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Brobbin E, Parkin S, Deluca P, Drummond C. A qualitative exploration of the experiences of transdermal alcohol sensor devices amongst people in receipt of treatment for alcohol use disorder. Addict Behav Rep 2024; 19:100544. [PMID: 38596194 PMCID: PMC11002804 DOI: 10.1016/j.abrep.2024.100544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 03/04/2024] [Accepted: 04/03/2024] [Indexed: 04/11/2024] Open
Abstract
Introduction Transdermal alcohol sensors (TAS) have the potential to be used as a clinical tool in alcohol treatment, but there is limited research with individuals with alcohol dependence using TAS. Our study is a qualitative evaluation of the views of people attending alcohol treatment and their experiences of wearing the BACtrack Skyn, within alcohol services in South London. Methods Participants with alcohol dependence wore a BACtrack Skyn TAS for one week and met with the researcher every two days, for a total of four meetings (for example: Monday, Wednesday, Friday, and Monday). In the final meeting, a post-wear survey (on their physical, social and comfort experience of the TAS) and semi-structured interview were completed. The Technology Acceptance Model (TAM) informed the topic guide and data analysis. Results Adults (N = 16) receiving alcohol treatment were recruited. Three core topics guided analysis: perceived usefulness, perceived ease of use and attitudes towards use. Participants found the TAS easy to wear and felt positive about its appearance and comfort. The only challenges reported were side effects, mostly skin irritation. The main two perceived uses were 1) TAS working as a drinking deterrent and 2) reducing daily breathalyser visits during detox. Conclusion Findings support the use of TAS amongst alcohol service users. Wearing the TAS for one week was acceptable and feasible for objective alcohol concentration measurement. Participants reported high perceived ease of use and usefulness of the Skyn in the context of alcohol treatment. These results are encouraging for the use of TAS in clinical settings.
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Affiliation(s)
- Eileen Brobbin
- National Addiction Centre, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
| | - Stephen Parkin
- National Addiction Centre, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
| | - Paolo Deluca
- National Addiction Centre, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
| | - Colin Drummond
- National Addiction Centre, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
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Richards VL, Turrisi RJ, Russell MA. Subjective intoxication predicts alcohol-related consequences at equivalent alcohol concentrations in young adults using ecological momentary assessment and alcohol sensors. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2024; 38:334-346. [PMID: 38271080 PMCID: PMC11065600 DOI: 10.1037/adb0000993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2024]
Abstract
OBJECTIVE Subjective intoxication (SI) when drinking may serve as an internal barometer of whether to continue drinking or engage in potentially unsafe behavior. Mobile assessments offer the potential to use SI as a prospective risk indicator during drinking episodes; little evidence exists for the validity of real-time SI measures. We test the correspondence of SI with estimated blood alcohol concentration and transdermal alcohol concentration (TAC) in young adults' natural settings. We provide a novel test of whether SI features (peak and mean SI) uniquely predict consequences adjusting for alcohol concentration. METHOD Two hundred twenty-two heavy-drinking young adults (Mage = 22.3, 64% female, 79% non-Hispanic White, 84% undergraduates) participated in a 6-day study that used ecological momentary assessment of drinking and TAC sensors. SI was assessed every 30 min during drinking episodes. Multilevel modeling was used to test hypotheses. RESULTS Momentary SI and estimated blood alcohol concentration had moderate associations at the moment and day levels (standardized βs = 0.5-0.6); SI was moderately associated with TAC at the day level (βs = 0.5). Associations between SI and alcohol concentration varied widely between persons and across days. Day-level SI features predicted consequences when adjusting for alcohol concentration (incidence rate ratios, IRRs = 1.29-1.70). CONCLUSIONS Our two-item SI measure shows evidence of validity in real-world settings with heavy-drinking young adults. SI was significantly correlated with alcohol concentration and was a unique predictor of consequences. The strength of these associations varied greatly across persons and days. Real-time SI measurement may be useful in preventive interventions, but continued research is needed into when and for whom momentary SI is most predictive of risk. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Affiliation(s)
- Veronica L Richards
- Edna Bennett Pierce Prevention Research Center, Pennsylvania State University
| | - Robert J Turrisi
- Edna Bennett Pierce Prevention Research Center, Pennsylvania State University
| | - Michael A Russell
- Edna Bennett Pierce Prevention Research Center, Pennsylvania State University
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Richards VL, Glenn SD, Turrisi RJ, Mallett KA, Ackerman S, Russell MA. Transdermal alcohol concentration features predict alcohol-induced blackouts in college students. ALCOHOL, CLINICAL & EXPERIMENTAL RESEARCH 2024; 48:880-888. [PMID: 38639884 PMCID: PMC11114374 DOI: 10.1111/acer.15290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Revised: 01/31/2024] [Accepted: 02/18/2024] [Indexed: 04/20/2024]
Abstract
BACKGROUND Alcohol-induced blackouts (AIBs) are common in college students. Individuals with AIBs also experience acute and chronic alcohol-related consequences. Research suggests that how students drink is an important predictor of AIBs. We used transdermal alcohol concentration (TAC) sensors to measure biomarkers of increasing alcohol intoxication (rise rate, peak, and rise duration) in a sample of college students. We hypothesized that the TAC biomarkers would be positively associated with AIBs. METHODS Students were eligible to participate if they were aged 18-22 years, in their second or third year of college, reported drinking 4+ drinks on a typical Friday or Saturday, experienced ≥1 AIB in the past semester, owned an iPhone, and were willing to wear a sensor for 3 days each weekend. Students (N = 79, 55.7% female, 86.1% White, Mage = 20.1) wore TAC sensors and completed daily diaries over four consecutive weekends (89.9% completion rate). AIBs were assessed using the Alcohol-Induced Blackout Measure-2. Logistic multilevel models were conducted to test for main effects. RESULTS Days with faster TAC rise rates (OR = 2.69, 95% CI: 1.56, 5.90), higher peak TACs (OR = 2.93, 95% CI: 1.64, 7.11), and longer rise TAC durations (OR = 4.16, 95% CI: 2.08, 10.62) were associated with greater odds of experiencing an AIB. CONCLUSIONS In a sample of "risky" drinking college students, three TAC drinking features identified as being related to rising intoxication independently predicted the risk for daily AIBs. Our findings suggest that considering how an individual drinks (assessed using TAC biomarkers), rather than quantity alone, is important for assessing risk and has implications for efforts to reduce risk. Not only is speed of intoxication important for predicting AIBs, but the height of the peak intoxication and the time spent reaching the peak are important predictors, each with different implications for prevention.
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Affiliation(s)
- Veronica L. Richards
- Edna Bennett Pierce Prevention Research Center, The Pennsylvania State University, University Park, Pennsylvania, USA
| | - Shannon D. Glenn
- Edna Bennett Pierce Prevention Research Center, The Pennsylvania State University, University Park, Pennsylvania, USA
- Department of Biobehavioral Health, The Pennsylvania State University, University Park, Pennsylvania, USA
| | - Robert J. Turrisi
- Edna Bennett Pierce Prevention Research Center, The Pennsylvania State University, University Park, Pennsylvania, USA
- Department of Biobehavioral Health, The Pennsylvania State University, University Park, Pennsylvania, USA
| | - Kimberly A. Mallett
- Edna Bennett Pierce Prevention Research Center, The Pennsylvania State University, University Park, Pennsylvania, USA
| | - Sarah Ackerman
- Edna Bennett Pierce Prevention Research Center, The Pennsylvania State University, University Park, Pennsylvania, USA
| | - Michael A. Russell
- Edna Bennett Pierce Prevention Research Center, The Pennsylvania State University, University Park, Pennsylvania, USA
- Department of Biobehavioral Health, The Pennsylvania State University, University Park, Pennsylvania, USA
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Wang Y, Porges EC, DeFelice J, Fridberg DJ. Integrating Alcohol Biosensors With Ecological Momentary Intervention (EMI) for Alcohol Use: a Synthesis of the Latest Literature and Directions for Future Research. CURRENT ADDICTION REPORTS 2024; 11:191-198. [PMID: 38854904 PMCID: PMC11155371 DOI: 10.1007/s40429-024-00543-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/21/2023] [Indexed: 06/11/2024]
Abstract
Purpose of Review Excessive alcohol use is a major public health concern. With increasing access to mobile technology, novel mHealth approaches for alcohol misuse, such as ecological momentary intervention (EMI), can be implemented widely to deliver treatment content in real time to diverse populations. This review summarizes the state of research in this area with an emphasis on the potential role of wearable alcohol biosensors in future EMI/just-in-time adaptive interventions (JITAI) for alcohol use. Recent Findings JITAI emerged as an intervention design to optimize the delivery of EMI for various health behaviors including substance use. Alcohol biosensors present an opportunity to augment JITAI/EMI for alcohol use with objective information on drinking behavior captured passively and continuously in participants' daily lives, but no prior published studies have incorporated wearable alcohol biosensors into JITAI for alcohol-related problems. Several methodological advances are needed to accomplish this goal and advance the field. Future research should focus on developing standardized data processing, analysis, and interpretation methods for wrist-worn biosensor data. Machine learning algorithms could be used to identify risk factors (e.g., stress, craving, physical locations) for high-risk drinking and develop decision rules for interpreting biosensor-derived transdermal alcohol concentration (TAC) data. Finally, advanced trial design such as micro-randomized trials (MRT) could facilitate the development of biosensor-augmented JITAI. Summary Wrist-worn alcohol biosensors are a promising potential addition to improve mHealth and JITAI for alcohol use. Additional research is needed to improve biosensor data analysis and interpretation, build new machine learning models to facilitate integration of alcohol biosensors into novel intervention strategies, and test and refine biosensor-augmented JITAI using advanced trial design.
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Affiliation(s)
- Yan Wang
- Department of Epidemiology, University of Florida, 2004 Mowry Rd, Gainesville, FL 32610, USA
| | - Eric C. Porges
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Jason DeFelice
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Daniel J. Fridberg
- Department of Psychiatry and Behavioral Neuroscience, The University of Chicago, Chicago, IL, USA
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Brobbin E, Deluca P, Coulton S, Drummond C. Accuracy of transdermal alcohol monitoring devices in a laboratory setting. Alcohol Alcohol 2024; 59:agad068. [PMID: 37873967 DOI: 10.1093/alcalc/agad068] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 09/06/2023] [Accepted: 09/28/2023] [Indexed: 10/25/2023] Open
Abstract
The development of transdermal alcohol sensors (TASs) presents a new method to monitor alcohol consumption with the ability to objectively measure data 24/7. We aimed to evaluate the accuracy of two TASs (BACtrack Skyn and Smart Start BARE) in a laboratory setting. Thirty-two adults received a dose of ethanol 0.56 g/kg body weight as a 20% solution while wearing the two TASs and provided Breath Alcohol Concentration (BrAC) measurements for 3.5 h postalcohol consumption. Pearson's correlations and repeated measures analysis of variance tests were conducted on the peak, time-to-peak, and area under the curve data. Bland-Altman plots were derived. A time series analysis and cross-correlations were conducted to adjust for time lag. Both TASs were able to detect alcohol and increase within 20 min. BrAC peaked significantly quicker than Skyn and BARE. BrAC and Skyn peaks were negatively significantly correlated (r = -0.381, P = .035, n = 31), while Skyn and BARE peaks were positively significantly correlated (r = 0.380, P = .038, n = 30). Repeated measures analysis of variance found a significant difference between BrAC, Skyn, and BARE (F(1.946, 852.301) = 459.873, P < .001)). A time series analysis found when BrAC-Skyn and BrAC-BARE were adjusted for the delay to peak, and there was still a significant difference. Failure rates: 1.7% (Skyn) and 4.8% (BARE). Some evidence was obtained for TAS validity as both consistently detected alcohol. Failure rates and time lag show improvements in older device generations. However, neither TAS presented strong equivalence to the breathalyser even when the lag time was adjusted. With further testing and technology advancements, TAS could be a potential alcohol monitoring tool. Two of the newest TAS devices were worn in laboratory conditions for one afternoon to compare their accuracy of alcohol monitoring to a breathalyser. Findings suggest that the two TASs (BACtrack Skyn and SmartStart BARE) recorded significantly similar data postalcohol consumption, but not with the breathalyser.
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Affiliation(s)
- Eileen Brobbin
- Addiction Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, 4 Windsor Walk, London SE5 8AF, United Kingdom
| | - Paolo Deluca
- Addiction Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, 4 Windsor Walk, London SE5 8AF, United Kingdom
| | - Simon Coulton
- Centre for Health Service Studies, University of Kent, Canterbury CT2 7NF, United Kingdom
| | - Colin Drummond
- Addiction Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, 4 Windsor Walk, London SE5 8AF, United Kingdom
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Gunn RL, Merrill JE, Haines AM, Fernandez ME, Souza T, Berey BL, Leeman RF, Wang Y, Barnett NP. Use of the BACtrack Skyn alcohol biosensor: Practical applications for data collection and analysis. Addiction 2023; 118:1586-1595. [PMID: 37060272 PMCID: PMC10330667 DOI: 10.1111/add.16207] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 03/28/2023] [Indexed: 04/16/2023]
Abstract
AIMS Alcohol biosensors, including the BACtrack Skyn, provide an objective and passive method of continuously assessing alcohol consumption in the natural environment. Despite the many strengths of the Skyn, six key challenges in the collection and processing of data include (1) identifying consumed alcohol; (2) identifying environmental alcohol; (3) identifying and determining the source of missing or invalid data; (4) achieving high participant adherence; (5) integrating Skyn and self-report data; and (6) implications for statistical inference. In this report we outline these challenges, provide recommendations to address them and identify future needs. DESIGN AND SETTINGS Procedures from several laboratory and field-based pilot studies are presented to demonstrate practical recommendations for Skyn use. Data from a pilot study including a 7-day ecological momentary assessment period are also presented to evaluate effects of environmental alcohol on BACtrack Skyn readings. CONCLUSIONS To address challenges in the collection and processing of data from the BACtrack Skyn alcohol biosensor, researchers should identify goals in advance of data collection to anticipate the processing necessary to interpret Skyn data. The Transdermal Alcohol Sensor Data Macro (TASMAC) version 2.0 software can help to process data rapidly; identify drinking events, missing data and environmental alcohol; and integrate the sensor with self-report data. Thorough participant orientation and regular contact in field studies can reduce missing data and enhance adherence. Many recommended methods for Skyn use are applicable to other alcohol sensors and wearable devices.
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Affiliation(s)
- Rachel L Gunn
- Brown University School of Public Health, Providence, RI, USA
| | | | - Anne M Haines
- Brown University School of Public Health, Providence, RI, USA
| | | | - Timothy Souza
- Brown University School of Public Health, Providence, RI, USA
| | | | - Robert F Leeman
- Department of Health Education and Behavior, College of Health and Human Performance, University of Florida, Gainesville, FL, USA
- Department of Health Sciences, School of Community Health and Behavioral Sciences, Bouvé College of Health Sciences, Northeastern University, Boston, MA, USA
| | - Yan Wang
- Department of Epidemiology, University of Florida, Gainesville, FL, USA
| | - Nancy P Barnett
- Brown University School of Public Health, Providence, RI, USA
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