JMIR Publications

ABSTRACT

Background:

Binge drinking, defined as consuming five or more standard alcoholic drinks for men (four for women) within a two-hour period, is common among young adults and is associated with significant alcohol-related morbidity and mortality. To date, most research on this problem in young adults has relied upon retrospective questionnaires or costly laboratory-based procedures. Smartphone-based ecological momentary assessment (EMA) may address these limitations by allowing researchers to measure alcohol use and related consequences in real-time, and in drinkers’ natural environments. However, no previous studies have systematically examined the utility of this approach in a sample of young adults during a real world heavy drinking episode.

Objective:

To evaluate the feasibility, acceptability, and safety of a new, smartphone-based EMA method to assess binge drinking and related outcomes in heavy drinking young adults during real-world drinking occasions.

Methods:

Young adult binge drinkers in the smartphone group (N=83; mean age = 25.4 years; 58% male; bingeing on 23.2% of days in the past month) completed baseline measures of alcohol use and drinking-related consequences, followed by 1-2 smartphone-based EMA of typical drinking behavior and related outcomes in their natural environments. They also completed next-day and two-week follow-up surveys further assessing alcohol use and related consequences during the EMA sessions and two weeks after study participation, respectively. A separate demographic- and drinking-matched safety comparison group (N=25) completed the baseline and two-week follow-up surveys but did not complete EMA of real-world drinking behavior.

Results:

Most (71%) participants in the smartphone group engaged in binge drinking during the 3-hour EMA session, consuming M±SD=8.3±4.2 standard alcoholic drinks. They completed 87% of system-initiated EMA prompts during the real-world drinking episode, supporting the feasibility of this approach. The procedure was acceptable, as evidenced by high participant ratings for overall satisfaction with the EMA software and study procedures, and low ratings for intrusiveness of the mobile surveys. Regarding safety, participants endorsed few drinking-related consequences during or after the real-world drinking episode, with no adverse/serious adverse events reported. There were no differences between the smartphone and safety comparison groups in terms of changes in drinking behavior or consequences from baseline to two-week follow-up.

Conclusions:

This study provided preliminary support for the feasibility, acceptability, and safety of a novel smartphone-based EMA of real-time alcohol use and related outcomes in young adult heavy drinkers. The results suggest that young adults can use smartphones to safely monitor drinking even during very heavy drinking episodes. Smartphone-based EMA has strong potential to inform future research on the epidemiology of and intervention for AUD by providing researchers with an efficient and inexpensive way to capture large amounts of data on real-world drinking behavior and consequences.