Using Online Respondent Driven Sampling for Vietnamese Youths' Alcohol Use and Associated Risk Factors

Behavioral economic indicators of risky drinking among community-dwelling emerging adults

Objective: Behavioral economic (BE) approaches to understanding and reducing risky drinking among college students are well established, but little is known about the generalizability of prior findings to peers who currently are not traditional college students and are more difficult to reach for assessment and intervention. This cross-sectional survey investigated whether drinking practices and negative consequences were associated with greater alcohol demand, alcohol reward value, and delay discounting in this target population. Method: Community-dwelling emerging adult drinkers aged 21 to 29 (N = 357) were recruited using Respondent-Driven Sampling adapted to a digital platform (Mage = 23.6 years, 64% women). Peers recruited peers in an iterative fashion. Participants completed a web-based survey of drinking practices, negative alcohol-related consequences, and BE measures of alcohol demand, alcohol reward value, and delay discounting. Results: Regression analyses supported the study hypotheses. Higher alcohol demand (intensity and elasticity) predicted higher drinks per drinking day, more past-month drinking days, and more negative consequences. Higher alcohol reward value (discretionary alcohol spending and alcohol-involved activities) and stronger preference for sooner smaller versus later larger rewards predicted select drinking risk variables in the hypothesized direction (p < .05). Conclusions: BE risk characteristics were generalized to community-dwelling emerging adult risky drinkers, with the most consistent associations found between alcohol demand and drinking risk measures. The findings lay a foundation for extending successful BE interventions with college drinkers to this underserved population. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Social Network Feedback and Drinking Outcomes among Emerging Adult Risky Drinkers Living in Urban Communities

Alcohol use and related problems often increase during emerging adulthood and are influenced by social networks. Investigating alcohol-specific feedback from network members may be useful for understanding social influences and designing interventions to reduce risky drinking among emerging adults.Purpose/Objectives: This study examined whether drinking practices and consequences among emerging adult risky drinkers living in disadvantaged urban communities were influenced by receipt of encouragement, discouragement, or mixed messages about drinking from network members.

METHODS

Risky drinkers ages 21-29 (N = 356; 228 females; mean age = 23.6 years) residing in the community were recruited using digitally implemented Respondent Driven Sampling, a peer-driven chain referral method. A web-based survey assessed drinking practices, negative alcohol-related consequences, and drinking feedback from social network members including friends, spouse/partner, and other family members.

RESULTS

Negative binomial generalized linear modeling showed that discouragement of drinking by friends was associated with fewer drinking days and negative consequences, whereas discouragement by family members (excluding spouse/partner) was associated with more drinks per drinking day. Mixed feedback (sometimes encouraging, sometimes discouraging drinking) from friends and spouse/partner was associated with more drinking days and negative consequences.Conclusions/Importance: Social network feedback had both risk and protective associations with drinking practices and problems among emerging adults, with discouragement to drink by friends appearing to serve a protective function. The findings suggest the utility of interventions delivered through social networks that amplify the natural protective function of friend discouragement of drinking, in addition to addressing established risks associated with peers.

Utility of digital Respondent Driven Sampling to recruit community-dwelling emerging adults for assessment of drinking and related risks

INTRODUCTION

Emerging adulthood often entails heightened risk-taking, including risky drinking, and research is needed to guide intervention development and delivery. This study adapted Respondent Driven Sampling, a peer-driven recruitment method, to a digital platform (d-RDS) and evaluated its utility to recruit community-dwelling emerging adult (EA) risky drinkers, who are under-served and more difficult to reach for assessment and intervention than their college student peers.

MATERIALS AND METHODS

Community-dwelling EA risky drinkers (N = 357) were recruited using d-RDS (M age = 23.6 years, 64.0% women). Peers recruited peers in an iterative fashion. Participants completed a web-based cross-sectional survey of drinking practices and problems and associated risk and protective factors.

RESULTS

d-RDS successfully recruited EA risky drinkers. On average, the sample reported recent drinking exceeding low-risk drinking guidelines and 8.80 negative consequences in the past three months. Compared to age-matched respondents from the representative U.S. National Survey on Drug Use and Health, the sample reported more past month drinking days and more drinks consumed per drinking day (ps < 0.001). At higher consumption levels, predicted positive associations were found with lower education and receipt of public assistance.

CONCLUSIONS

Results supported the utility of d-RDS as a sampling method and grassroots platform for research and intervention with community-dwelling EA drinkers who are harder to reach than traditional college students. The study provides a method and lays an empirical foundation for extending efficacious alcohol brief interventions with college drinkers to this underserved population.

Latkin C, C. M. Ho R, S. H. Ho C. Patterns of Risky Sexual Behaviors and Associated Factors among Youths and Adolescents in Vietnam

Youths and adolescents are vulnerable to HIV/STIs from unprotected sex. Promotion of young population's awareness about risky sexual behaviors is essential to develop contextualized interventions. A cross-sectional study was conducted in five Vietnamese provinces to document current attitudes and practices regarding sexual behaviors among youths. The information on sociodemographic characteristics, substance use, and sexual behaviors was collected via self-reported questionnaires. The factors associated with risky sexual behaviors were identified by the multivariate logistic regression. Among the 1200 participants, 73.5% reported having sex in their lifetime, and 48.1% used condoms at their latest sexual intercourse. Participants in urban areas were more likely not to intend to use condoms and had a higher unintended pregnancy rate than in rural areas. Older age was positively associated with not wanting to use and not using condoms. Substance-using participants were more likely to not use condoms. The participants taking alcohol or other stimulants before sex had a higher likelihood of unintended pregnancy. Respondents' attitudes and practices regarding sexual behaviors were associated with gender and employment. This study indicated that young population's awareness in Vietnam is high, however, risky sexual behaviors also remain common. Sex-related educational programs about the consequences of substance use, multiple sex partners, and unprotected sex should be developed.

Risk Factors Related to Binge Drinking

The characteristics of and risk factors associated with binge drinking among South Korean and American adolescents were identified in this study. Data on adolescents in the 9th to 12th grades were extracted from two nationwide data sets: the Korea Youth Risk Behavior Web-based Survey System and the U.S. Youth Risk Behavior Surveillance System. Binge drinking was observed among 16% of American adolescents during the past month and among 11.6% of Korean adolescents during the past year. For adolescents from both countries, the following seven similar significant factors were associated with binge drinking: female gender, higher grade, fighting-related injury experience, current cigarette smoking, preteen smoking initiation, participation in team sports, and depression. Among Korean adolescents, higher or lower level of academic achievement and inadequate sleep were additional unique factors associated with binge drinking. These results could be useful for developing interventions for adolescents engaging in binge drinking in both countries.

A pilot study of a smartphone application supporting recovery from drug addiction

BACKGROUND

Mobile health (mHealth) technologies have the potential to facilitate self-monitoring and self-management for individuals with substance use disorders (SUD). S-Health is a bilingual smartphone application based on cognitive behavioral principles and is designed to support recovery from drug addiction by trigger recognition so as to allow practice in-the-moment coping to prevent relapse.

METHOD

For this pilot randomized controlled study, 75 participants were recruited from methadone maintenance treatment clinics and the social worker consortium in Shanghai, China. Participants in the control group (N=25) received text messages from S-Health (e.g., HIV prevention and other educational materials). Participants in the intervention group (N=50) received both text messages and daily surveys on cravings, affects, triggers, responses to triggers, and social contexts.

RESULTS

At the end of the 1-month study trial, 26.2% of the intervention group and 50% of the control group had positive urine test results (p=0.06). Also, the number of days using drug in the past week was significantly lower among participants in the intervention group (Mean=0.71, SD=1.87) relative to the control group (Mean=2.20, SD=3.06) (p<0.05). The two groups did not differ in slopes (i.e., rates of change in outcomes measured weekly) based on the mixed effects model. Participants in the intervention group also preferred answering questions on the cellphone (46.8%) relative to in-person interviews (36.2%).

CONCLUSIONS

This pilot demonstrated the feasibility and potential benefits to deliver mobile health intervention among participants with SUD. Further research with larger samples over a longer period of time is needed to test the effectiveness of S-Health as a self-monitoring tool supporting recovery from addiction.

Social and structural barriers for adherence to methadone maintenance treatment among Vietnamese opioid dependence patients

Introduction

Methadone maintenance treatment (MMT) services may reduce the risk of HIV transmission if patients completely adhere to the treatment. Identifying adherence patterns and potential related factors is vital for the sustainability of MMT program in Vietnam. This study examined social and structural factors associated with adherence to MMT among patients in different service delivery models.

Materials and methods

A total of 510 patients at three MMT clinics in Hanoi were interviewed. Measures of self-reported adherence included the number of missed doses in the past 7 days and the level of adherence in the past 30 days using a visual analog scale (VAS) scoring from 0 (non-adherence) to 100 (perfect adherence). Multivariate regressions were employed to identify factors associated with non-adherence to MMT.

Results

A total of 17.7% of participants reported incomplete MMT adherence in the last 30 days and 8.3% reported missing a dose in the last seven days, respectively. Living with HIV/AIDS, poor self-care and usual activities, and disclosure of health issues to spouses or intimate partners were associated with non-adherence. Those patients with pain or depression were more likely to report better adherence. Disclosing health status to spouse/partner increased the risk of incomplete adherence, while disclosing to friends reduced the number of missed dose in the last seven days. Patients attending clinics with comprehensive services had a lower VAS score of adherence compared to those enrolling in clinics with only MMT and general health care.

Conclusions

Sustaining the compliance of patients to MMT is principal in the rapid expansion of this service in Vietnam. It is necessary to address the complexity of health care demands of drug users, their difficulties to be rehabilitated into workforce and society, and the stigmatization to maximize the outcomes of MMT program.

Quality of life profile of general Vietnamese population using EQ-5D-5L

BACKGROUND

Health-related quality of life (HRQOL) is a vital benchmark to assess the effects of health interventions and policies. Measuring HRQOL of the general population is essential to establish a reference for health outcomes evaluations. However, evidence on HRQOL of general populations in low and middle income countries is very limited. This study aimed to measure HRQOL of the Vietnamese population by using the EuroQol-5 dimensions-5 levels (EQ-5D-5L) instrument and determine its associated factors.

METHODS

A cross-sectional study was performed in Hanoi with 1571 residences in Hanoi, the capital city of Vietnam. EQ-5D-5L and EQ- visual analogue scale (EQ-VAS) were used to assess HRQOL. Potential covariates included socio-demographic characteristics, having acute symptoms in the last four weeks, chronic diseases in the last three months, having multiple health issues, and health service utilisation in the last twelve months. A generalized linear model was employed to identify the association between HRQOL and covariates.

RESULTS

Overall, the mean EQ-5D utility index was 0.91 (SD = 0.15), and the mean EQ-VAS score was 87.4 (SD = 14.3). The highest proportion of respondents reporting any problems was in Usual activities (24.3%), followed by Anxiety/Depression (15.2%) and Pain/Discomfort (10.0%), while the lowest percentage was in Self-care (2.5%). Lower HRQOL composite scores were related to unemployment, lower income, higher education, living in urban areas, having chronic diseases, having multiple health issues and using health service. For any health problem self-reported by respondents, the health utility reduced by 0.02 (respiratory diseases) to 0.15 (musculoskeletal diseases).

CONCLUSIONS

Health utility of the general population and reductions for self-reported health problems in this study are useful for future population health evaluations and comparisons. It also informs the development of interventions to reduce health problems of the general population.

Quality of life profile of general Vietnamese population using EQ-5D-5L

BACKGROUND

Health-related quality of life (HRQOL) is a vital benchmark to assess the effects of health interventions and policies. Measuring HRQOL of the general population is essential to establish a reference for health outcomes evaluations. However, evidence on HRQOL of general populations in low and middle income countries is very limited. This study aimed to measure HRQOL of the Vietnamese population by using the EuroQol-5 dimensions-5 levels (EQ-5D-5L) instrument and determine its associated factors.

METHODS

A cross-sectional study was performed in Hanoi with 1571 residences in Hanoi, the capital city of Vietnam. EQ-5D-5L and EQ- visual analogue scale (EQ-VAS) were used to assess HRQOL. Potential covariates included socio-demographic characteristics, having acute symptoms in the last four weeks, chronic diseases in the last three months, having multiple health issues, and health service utilisation in the last twelve months. A generalized linear model was employed to identify the association between HRQOL and covariates.

RESULTS

Overall, the mean EQ-5D utility index was 0.91 (SD = 0.15), and the mean EQ-VAS score was 87.4 (SD = 14.3). The highest proportion of respondents reporting any problems was in Usual activities (24.3%), followed by Anxiety/Depression (15.2%) and Pain/Discomfort (10.0%), while the lowest percentage was in Self-care (2.5%). Lower HRQOL composite scores were related to unemployment, lower income, higher education, living in urban areas, having chronic diseases, having multiple health issues and using health service. For any health problem self-reported by respondents, the health utility reduced by 0.02 (respiratory diseases) to 0.15 (musculoskeletal diseases).

CONCLUSIONS

Health utility of the general population and reductions for self-reported health problems in this study are useful for future population health evaluations and comparisons. It also informs the development of interventions to reduce health problems of the general population.

Perceptions of Health-Related Information on Facebook: Cross-Sectional Study Among Vietnamese Youths

Background

While health information websites may have previously been the core source of information about health-related conditions on the Internet, social networking sites are increasingly replacing those websites as a source of health-related information. The increasingly popularity of social networking sites among the general population has consequential impact on health policies as well as health-related interventions. To date, there remains a paucity of research conducted in developing countries like Vietnam looking at the influence of social networking sites.

Objective

Our goal is to establish the baseline use of Facebook among Vietnamese youths and establish their perception of the reliability and usefulness of health-related information that they previously encountered while using the social networking site.

Methods

An online cross-sectional study was conducted from August 2015 to October 2015. Respondent-driven sampling (RDS) technique was used in the recruitment of participants. Sociodemographic, health status, behaviors, Facebook use and belief of information on Facebook, and interpersonal influence of social network sites were collected via an online structured questionnaire.

Results

Among 1080 participants, 72.87% (787/1080) reported being interested in health information on Facebook, and 50.74% (548/1080) and 17.50% (189/1080) perceived the information to be reliable and useful, respectively. A total of 10.93% (118/1080) of the participants also reported that they would follow the health advice they obtained from Facebook. Of significance, 7.13% (77/1080) of the participants also reported peer influences on their behavior. Factors that mediate Vietnamese perceptions of the information online include gender, level of perceived stress, age, educational level, and interpersonal influences from Facebook.

Conclusions

Our study is perhaps one of the first conducted in Vietnam that looks at the relationship between health information on Facebook and factors that might influence young Vietnamese perceptions of the information and the consequential use of that information.

Health insurance for patients with HIV/AIDS in Vietnam: coverage and barriers

Background

Health insurance (HI) plays an important role in ensuring the financial equity by the risk pooling mechanism and reducing the economic burden of healthcare for HIV/AIDS patients. However, there is a lack of evidence to clearly understand HI coverage in regard to people living with HIV (PLWH). We conducted this study to explore the coverage and barriers of HI among PLWH in Vietnam.

Methods

A cross- sectional study was conducted in multi-sites including 3 hospitals and 5 outpatient clinics in Hanoi and Nam Dinh in 2013. A convenience sampling approach was used to recruit the participants. A structured questionnaire was used to examine current status of using HI, lacking information about HI, feeling difficulties in accessing, using and paying HI. Multivariate logistic regression was conducted to examine factors associated with HI use and barriers.

Results

Among 1133 HIV/AIDS patients, the coverage of HI was 46.0%. About 36.4% lacked information about HI, 21.0% felt difficulty in accessing HI. Meanwhile, the proportions of patients feeling difficulty in using HI and paying HI were 19.9 and 18.6%, respectively. Multivariate regression found that lacking information about HI and feeling difficulty in accessing HI were main barriers of having HI among PLWH.

Conclusion

This study found a high proportion of PLWH was not covered by HI. Lacking information about HI and feeling difficulty in accessing HI were primary barriers that should be resolved via timely educational campaigns and consultations as well as supports from families in order to expand effectively the HI coverage.