Use of Ecological Momentary Assessments to Evaluate Drinking in Native Women

PROJECT SUMMARY Reducing alcohol consumption to below bingeing levels is a focus of Healthy People 2030, which sets data- driven national objectives to improve health in the United States. Risky drinking is especially concerning for women as they are more likely to develop medical problems because of their drinking when compared to men. In tribal communities, American Indian women who drink tend to do so at risky levels, and drinking is typically done with groups of people in a home setting. However, more data on the situational context is necessary to better understand the social context of drinking patterns in this population and to subsequently inform interventions to reduce risky drinking in American Indian women of childbearing age. One way to collect more timely and accurate alcohol data is through ecological momentary assessment (EMA). Using widely available technology such as smartphones, EMA involves repeated sampling of subjects' current behaviors and experiences in real time and in subjects' natural environments, which minimizes recall bias, maximizes ecological validity, and allows study of micro-processes that influence behavior in real-world contexts. Therefore, we will build on the success of a proof-of-concept project led by this team that shows EMA with American Indian women is both feasible and acceptable, and we will use EMA to better understand the drinking contexts, patterns, and risk factors with this population. There are three iterative phases to the project: 1) formative, community-engaged work to validate the measures within the EMA data capture system; 2) use of EMA to elucidate alcohol use in American Indian women of childbearing age, such as drinking style, risky times/days of drinking, mood and affect prior to and during drinking, and the social context in which drinking occurs; and 3) the dissemination of results to tribal communities using community engagement principles combined with health communication techniques. The synergistic impact of this project lies in the knowledge gained from the EMA research project to better understand alcohol consumption with American Indian women of childbearing age, as well as learn more about predictors of non-drinking days. This tool could also potentially be used within alcohol-exposed pregnancy intervention and prevention work and as a way to build social support. As well, the project will impact the undergraduate research environment of the lead institution by providing student-centered experiences such as opportunities to be involved as individual undergraduate student research assistants and also within the classroom by focusing our project dissemination efforts on student engagement in the research dissemination process.