Daily assessments of behavioral economic indices and drinking among rural-residing adults with at-risk drinking

Abstract

In a secondary analysis among adults with at-risk drinking who live in rural areas (N = 75; 62.7% Female; 98.7% White), we examined the predictive ability of behavioral economic (BE) indices (demand, delay discounting, and proportion of alcohol-free activities) for next-day alcohol use via daily surveys across the range of alcohol use severity. These relations were tested using linear mixed-effects models, including evaluating the interaction of BE indices with alcohol use severity. In unadjusted analyses, proportion of alcohol-free activities (β [95% CI]: −0.022 [−0.038, −0.006]), demand intensity (i.e., drinks when free; β [95% CI]: 0.267 [0.143, 0.391]), and maximum expenditure (Omax, β [95% CI]: 0.036 [0.014, 0.059]) were significant predictors of next-day alcoholic drinks consumed. In adjusted analyses, we observed a significant interaction between baseline alcohol use severity and intensity of alcohol demand (β [95% CI]: −0.014 [−0.027, −0.001]) and Omax (β [95% CI]: 0.005 [0.000, 0.010]) wherein there was a stronger relations between the BE measure and next-day drinking among lower and higher alcohol use severities, respectively. These results support the inclusion of BE measures in daily survey research to support digital and potentially just-in-time adaptive interventions.