Alcohol Impaired Driving in the Natural Environment
Condition: Driving Under the Influence
Study type: Interventional

Summary: 
      This is a pilot study to set up a larger investigation examining predictors of the decision
      to drive after consuming alcohol. All participants will carry a study provided smartphone and
      breathalyzer device for the 2 week period of the study. The intervention is that participants
      are randomly assigned to one of 2 breathalyzer feedback conditions - one where they receive a
      warning that their results indicate they should not drive and one where they receive no
      feedback. The study is designed to provide information needed for a larger version with a
      similar protocol, but also to provide an initial test of project hypotheses as well.
    

Detailed description: 
      Despite previous success in reducing alcohol impaired driving (AID) and fatal crashes, rates
      have not decreased significantly since the 1990s. Developing novel approaches to
      prevention/intervention are likely required to produce further progress.

      This project is designed to evaluate a potential intervention for AID using mobile
      technology. In addition, the project is designed to provide pilot data for a large scale
      investigation.

      Recent laboratory work by the PI has demonstrated the utility of assessing AID risk factors
      when participants are intoxicated. We identified four risk factors that, measured under
      intoxication, are cross-sectional predictors of AID: AID attitudes (Morris et al., 2014),
      impulsivity (McCarthy et al., 2012), behavioral economic demand (Amlung et al., 2016) and
      subjective intoxication (Amlung et al., 2014).

      The proposed project will evaluate these factors as prospective predictors of AID and extend
      this work outside the laboratory and into participants' natural drinking environment using
      Ambulatory Assessment (AA). AA is a set of techniques used to collect data from individuals
      in the course of their daily life. AA methods provide increased ecological validity across
      multiple modalities (e.g., self-report, physiological measures). No study to date has used AA
      to examine AID. We will employ a combination of three AA methods: ecological momentary
      assessment, geospatial technology, and portable breath analysis.

      Ecological Momentary Assessment (EMA) is a form of AA that allows participants to self-report
      on their current thoughts, feelings, and behaviors in their natural environment (Shiffman et
      al., 2008). EMA avoids most pitfalls of retrospective reports, and is increasingly used to
      study temporally proximal influences on substance use behaviors (Shiffman, 2009). Despite the
      importance of such influences to AID decisions (Quinn & Fromme, 2012), no study to date has
      applied EMA methods to the study of AID.

      Advancements in mobile technology, such as global position systems (GPS) and portable
      breathalizers, allow for the collection of objective data on participant location and alcohol
      use in real-time. We will combine location data (e.g., drinking venue, distance from home)
      and in-the-moment breathalyzer data with self-report EMA data from each participant drinking
      episode. This combination will allow for a more complete assessment of event-level factors
      that contribute to AID decisions.

      This pilot project will test the hypothesis that temporally proximal measures of AID risk
      factors (subjective impairment, perceived risk) collected during a drinking episode will
      improve prediction of AID, over and above trait measures of AID risk factors.

      The pilot project will also test the potential for AA to function as an intervention for AID.
      In this pilot, participants will be randomly assigned to either receive some feedback from
      their breathalyzer (a warning that they have consumed too much to drive safely) or not to
      receive any feedback. Note that participants will not be told their BAC, due to potential
      risks of specific feedback (increased consumption, titrating drinking to drive at slightly
      below .08). Instead, feedback will be general ("Your results indicate that you have drank too
      much to drive safely"), and participants will not be aware of what BAC triggers these
      warnings.

      Comparisons of all participants AID behavior at baseline (from a Timeline Follow-back
      assessment) with their AID behavior during study participation will be used to test whether
      the increased self-monitoring of AA can alter AID decisions. In addition, comparisons between
      groups (feedback vs. none) will test for potential effects of BAC feedback on AID decisions.
      Support for these hypotheses could lead to novel, cost-effective interventions to reduce AID
      using mobile technology.

      This pilot will enroll 40 moderate-to-heavy drinking young adults. Participants will complete
      a brief laboratory session of AID risk measures, followed by two weeks of AA. They will be
      randomly assigned to one of two conditions (BAC feedback vs. none). Interview assessments of
      AID will be conducted at baseline and at the completion of AA assessments, with interviewers
      blind to condition.
    

Intervention name(s): BAC Driving Feedback/Warning; No Feedback
Intervention type(s): Behavioral; Behavioral
Intervention description(s): Participants will receive a warning at a set BAC limit, indicating they are too impaired to drive.; Participants will receive no information about BAC, but will still complete study assessments and provide breath samples during drinking sessions.
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: Participants will be assigned to either receive feedback from a breathalyzer device or to receive no information.
Masking: Single (Outcomes Assessor)
Primary purpose: Prevention
Keywords: drunk driving; alcohol impaired driving; drinking and driving; ambulatory assessment