Michael Fendrich

Computer Literacy and the Accuracy of Substance Use Reporting in an ACASI Survey

In recent years, audio computer-assisted self-interviews (ACASI) have been demonstrated to increase and presumably improve the quality of drug reporting in epidemiologic research. Surprisingly little research is available, however, regarding the potential limitations of this technique. For example, it is unclear what effects computer literacy may have on the validity of substance use information collected via ACASI. Respondents with limited computer skills may become distracted by the automated technology, requiring the devotion of considerable cognitive effort to the navigation of unfamiliar computer equipment and software that would otherwise be available for use to more carefully process and answer survey questions. In this study, we report findings from a community ACASI survey conducted in Chicago, which are used to address this problem. Using multiple indicators of computer literacy, a covariance structure model was developed to test the hypothesis that persons with low computer literacy skills may report drug use with less accuracy. Biological assays were used to evaluate 30-day cocaine use reporting accuracy. Model findings confirmed a positive relationship between computer literacy and the accuracy of cocaine use reports. Future research should investigate strategies for improving the usability of self-administrated computer reporting systems for persons with little direct computer experience.

The association of long-term alcohol biomarkers with risk for alcohol-related injury: Implications for screening

Abstract Alcohol misuse is a leading risk factor for serious injury and death. For those experiencing trauma in emergency care settings, recent alcohol misuse history is typically assessed via self-report measures. Since underreporting may be a problem in these settings, objective indicators like long-term biomarkers may be useful for identifying hazardous drinkers who may need intervention. Recognizing this, we investigated (1) whether hazardous drinking was linked to reports of alcohol-related injury in a probability sample of over 600 college students from a large, Midwestern, urban university; (2) whether elevated long-term biomarkers showed similar associations in the same sample. Associations derived from responses to the Alcohol Use Disorder Identification Test-C (AUDIT-C) as well as from hair and fingernails tested for ethyl glucuronide, a direct alcohol biomarker, suggested that hazardous drinking is significantly associated with elevated risk for alcohol-related injury. Implications for screening and intervention in health care settings are discussed.

Prior prescription opioid misuse in a cohort of heroin users in a treatment study

This study investigates prior prescription opioid misuse in a cohort of heroin users whose progress was tracked in a treatment study conducted in the US from 2006 to 2010. Half of the sample misused prescription opioids (“other opiates/analgesics”) prior to their onset of heroin misuse (POBs). We found that POBs were demographically younger and more likely to be white than other heroin users (OHUs). There were differences between the two groups with respect to the reporting of at least one year of regular use of substances and age of onset of substance use. POBs were more likely to report regular use, and earlier onset of use of several substances, mostly of the type potentially obtained via prescription. POBs were more persistent in their opioid use and more likely to suffer near-term elevated depressive symptoms compared with OHUs. These findings suggest that heroin addiction treatment may need to be tailored according to opioid misuse history.

The use of biological measures in social research on drug misuse

This chapter focuses on the use of biological measures for assessing illicit drugs, such as cocaine, marijuana, opiates, amphetamines, as well as for assessing legal drugs with high potential for abuse in “field” studies. Field studies are defined as those that are done in real-life settings. An overview of the major biological tests is provided. Studies employing biomarkers are classified into two broad categories: validity and prevalence studies. This review focuses less on the technological assessment of alternative methods than it does on the implementation and use of those methods. Overall, biomarker assessment is found to be applicable in a wide variety of settings and populations. Implementation concerns focus primarily on the potential of refusal present as well as requirements for separate sets of toxicological analyses. Implementation of stand-alone biomarker studies needs to be informed by knowledge of the sample and sampling process to be useful in community-based studies. Despite recent research on the development of biomarkers for heavy alcohol use, this review is limited to nonalcohol substances.

Family history density of substance use problems among undergraduate college students: Associations with heavy alcohol use and alcohol use disorder

PURPOSE A family history of alcoholism has been found associated with problematic alcohol use among college students, but less research has examined the effects of family history density of substance use problems in this population. This study examined the prevalence of family history density of substance use problems and its associations with heavy alcohol use, negative alcohol consequences, and alcohol use disorder in a college sample. METHODS Based on a secondary analysis of a probability sample, data were analyzed from 606 undergraduate students. Family history density of substance use problems included both first and second degree biological relatives. Heavy alcohol use was the total number of days in which participants drank five/four or more drinks for men/women, negative alcohol consequences were derived from items commonly asked in college student surveys, and an alcohol use disorder was defined as meeting diagnostic criteria for alcohol abuse or dependence. Point prevalence estimated rates of family history density of substance use problems, and negative binomial, ANCOVA, and logistic regression models examined associations between family history density and the alcohol variables while adjusting for sociodemographic variables. RESULTS Family history density of substance use problems was not significantly associated with total days of heavy alcohol use. Having a second degree, a first degree, or both a first and second degree relative(s) with a substance use problem, however, was significantly associated with experiencing negative alcohol consequences. In addition, having both a first and second degree relative(s) with a substance use problem significantly increased the odds of having an alcohol use disorder. CONCLUSIONS Family history density of substance use problems may play a role in experiencing negative alcohol consequences and in having an alcohol use disorder among undergraduate college students and may be an important risk factor to assess by college health professionals.

Evaluation: Concepts, Plans, and Progress

This chapter describes a general logic model that can be used as a framework for evaluating community demonstration projects. We then show how this model can be applied to Serve Here Connecticut Project. Consistent with the logic model framework, we discuss program goals and activities, ongoing program monitoring activities, outcome evaluation, and longer term program consequences. We conclude by presenting a questionnaire that will be used for the Serve Here evaluation. The plan is to administer the questionnaire on repeated occasions to applicants and those not admitted to the program due to space limitations. Our aim is to understand how program participation potentially impacts key measures such as community satisfaction, participation, trust, self-efficacy, and overall happiness.

The utility of collateral student drinking reports: Evidence from a biomarker study.

INTRODUCTION Researchers have increasingly used collateral informants to validate the reports provided by primary research subjects. We assessed the utility of collateral informants for college students in a study that incorporates biomarkers to validate student reports of recent drinking behavior. METHODS Students from a Midwestern university were randomly selected for a study in which they provided 90-day Timeline Followback data, hair and fingernail specimens for ethylglucuronide (EtG) testing, and information about collateral (friends or peers) informants who were familiar with their drinking behavior. We compared summary measures of recent drinking to collateral informant reports for the subset of 72 students who were selected to participate in the collateral validation process who had complete measures. Kappa, weighted kappa, and McNemar tests were performed to evaluate levels of agreement. We compared levels of use indicated by each informant within the context of EtG findings. We also compared respondent and collateral reports with respect to heavy drinking directly to EtG test results. RESULTS There was considerable overlap between the reports provided by the student participants and their collateral informants. Within the context of EtG-informed analyses, collaterals rarely provided new information about heavy use beyond that provided by the study subjects. CONCLUSIONS Collateral informants have limited utility in non-clinical studies of heavy drinking in randomly selected college students.