open-ended questionnaires to assess their perception of alcohol use and road accidents. Of the 102 respondents, 75% were males, and 60% were between 15 and 35 years old. About 69% of respondents admitted to using alcohol, while 31%, including a single female, screened positive for alcohol use disorder. A significant majority of about 90% of respondents believed in some myths of alcohol use in Ghana, and a similar percentage were aware of the risks alcohol use posed to road use. Over 30% of respondents, mainly drivers or riders, had used alcohol within 12 hours of the accident. All but three respondents knew alcohol-induced aggression and poor coordination of movements. A similar number of respondents knew alcohol made people cross roads carelessly and were hyperactive or disinhibited. Alcohol use and alcohol use disorder are significantly high among persons presenting with RTA to the emergency. Knowledge of the deleterious effects of alcohol is high, yet their behavior did not reflect the knowledge. Therefore, a significant reduction in RTA can be achieved by enforcing blood alcohol concentration limits for road users and intensive education to the populace.

Prom, graduation and parties: Alcohol use and normative perceptions among high school seniors during specific events

BackgroundPrevious research has shown that a majority of adolescents in the United States initiate and drink alcohol prior to graduating high school and nearly twenty percent of high school seniors engage in heavy episodic drinking. Despite anecdotal evidence and media portrayals of alcohol use during high school events (e.g., prom), little is understood about alcohol use surrounding specific events that may be identified as “high-risk” events and addressed in specific interventions. Similarly, normative perceptions exert powerful influence on behaviors but little is understood about normative perceptions of alcohol use at high school events. Objectives: The purpose of the present study was to understand whether high school alcohol use is associated with specific events by describing behaviors and normative perceptions. MethodsParticipants were 386 U.S. college students age 18 to 19 (60.4 % female, mean age = 18.4) who provided retrospective accounts of their alcohol use surrounding senior year high school events (either before, which is relevant to pregaming addressed in this special issue, during, or after). ResultsMost students did not drink surrounding high school events but nearly all reported that they perceived that the typical high school senior did. Those who did drink alcohol tended to drink heavily, particularly during prom. Alcohol use was associated with other high school events ranging from the beginning of senior year (e.g., Homecoming) though the end (e.g., graduation parties) ConclusionsResults indicate the importance of future research efforts tailoring intervention efforts around specific events and the applicability of personalized normative feedback approaches.

Student perceptions of the current drinking culture in three Australian residential colleges: Drinking motives, consequences and recommendations for harm minimisation strategies.

Systemic cultural factors related to excessive alcohol consumption have been identified in Australian university residential colleges. In this mixed methods study, we conducted focus groups with student leaders at three Australian residential colleges. We aimed to explore students' perceptions of alcohol use and related consequences in their current college environment and gather feedback from students on the utility of alcohol harm minimisation strategies in this context. In November 2020, 77 student leaders from three colleges participated in focus groups. Each focus group ran for 1.5-2hours and included three sections: (i) quantitative survey; (ii) semi-structured group interview; and (iii) feedback on a potential alcohol harm minimisation workshop. The survey revealed that 81% of participants reported drinking hazardously. Thematic analysis of the interview data indicated many students perceived college as a supportive environment regarding students' alcohol use choices (direct peer pressure to drink was uncommon). However, indirect social influence to drink appeared to maintain a 'culture of intoxication'. Specifically, social norms to attend college events (where drinking is implied) and modelling of excessive drinking were key indirect influences on heavy drinking norms. Students were aware and accepting of many alcohol harm minimisation strategies and interested in improving current strategies. Despite the supportive college environment described by students, regarding alcohol use choices, a 'culture of intoxication' driven by indirect social influences was evident. Student leaders' interest in increasing the availability of harm minimisation strategies highlights the potential utility of peer-led alcohol interventions in colleges.

Alcohol Drinking Patterns and Contributing Factors among Medical Students, a Systematic Review

Background:The use of Alcohol has become an important public health concern with a variety of negative consequences, it is important to understand the variables that may be risk factors for this phenomenon. Further, university students represent a group of individuals who have unique drinking patterns and different risk factors and concerns related to problematic drinking than the population in general. Legal substances like alcohol accounts for the vast majority of negative medical, economic, and social impact. Although alcohol use occurs across many age groups, young adults aged 18–24 years show the highest rates of alcohol use and have the greatest percentage of problems drinkers (Kandel & Logan, 1984). Namibia is ranked fifth on the African continent in terms of annual alcohol consumption with the average Namibian consuming 9.62 liters of alcohol per year (WHO 2011). This review addresses problematic drinking and the variables associated with it for medical students. The purpose of this systematic review is to compare the perception and attitude of alcohol consumption among medical students and weigh the factors associated with drinking habits. Methods:A qualitative and quantitative systematic review of article from multiple search engines. Five articles were within the inclusion criteria thus appraised and reviewed for this paper. The common study method used was cross sectional, with varying sample sizes. Commonly, the use of self-assessment questionnaires and objective AUDIT C and CAGE score evaluation were used frequently between these articles. Results:The review showed that there are multiple factors that influence the use of alcohol among medical students. Personal factors such as a new found sense of independence, peer pressure, inability to handle academic stressors. Socio-economic factors include high tolerance of alcohol use in the communities and monthly expenses. It was also noted that the use of alcohol in medical students is higher than the average university student. A highlighted noted is that the use of alcohol is much higher among male than female medical students. Conclusion:Findings suggested that the perceptions of alcohol use is depended on multiple factors majority being academic perceived stress. It is also noted that continuation of these maladaptive coping mechanisms may lead to dysfunction in the future. The findings of systematic review are limited by the number of articles appraised and reliant on the information provided by the authors.

Alcohol Consumption and Depression Among University Students and Their Perception of Alcohol Use.

To investigate the association between alcohol use and depression among university students in Hong Kong, their stress-coping methods, and their knowledge and perception of the effects of alcohol on health. 345 full-time undergraduate students from The University of Hong Kong were invited to complete a questionnaire to assess their alcohol consumption (Alcohol Use Disorders Identification Test, CAGE questionnaire), depressive symptoms (Patient Health Questionnaire-9), and stress-coping methods (Coping Orientation to Problems Experienced Inventory), as well as knowledge and perception of alcohol consumption on health. Multiple linear regression was used to determine significant variables associated with depressive symptoms. Multinominal logistic regression was used to determine the effect of such variables on depressive symptom caseness and AUDIT drinking risk groups. 43.2% of respondents were moderate- to high-risk drinkers, but only 23.2% were self-reported as moderate- to high-level drinkers. 57.9% of respondents had mild to severe depressive symptoms. Probable depression was more likely to occur in female students, those with higher general stress, those who do not use social support for stress-coping, and those who smoke. High-risk drinkers were more likely to occur in older students, smokers, those with higher household income, and those with higher general stress levels. Students with higher levels of depressive symptoms and higher risk of alcohol consumption were more likely to use avoidance for stress-coping. 89.5% of students considered alcohol consumption moderately to very harmful to health, but students demonstrated only moderate knowledge levels of alcohol consumption on health. Alcohol consumption and depressive symptoms are prevalent among university students in Hong Kong. The use of avoidance for stress-coping is common in those with higher levels of depressive symptoms and higher-risk drinkers. Students tend to avoid seeking help for depressive symptoms and potentially take up drinking as a coping strategy. Context-specific approaches should be used when providing counselling services for student wellbeing in university settings. Further education of university students on knowledge and perception of alcohol consumption on health should be provided.

The Association between Hazardous Drinking Indicators and Drinking Problem Concerns among Sexual Minority Women.

Sexual minority women (SMW) report high rates of hazardous drinking (HD), treatment utilization that is not commensurate with need, and low perceived alcohol use severity. This study examined SMW's drinking problem concerns by sexual identity and other demographic characteristics, and the strength of associations between endorsement of unique HD indicators and drinking problem concerns. Data were from a supplemental sample of SMW added in Wave 3 of the longitudinal, community-based Chicago Health and Life Experiences of Women (CHLEW) study. HD was measured using a validated 13-item HD Index (HDI). Multivariable logistic regression models examined independent associations between past-five-year drinking problem concerns and each HD indicator. Twelve HD indicators were significantly associated with past-five-year drinking problem concerns, adjusting for age and sexual identity. Adjusted odds ratios varied from 2.44 for driving drunk to 15.52 for drinking first thing in the morning. After adjusting for number of HD indicators endorsed, associations were no longer significant, indicating that number of endorsed indicators was a more important predictor of drinking problem concerns than were individual HD indicators. Early intervention and harm reduction strategies could support SMW in addressing salient aspects of HD before progression to alcohol use disorder.

HIV Related Knowledge, HIV Testing Decision-Making, and Perceptions of Alcohol Use as a Risk Factor for HIV among Black and African American Women.

The HIV/AIDS epidemic disproportionately affects Black and African American women in the United States. This study examined the extent of HIV related knowledge, HIV testing decision-making, and perceptions of alcohol use as a risk factor for HIV among Black and African American women in urban and suburban communities. Seven focus groups were conducted with 37 women aged 18 to 49 residing in the Commonwealth of Massachusetts. Women participating in focus groups had a wide breadth of HIV related knowledge. Findings suggest the influence of interpersonal relationships and provider–patient interactions on HIV testing, the need for building community capacity and leveraging community resources towards HIV prevention, and the influence of alcohol outlet density on HIV vulnerability and exposure in communities of color. Comprehensive multifaceted evidence informed interventions that are culturally relevant and gender responsive are needed to reduce HIV/AIDS disparities.

Frequency of Binge Drinking and Perception of Peer Alcohol Use: A Survey of University Students in a Western Canadian Province.

College and university student binge drinking is a critical health issue, and studies demonstrate students perceive high rates of drinking among their peers. High alcohol consumption and binge drinking are normalized throughout college and university, and there are gross misperceptions of perceived alcohol use among peers. The purpose of our study was to examine differences in perceptions of peer alcohol use after grouping students based on their frequency of binge drinking over a 2-week period. A one-way analysis of variance test was used to compare the differences in the perception of peer alcohol use after grouping students by their frequency of binge drinking. Students who binge drink have significantly higher perceptions of peer alcohol use than their non-binge-drinking and abstaining peers. These findings provide direction toward the feasibility of using perceptions of peer alcohol use to identify at-risk students to curtail dangerous drinking behavior.

Event-specific and individual factors impacting college students’ decisions to intervene in a potentially risky scenario

Universities have attempted to address sexual violence on campuses through various prevention programs, including bystander intervention. Unfortunately, the extant literature on bystander intervention has primarily focused on bystander characteristics. Little is known about how situational characteristics affect the likelihood of intervening during sexual violence; yet, these variables have the potential to influence the effectiveness of bystander intervention programs. Using data collected from college students (N = 626) at a single university located in a large Southern metropolitan city, the present study utilizes a factorial survey design to investigate the impact of location, victim/offender sex, and perceptions of alcohol use on self-reported probability of intervention in an ambiguous sexual scenario. Results indicate that participants were more likely to intervene in scenarios that depicted a fraternity-hosted social (vs. on-campus) and less likely when there was a female perpetrator and a male victim. Perceived alcohol use did not impact intervention.

Measuring peer influence susceptibility to alcohol use: Convergent and predictive validity of a new analogue assessment

Research on peer socialization rarely examines individual differences in adolescents’ susceptibility to peer influence, perhaps because few theories or methods have elucidated how susceptibility is operationalized. This study offers a new analogue measure of peer influence susceptibility in adolescence that is adapted from sociological theory. A preliminary examination of this new paradigm included the study of individual differences in susceptibility to peer influence, convergent validity correlates, and predictive validity by examining decision-making on the task as a moderator of the prospective association between friends’ and adolescents’ engagement in one form of real-world risk-taking. Participants included 714 adolescents (54% female; 46.1% White, 20.9% Black, 24.2% Hispanic/Latinx, 6.2% mixed race or other) aged 15–18 years (M = 16.1). Participants completed the Peer Analogue Susceptibility Task, peer nominations, and self-report measures at Time 1 and repeated an assessment of their own alcohol use 1 year later. Participants’ friends also reported their own alcohol use. Results indicated concurrent associations with peer influence susceptibility, rejection sensitivity, perceived importance of peer status, peer-nominated popularity, and self-reported resistance to peer influence. Furthermore, among adolescents demonstrating average and high levels of peer influence susceptibility on the task, greater perceived alcohol use among friends was associated with their own alcohol use 1 year later. Findings offer preliminary evidence for the convergent and predictive validity of a new approach to study peer influence susceptibility.

Updated Understanding of the Experiences and Perceptions of Alcohol Use in Later Life.

The purpose of this study was to update our understandings of older adults' experiences and perceptions of alcohol use. Taking a community-based research approach, three Knowledge Café workshops hosted 66 older adults and service providers in Vancouver, BC. Thematic analysis identified three overarching categories: (a) reasons older adults use alcohol, including out of habit, social expectations, or to self-medicate; (b) personal experiences of alcohol use, including reduced consumption over time as a result of the cost of alcohol, the physical effects, and increased knowledge about the effects of alcohol; and (c) older adults' perceptions of alcohol use outcomes, including positive outcomes from drinking in moderation and negative outcomes that can worsen one's health, lead to tolerance, and harm others. Developing and promoting healthy drinking behaviours in later life is needed as the general population continues to age.

Social and structural determinants of youth alcohol use in Tanzania: The role of gender, social vulnerability and stigma

ABSTRACT Adolescent alcohol use remains an under-addressed population health issue across Africa. Although the literature explores the intersection of alcohol use and vulnerability to HIV and AIDS, there is limited evidence on the gendered uptake and use of alcohol among adolescents. Capturing adolescents’ voiced experiences about the societal influences shaping their alcohol usage is essential for identifying contextually relevant interventions to reduce their vulnerability to alcohol and related risky behaviours, such as unsafe sex. We conducted qualitative research in urban Tanzania, including key informant interviews, systematic mapping of alcohol availability, in-depth interviews with adolescents in and out of school and adults, and participatory methodologies with adolescents ages 15-19. The findings described here were drawn from the participatory methodologies (n = 177); and in-depth interviews with adolescents (n = 24) and adults (n = 24). Three key themes emerged: (1) boys’ increased social vulnerability to alcohol consumption; (2) the ways in which stigma shapes girls’ alcohol usage; and (3) how gendered perceptions of alcohol use reinforce societal inequalities. There exists an urgent need to address the social and gendered vulnerabilities of youth in Africa to the uptake and use of alcohol, and identify interventions that reshape notions of masculinity increasing boy’s vulnerability to use.

Parental Perceptions About Alcohol Use for Their Adolescent with Attention-Deficit/Hyperactivity Disorder.

Alcohol use can worsen attention-deficit/hyperactivity disorder (ADHD) symptoms, interfere with treatment, and worsen outcomes. Our objective was to describe parental perceptions of alcohol use for their adolescents with ADHD. Parents of adolescents with ADHD completed an online survey about perceptions of adolescent alcohol use for adolescents with ADHD. We described the level of parental concern about the impacts of alcohol use on their adolescent's functioning. We assessed whether specific covariates were associated with the level of parental concern. Of 290 parents who completed the survey, 96.5% were women, and 66.1% had an educational attainment of college degree or higher. Most adolescents (75.4%) took ADHD medication, and 59.9% had comorbid anxiety or depression. Almost one-third (30.3%) of parents perceived that their adolescent was more likely to use alcohol because of ADHD, whereas 34.8% of parents disagreed with this and 34.8% of parents were neutral. Parents who suspected their adolescent regularly used alcohol were less likely to report concern about the impact of alcohol on their adolescent's school performance or ADHD medication effectiveness compared with parents who did not suspect regular adolescent alcohol use. Almost half of the parents (48.5%) did not report discussing the impact of alcohol use on ADHD with their adolescent. Many parents of adolescents with ADHD do not understand the unique risks of alcohol use for their adolescents. In addition, if alcohol use harm is not obvious, parents may not perceive there to be concerns about alcohol use on functioning. Parental education about alcohol use and ADHD is needed.

Contexts of alcohol use: A latent class analysis among Argentinean college students

BackgroundAlcohol use, and the association between alcohol-related variables and drinking outcomes, seem to be context dependent. We employed Latent Class Analysis, a person-centered approach, to identify distinct subpopulations based on contexts of alcohol use. We also examined if the resulting classes differ in a set of alcohol-related variables that hold promise as potential targets of interventions. MethodArgentinean college students N = 1083; 64 % women; M age = 19.73 ± 3.95) completed an online survey that assessed alcohol outcomes and related variables [motives for substance use, protective behavioral strategies (PBS) and normative perceptions of alcohol use]. ResultsLatent Class Analysis identified a 4-classes model for drinking contexts. These classes showed differential patterns of alcohol use (both in terms of frequency and quantity) and also differed in alcohol-related variables. Alcohol use was more prevalent in contexts characterized by the presence of peers, particularly the closest friend, small same-sex or coed groups. Close to 50 % of the sample reported drinking with family members. Students with a high probability of engaging in pregaming and nightclub drinking tend to use more PBS to control how much alcohol is consumed than those who do not drink in these contexts. All the classes significantly differed in their social reasons for drinking and in the number of alcohol-related negative consequences. ConclusionsOur findings revealed subpopulations of college students that are heterogeneous regarding contexts of alcohol use, patterns of use and in a number of relevant variables. These distinctive subpopulations require different targeted interventions.

Social acceptance of alcohol use in Uganda

BackgroundAlcohol use is part of many cultural, religious and social practices, and provides perceived pleasure to many users. In many societies, alcoholic beverages are a routine part of the social landscape for many in the population. Relatively low rates were reported for Alcohol Use Disorders (AUD) in a community-based survey and facility detection survey conducted in the study site contrary to findings in earlier formative studies where alcohol use was reported to be a major health problem. The aim of this study was to understand the reasons for under-reporting and the low detection rate for AUDs, exploring societal perceptions of alcohol use in the study district.MethodsThe study was conducted in Kamuli District (implementation site for the PRIME project). Semi-structured interviews and focus group discussions were conducted with purposively selected participants that included local and religious leaders, lay people, health workers as well as heavy alcohol drinkers and their spouses. Interviews were tape-recorded and transcribed verbatim. The analysis followed four thematic areas, which include the extent and acceptability of alcohol use, patterns of alcohol use, perceived health problems associated with alcohol use and help-seeking behavior for persons with alcohol related problems.ResultsThe findings indicate that alcohol consumption in the study site was common and widely acceptable across all categories of people and only frowned upon if the person becomes a nuisance to others. These findings suggest that the health problems associated with alcohol use are overlooked except when they are life-threatening. Help-seeking for such problems was therefore reported to be relatively rare.ConclusionAlcohol was readily available in the community and its consumption widely acceptable, with less social sanctions despite the legal restrictions to the minors. The social acceptance results in low recognition of alcohol use related health problems, consequently resulting in poor help-seeking behavior.

Longitudinal Associations Between Perceptions of Peer Group Drinking Norms and Students' Alcohol Use Frequency Within College Sport Teams.

Students' alcohol use behaviors are shaped by the attitudes and behaviors of others, especially the peers within students' proximal social groups. Explaining the association between perceived drinking norms and alcohol use, researchers propose contradicting pathways that focus on conformity (i.e., social norms predict alcohol use) and projection (i.e., alcohol use predicts perceived norms). The current study examined the extent to which conformity and projection processes were evident in the association between college student alcohol use and the perceived alcohol use norms for students' club sport teams. The sample comprised 1,054 college students (61% female) nested in 35 intact same-sex club sport teams. On 3 separate occasions during a single school year (3-month lag), participants reported drinking frequency and perceptions of descriptive and injunctive group drinking norms. We employed random intercepts cross-lagged panel modeling to estimate prospective within-person associations separately from stable trait-like between-person associations. Descriptive and injunctive group drinking norms were both positively related to students' alcohol use frequency at the between-person level. Individuals nevertheless demonstrated variability at the within-person level. Results revealed a strong contemporaneous association between descriptive norms and alcohol use frequency within each timepoint, but no prospective associations. Models including perceptions of injunctive drinking norms demonstrated similar contemporaneous associations with alcohol use frequency, but also identified significant prospective associations signifying conformity. Findings align with previous research reporting a strong and positive association between student's self-reported alcohol use and subjective peer alcohol use norms. After disentangling within- and between-person effects to probe for conformity and projection processes, the current findings are somewhat contrary to previous research that has reported reciprocal relationships between social norms and alcohol use behavior. Further investigation of the potential conformity and projection mechanisms of social norms is critical to advance norm-based strategies to reduce harm.

Psychometric Validation of the Brief Alcohol Social Density Assessment in an Adult Community Sample.

Individuals' social networks exert a strong influence on alcohol use, but valid assessment of network drinking behavior is typically lengthy and high in participant burden. The aim of this study was to validate the Brief Alcohol Social Density Assessment (BASDA), an efficient measure of perceived alcohol use within a person's social network, in a sample of adult drinkers from the general community. Specifically, the convergent, criterion-related, incremental validity and internal validity were investigated by examining the BASDA in relation to other established measures of drinking motives, weekly drinking level, and severity of involvement. Participants were 903 (56% female) adults who reported drinking in the last year and who completed the BASDA, the Drinking Motives Questionnaire, the Daily Drinking Questionnaire, and the Alcohol Use Disorders Identification Test (AUDIT). Significant positive correlations were found between the BASDA and drinking motives, drinking quantity, and the AUDIT (rs=0.21 to 0.51, ps<0.001), providing support for convergent validity. There was a significantly higher BASDA score for those scoring at or above an AUDIT cutoff for hazardous drinking (p<0.001), providing support for criterion-related validity. Finally, beyond motives and covariates, the BASDA was significantly associated with total AUDIT score (ΔR2 =0.09, p<0.001), indicating its additive contribution and providing support for incremental validity. Confirmatory factor analysis revealed excellent fit, and all items significantly loaded onto a single factor (p<0.0001), providing evidence of internal validity. The resulting alcohol social density latent variable was significantly and robustly associated with drinks per week and AUDIT total score. These findings provide further support for the BASDA as a valid and efficient measure of social network alcohol density for understanding social influences on alcohol misuse.

Perceptions of alcohol use among injury patients and their family members in Tanzanian society.

Alcohol is one of the leading causes of death and disability worldwide. Rates of alcohol abuse in Moshi, Tanzania, are about 2.5 times higher than the Tanzanian average. We sought to qualitatively assess the perceptions of alcohol use among injury patients in Moshi, including availability, consumption patterns, abuse, and treatments. Participants were Emergency Department injury patients, their families, and community advisory board members. Participants were included if they were ≥18 years of age, a patient or patient's family member seeking care at the Kilimanjaro Christian Medical Center Emergency Department, Moshi, Tanzania, for an acute injury, clinically sober at the time of enrollment, medically stable, able to communicate in Swahili and consented to participate. Focus group discussions were audiotaped, transcribed, translated, and analyzed in parallel using an inductive thematic content analysis approach. Resultant themes were then reanalyzed to ensure internal homogeneity and external heterogeneity. Fourteen focus group discussions, with a total of 104 participants (40 patients, 50 family members, 14 community advisory board members), were conducted. Major themes resulting from the analysis included: 1) Early/repeated exposure; 2) Moderate use as a social norm with positive attributes; 3) Complications of abuse are widely stigmatized; and 4) Limited knowledge of availability of treatment. Our findings suggest that, among our unique injury population and their families, despite the normalization of alcohol-related behaviors, there is strong stigma toward complications stemming from excess alcohol use. Overall, resources for alcohol treatment and cessation, although broadly desired, are unknown to the injury population.