The feasibility of integrating remote breath alcohol monitoring into ecological momentary assessment of intimate partner violence among young adults with a history of heavy drinking and aggression.

Abstract

Aims: We examined the feasibility and acceptability of pairing portable breathalyzers to assess field alcohol use with mobile ecological momentary assessment (EMA) to assess intimate partner violence (IPV; psychological, cyber, physical and sexual aggression) perpetration and victimization among undergraduates who drink heavily and were recently aggressive.

Design, setting and participants: We assessed EMA/breathalyzer completion rates, drinking captured via breathalyzer versus self-report, number of IPV events captured, procedural acceptability and reactivity to assessment. Sex differences were examined. Undergraduates aged 18-25 (n = 103; M age = 21 years, SD = 2.0; 52% women; 80.6% heterosexual; 64.1% white; 93.2% non-Hispanic) recruited from a large Mid-Atlantic university in the United States completed a baseline survey then a 30-day EMA wherein they were prompted to complete one morning and three evening surveys (7 PM, 9 PM, 11 PM) daily. After each evening survey, participants were prompted to submit a breath alcohol content (BrAC) sample to a breathalyzer linked to surveys. Participants could self-initiate surveys after drinking or IPV outside of assessment periods. Afterward, participants completed an exit survey.

Measurements: Outcome variables were self-reported alcohol use and IPV assessed via EMA surveys, and BrAC assessed via breathalyzer. Self-reported procedural acceptability was assessed in the exit survey. Reactivity to assessment was assessed by analyzing daily trends in IPV and drinking by sex using generalized linear mixed effects models.

Findings: Participants completed 80% of surveys and responded to 91% of breathalyzer prompts. BrAC was captured in 89.4% of self-reported drinking events, 91.4% of self-reported non-drinking events and 95.8% of IPV events, with greater responsiveness to breathalyzer prompts as the evening progressed despite increasing intoxication. More IPV events were captured during evening and event triggered (358 combined total events) than morning surveys (245 events). Results were comparable across women and men. Each additional study day was associated with modest declines in odds of experiencing any IPV [odds ratio (OR) = 0.95, 95% confidence interval (CI) = 0.94-0.97, P < 0.001], IPV perpetration (OR = 0.94, 95% CI = 0.92-0.96, P < 0.001), IPV victimization (OR = 0.97, 95% CI = 0.96-0.99, P = 0.004), any drinking (OR = 0.99, 95% CI = 0.98-1.00, P = 0.01) and positive BrAC readings (OR = 0.99, 95% CI = 0.98-1.00, P = 0.052), suggesting minimal reactivity to assessment. Participants reported high overall satisfaction with study components.

Conclusions: Pairing ecological momentary assessment with portable breathalyzers to capture data on drinking and intimate partner violence across 30 days among US undergraduates who were previously aggressive and who drink heavily appears to be both feasible and acceptable.