Image-Based Dietary Assessment and Tailored Feedback Using Mobile Technology: Mediating Behavior Change in Young Adults

Assessing the implementation of nutrition interventions is important to identify characteristics and dietary patterns of individuals who benefit most. The aim was to report on young adults' experiences of receiving dietary feedback text messaging intervention. Diet was captured using an image-based 4-day mobile food recordTM application (mFRTM) and assessed to formulate two tailored feedback text messages on fruit and vegetables and energy-dense nutrient-poor (EDNP) foods and beverages. At 6-months 143 participants completed a second mFRTM and a questionnaire evaluating the dietary feedback. Participants who agreed the text messages made them think about how much vegetables they ate were more likely to increase their intake by at least half a serve than those who disagreed [odds ratio (OR) = 4.28, 95% Confidence Interval (CI): 1.76 to 10.39]. Those who agreed the text messages made them think about how much EDNP foods they ate, were twice as likely to decrease their intake by over half a serve (OR = 2.39, 95%CI: 1.12 to 5.25) than those who disagreed. Undertaking detailed dietary assessment ensured the tailored feedback was constructive and relevant. Personal contemplation about vegetable and EDNP food intake appears to be a mediator of dietary change in young adults.

Effectiveness of a Community-Based Physical Activity and Nutrition Behavior Intervention on Features of the Metabolic Syndrome: A Cluster-Randomized Controlled Trial

BACKGROUND

Metabolic syndrome (MetS) and its subclinical diseases are now public health problems in Vietnam. This study aimed at determining the effectiveness of a physical activity and nutrition program for reducing MetS proportion and its components among adults with MetS in Hanam province, Vietnam.

METHODS

A total of 417 volunteers aged 50-65 years with MetS were recruited from 10 communes. The communes were randomly allocated to an intervention group (five communes, n = 214) and a control group (five communes, n = 203). The participants in the intervention group received a nutrition and physical activity program for 6 months, whereas participants in the control group received standard diet and physical activity advice on only one occasion. Anthropometry, lipid profiles, glycemic status, and blood pressure were measured at baseline and at 6 months to evaluate program effectiveness.

RESULTS

In total, 175 intervention (81.8%) and 162 control (79.8%) participants completed the post-program evaluation. After controlling for the effects of clustering and confounding factors, the intervention group showed significant improvements in high-density lipoprotein cholesterol (+0.42 mM, P < 0.001), waist circumference (-1.63 cm, P < 0.001), waist-to-hip ratio (-0.024, P < 0.001), weight (-1.44 kg, P < 0.001), and body mass index (-0.59 kg/m², P < 0.001) when compared with the control group. A reduction in the MetS proportion was found in both intervention and control groups (P < 0.001), decreasing to 56.0% and 75.9%, respectively, but the post-program proportion was significantly lower among the intervention participants (P < 0.001). Furthermore, the mean number of MetS components exhibited by individuals decreased significantly in the intervention group (P < 0.001).

CONCLUSIONS

The community-based physical activity and nutrition program reduced MetS proportion, with significant improvements in several metabolic and anthropometric parameters for Vietnamese adults with MetS.

Review of Effects of Alcohol and other Licit Drugs on Driving-Related Performance

A review is presented of the effects of alcohol and licit drugs on performance related to driving. About 20% of persons of driving age use some licit drug, while a much greater percentage drink alcohol. Alcohol is used in combination with another licit drug by about 10% of persons of driving age. Alcohol is associated with about 50% of fatal traffic accidents, 30% of injury accidents and 10% of non-injury accidents. Other licit drugs, such as diazepam, are involved in about 20% of non-fatal accidents. Alcohol combined with other licit drugs, such as diazepam, is involved in about 10% of injury accidents.

The effects of alcohol on driving-related skills is relatively well-documented, but tests on the effects of other licit drugs present variable findings. There is some research which indicates additive or synergistic effects when alcohol is combined with other drugs.

Research to date on the effects of licit drugs alone, and in combination with alcohol, has many limitations. There have been comparatively few studies to test decision-making and perceptual-motor skills, such as used in driving or those involving actual driving tasks.

However, studies indicate that when combined with alcohol, some licit drugs lead to a deterioration in driving-related performance, but a need exists for further research involving more complex driving-related tests and actual driving situations.

The connecting health and technology study: a 6-month randomized controlled trial to improve nutrition behaviours using a mobile food record and text messaging support in young adults

BACKGROUND

Early adulthood represents the transition to independent living which is a period when changes in diet and body weight are likely to occur. This presents an ideal time for health interventions to reduce the effect of health problems and risk factors for chronic disease in later life. As young adults are high users of mobile devices, interventions that use this technology may improve engagement. The Connecting Health and Technology study aimed to evaluate the effectiveness of tailored dietary feedback and weekly text messaging to improve dietary intake of fruit, vegetables and junk food over 6 months among a population-based sample of men and women (aged 18-30 years).

METHODS

A three-arm, parallel, randomized control trial was conducted. After baseline assessments, participants were randomized to one of three groups: A) dietary feedback and weekly text messages, B) dietary feedback only or C) control group. Dietary intake was assessed using a mobile food record App (mFR) where participants captured images of foods and beverages consumed over 4-days at baseline and post-intervention. The primary outcomes were changes in serves of fruits, vegetables, energy-dense nutrient-poor (EDNP) foods and sugar-sweetened beverages (SSB). The intervention effects were assessed using linear mixed effect models for change in food group serves.

RESULTS

Young adults (n = 247) were randomized to group A (n = 82), group B (n = 83), or group C (n = 82). Overall, no changes in food group serves for either intervention groups were observed. An unanticipated outcome was a mean weight reduction of 1.7 kg (P = .02) among the dietary feedback only. Men who received dietary feedback only, significantly reduced their serves of EDNP foods by a mean of 1.4 serves/day (P = .02). Women who received dietary feedback only significantly reduced their intake of SSB (P = .04) by an average of 0.2 serves/day compared with controls.

CONCLUSIONS

Tailored dietary feedback only resulted in a decrease in EDNP foods in men and SSB in women, together with a reduction in body weight. Using a mobile food record for dietary assessment and tailored feedback has great potential for future health promotion interventions targeting diet and weight in young adults.

TRIAL REGISTRATION

Australian Clinical Trials Registry Registration number: ACTRN12612000250831 .

Preferred Tone of Nutrition Text Messages for Young Adults: Focus Group Testing

Background

Young adults are a particularly hard to reach group using conventional health promotion practices as they do not see nutrition messages as personally relevant to them. Text messaging (short message service, SMS) offers an innovative approach to reaching young adults to support and promote dietary behavior change.

Objective

The aim of this study was to develop and test tonal preferences for nutrition text messages among young adults using focus groups.

Methods

A total of 39 young adults aged 18-30 years residing in Perth, Western Australia participated in four focus groups. Participants briefly discussed their perception of healthy eating and their responses to messages about increasing fruit and vegetables, and reducing “junk food” and alcohol intake. They ranked their preference for 15 nutrition messages across 3 dietary behaviors (fruit and vegetables, junk food, and alcohol) with 5 different message tones (authoritative, empathetic, generation Y, solutions, and substitutions) and identified the messages most likely to persuade young adults to change their diet. A 5-point ranking of the nutrition messages was from the most likely to least likely to persuade (1-5). The focus groups were conducted by a trained facilitator and observer and were recorded. Data driven content analysis was used to explore themes. Tonal preferences and potential motivators were collated and frequencies presented.

Results

Participants ranked offering substitutes (29%, 11/39) and using empathy (22%, 9/39) as the most persuasive message techniques in improving diets of young adults, with low responses for Generation Y (17%, 7/39), solutions (17%, 7/39), and authoritative (15%, 6/39) tones. Females were more likely to consider substitution messages persuasive (35%, 7/20) compared with males (22%, 4/19). A greater proportion of males compared with females considered authoritative messages persuasive: (22%, 4/19) compared with (7%, 1/20). There is a strong preference for a substitution tone for fruit and vegetable messages (52%, 20/39), and no overall message tone preference for junk food and alcohol messages. Substitutions were viewed as helpful and practical. Empathy was liked as it acknowledged previous efforts. Responses to authoritative tone were mixed with some feeling guilt while others found them informative. Acceptability of the solutions depended on the behavioral change and acceptability of the solution proposed. Generation Y tone had some support for junk food and alcohol messages, and if favored, was considered casual, humorous, catchy, and motivational.

Conclusions

Substitutions and tone of empathy were favored as the most likely execution styles to motivate nutrition behavior change across all participants. There is no “one size fits all” with different tones preferred by individuals for different dietary behaviors. Although text messaging provides instant message delivery direct to the individual, these results demonstrate the complexity of developing motivational nutrition message for young adults. These findings reveal the importance of considering the tone and content and pretesting messages for health promotion text message interventions.

A study to prolong breastfeeding duration: design and rationale of the Parent Infant Feeding Initiative (PIFI) randomised controlled trial

BACKGROUND

Very few Australian infants are exclusively breastfed to 6 months as recommended by the World Health Organization. There is strong empirical evidence that fathers have a major impact on their partner's decision to breastfeed and continuation of breastfeeding. Fathers want to participate in the breastfeeding decision making process and to know how they can support their partner to achieve their breastfeeding goals. The aim of the Parent Infant Feeding Initiative (PIFI) is to evaluate the effect on duration of any and exclusive breastfeeding of three breastfeeding promotion interventions of differing intensity and duration, targeted at couples but channelled through the male partner. The study will also undertake a cost-effectiveness evaluation of the interventions.

METHODS/DESIGN

The PIFI study is a factorial randomised controlled trial. Participants will be mothers and their male partners attending antenatal classes at selected public and private hospitals with maternity departments in Perth, Western Australia. Fathers will be randomly allocated to either the usual care control group (CG), one of two medium intensity (MI1 and MI2) interventions, or a high intensity (HI) intervention. MI1 will include a specialised antenatal breastfeeding education session for fathers with supporting print materials. MI2 will involve the delivery of an antenatal and postnatal social support intervention delivered via a smartphone application and HI will include both the specialised antenatal class and the social support intervention. Outcome data will be collected from couples at baseline and at six and 26 weeks postnatally. A total of 1600 couples will be recruited. This takes into account a 25% attrition rate, and will detect at least a 10% difference in the proportion of mothers breastfeeding between any two of the groups at 26 weeks at 80% power and 5% level of significance, using a Log-rank survival test. Multivariable survival and logistic regression analyses will be used to assess the effect of the treatment groups on the outcomes after adjusting for covariates.

DISCUSSION

The PIFI study will be the first Australian study to provide Level II evidence of the impact on breastfeeding duration of a comprehensive, multi-level, male-partner-focused breastfeeding intervention. Unique features of the intervention include its large sample size, delivery of two of the interventions by mobile device technology, a rigorous assessment of intervention fidelity and a cost-effectiveness evaluation.

TRIAL REGISTRATION

Australian New Zealand Clinical Trials Registry ACTRN12614000605695. Registered 6 June 2014.

A cluster-randomised controlled trial of a physical activity and nutrition programme in retirement villages: a study protocol

INTRODUCTION

Physical activity levels of Australia's ageing population are declining and coincidentally rates of overweight and obesity are increasing. Adequate levels of physical activity and a healthy diet are recognised as important lifestyle factors for the maintenance of a healthy weight and prevention of chronic diseases. Retirement village (RV) residents rarely engage in physical activity and nutrition programmes offered, with poor attendance and low use of existing facilities such as on-site fitness centres and classes and nutrition seminars. The RV provides a unique setting to access and engage with this older target group, to test the effectiveness of strategies to increase levels of physical activity, improve nutrition and maintain a healthy weight.

METHOD AND ANALYSIS

This cluster-randomised controlled trial will evaluate a physical activity, nutrition and healthy weight management intervention for insufficiently active ('not achieving 150 min of moderate-intensity physical activity per week') adults aged 60-75 residing in RV's. A total of 400 participants will be recruited from 20 randomly selected RV's in Perth, Western Australia. Villages will be assigned to either the intervention group (n=10) or the control group (n=10) each containing 200 participants. The Retirement Village Physical Activity and Nutrition for Seniors (RVPANS) programme is a home-based physical activity and nutrition programme that includes educational resources, along with facilitators who will motivate and guide the participants during the 6-month intervention. Descriptive statistics and mixed regression models will be performed to assess the intervention effects. This trial will evaluate an intervention for the modification of health risk factors in the RV setting. Such research conducted in RV's has been limited.

ETHICS AND DISSEMINATION

Curtin University Human Research Ethics Committee (approval number: HR128/2012). Dissemination of the study results will occur through publications, reports, conference presentations and community seminars.

TRIAL REGISTRATION NUMBER

Australia and New Zealand Clinical Trial Registry (ACTRN12612001168842).

Dietary outcomes of a community based intervention for mothers of young children: a randomised controlled trial

BACKGROUND

Unhealthy dietary behaviours are one of the key risk factors for many lifestyle-related diseases worldwide. This randomised controlled trial aimed to increase the level of fruit, vegetable and fibre intake and decrease the fat and sugar consumption of mothers with young children (0-5 years) via the playgroup setting.

METHODS

Playgroups located in 60 neighbourhoods in Perth, Western Australia were randomly assigned to an intervention (n = 249) or control group (n = 272). Those in the intervention group received a 6-month multi-strategy primarily home-based physical activity and nutrition program (data is only presented on dietary behaviours). Data on dietary consumption was collected via the Fat and Fibre Barometer and frequency of serves of fruit and vegetable and cups of soft drink, flavoured drink and fruit juice. The effects of the intervention on continuous outcome measures were assessed using analysis of variance (ANOVA), after adjusting for mother's age and the corresponding variables.

RESULTS

The outcomes of the intervention were positive with the intervention group showing statistically significant improvements, when compared to the control group in the overall consumption of fat and fibre (p < 0.0005); of fibre (p < 0.0005) - fruit and vegetables (p < 0.0005), wholegrain (p = 0.002): and fat (p = 0.005) - dairy products (p = 0.006) and lean meat and chicken (p = 0.041). There were no significant changes in the consumption of sweet drinks.

CONCLUSIONS

This intervention was successful in improving dietary intake in the intervention group participants. The moderate positive outcomes indicate that playgroups potentially provide quite a viable setting to recruit, engage and retain this hard to reach group of mothers of young children in programs that support the adoption of health-enhancing behaviours. This adds valuable information to this under researched area.

TRIAL REGISTRATION

Australian and New Zealand Clinical Trials Registry ACTRN12609000718246.

Results of a randomized controlled trial to promote physical activity behaviours in mothers with young children

OBJECTIVE

Increasing levels of physical activity in mothers have long-term health benefits for the mother and family. The study aimed to evaluate the effect of a six-month, physical activity RCT for mothers of young children.

METHODS

Women were recruited via playgroups and randomly assigned to intervention (n=394) or control group (n=322). The intervention group received a six-month multi-strategy programme delivered via playgroups in Perth, Australia. measures were mean minutes per week of moderate (M) and vigorous (V) intensity physical activity (PA), and number of days/week of muscle strength exercises.

RESULTS

The intervention had a significant effect on mean time for vigorous (p=0.008), moderate (p=0.023) and total physical activity (p=0.001) when compared to the control group. The intervention group increased their vigorous activity by a mean of 24min/week, moderate activity by 23min/week and total physical activity by 72min/week.

CONCLUSIONS

A relatively minimum home based intervention was able to demonstrate modest but statistically significant improvements in physical activity in a hard to reach group. These changes if maintained over a longer period are likely to improve the health of mothers and have a positive impact on their partners and children. Australian and New Zealand Clinical Trials Registry ACTRN12609000735257.

Recreational physical activity as an independent predictor of multivariable cardiovascular disease risk

The role of physical activity in preventing CVD has been highlighted by Professor Jerry Morris in the 1950's. We report outcome of a 15-year prospective study with the aim to identify whether physical activity showed cardiovascular benefit independent of common risk factors and of central obesity. Baseline data of 8662 subjects, with no previous history of heart disease, diabetes or stroke, were obtained from an age- and gender- stratified sample of adults in Australian capital cities and were linked with the National Death Index to determine the causes of death of 610 subjects who had died to 31 December 2004. The study consisted of 4175 males (age 42.3 ± 13.1 years) and 4487 females (age 42.8 ± 13.2 years). Fasting serum lipid levels, systolic and diastolic blood pressure and smoking habits at baseline were recorded. The Framingham Risk Scores of 15-year mortality due to CHD and CVD were calculated using established equations. Subjects were also asked if they engaged in vigorous exercise, less vigorous exercise or walk for recreation and exercise in the past 2 weeks. Subjects in the high recreational physical activity category were 0.16 (0.06-0.43; p<0.001) and 0.12 (0.03-0.48; p = 0.003) times as likely as subjects in the low category for CVD and CHD mortality respectively. After adjusting for both the Framingham Risk Score and central obesity (Waist circumference to Hip circumference Ratio), those in the high recreational physical activity group were 0.35 (0.13-0.98) times less likely compared to the low category for CVD mortality. Recreational physical activity independently predicted reduced cardiovascular mortality over fifteen years. A public health focus on increased physical activity and preventing obesity is required to reduce the risk of CVD and CHD.

Physical activity and nutrition behavioural outcomes of a home-based intervention program for seniors: a randomized controlled trial

Background

This intervention aimed to ascertain whether a low-cost, accessible, physical activity and nutrition program could improve physical activity and nutrition behaviours of insufficiently active 60–70 year olds residing in Perth, Australia.

Methods

A 6-month home-based randomised controlled trial was conducted on 478 older adults (intervention, n = 248; control, n = 230) of low to medium socioeconomic status. Both intervention and control groups completed postal questionnaires at baseline and post-program, but only the intervention participants received project materials. A modified fat and fibre questionnaire measured nutritional behaviours, whereas physical activity was measured using the International Physical Activity Questionnaire. Generalised estimating equation models were used to assess the repeated outcomes over both time points.

Results

The final sample consisted of 176 intervention participants and 199 controls (response rate 78.5%) with complete data. After controlling for demographic and other confounding factors, the intervention group demonstrated increased participation in strength exercise (p < 0.001), walking (p = 0.029) and vigorous activity (p = 0.015), together with significant reduction in mean sitting time (p < 0.001) relative to controls. Improvements in nutritional behaviours for the intervention group were also evident in terms of fat avoidance (p < 0.001), fat intake (p = 0.021) and prevalence of frequent fruit intake (p = 0.008).

Conclusions

A minimal contact, low-cost and home-based physical activity program can positively influence seniors’ physical activity and nutrition behaviours.

Trial registration

anzctr.org.au Identifier: ACTRN12609000735257

The effectiveness of a walking booster program for seniors

PURPOSE

To determine the effectiveness of a 3-month home-based booster program for seniors to increase walking.

DESIGN

A longitudinal prospective study.

SETTING

Perth, Western Australia.

SUBJECTS

Of the 177 (of 260) program participants and 236 (of 313) controls who initially completed the neighborhood walking intervention, 114 (64%) and 134 (57%) were available for the booster, and 100 and 131 participants completed the entire program, respectively.

INTERVENTION

A 6-month neighborhood walking intervention was followed 12 months later by a 3-month home-based booster program comprised of print-based materials, a pedometer, and two motivational phone calls.

MEASURES

A self-reported questionnaire was administered at four time points: original intervention, baseline (t1) and 6 months (t2); booster, 18 months (t3) and 21 months (t4). Physical activity levels were measured using the International Physical Activity Questionnaire. Personal and demographic information was collected.

ANALYSIS

Descriptive statistics and repeated-measures analysis of variance.

RESULTS

The intervention group's mean time spent walking for recreation and mean time spent walking for errands per week showed significant increases between t1 and t2, but the weekly mean time walking for recreation dropped by 52 minutes from t2 to t3. Significant increases were evident from t3 to t4 as a result of the booster. Walking levels for the control group remained stable over the study period.

CONCLUSION

Physical activity levels of seniors revert once an intervention concludes. A home-based booster program can reactivate physical activity levels. Hence, program planners should include booster sessions for program sustainability.

Thiamin in beer: a health promotion perspective

Wernicke's encephalopathy (WE) is a serious disease resulting from excessive alcohol intake. As well as the disastrous consequences for the individual, patients with WE place a heavy burden for continuing care on the community. Australia appears to have a higher rate of WE than other western countries, probably due to differences in the consumption patterns of alcoholic beverages. Unlike most other western countries, Australia does not fortify flour with thiamin. On the other hand the USA does fortify flour and has higher thiamin intakes and lower rates of WE. In Australia it has been proposed that thiamin be added to alcoholic beverages. Given that technical problems related to stability, taste and absorption can be solved, the fortification of a substance which is potentially harmful, raises serious problems for health educators. The labeling of alcoholic beverages as 'vitamin enriched' could result in changes in the community's beliefs about alcohol and in increased alcohol consumption. The nutrition and education implications of this proposal are discussed. The conclusion is drawn that Australia should follow the example of other western countries and fortify flour with thiamin.

A physical activity program to mobilize older people: a practical and sustainable approach

PURPOSE

Despite the documented benefits of physical activity, it remains difficult to motivate older adults to start and maintain regular physical activity. This study tested an innovative intervention for mobilizing older adults into a neighborhood-based walking program.

DESIGN AND METHODS

Researchers recruited a total of 260 healthy but insufficiently active adults aged 65 to 74 years and randomly selected from the Australian electoral roll from 30 Perth metropolitan neighborhoods. Social cognitive theory guided the design of the program. Researchers collected both qualitative and quantitative data to inform the development, together with ongoing process evaluation.

RESULTS

A total of 65% of participants completed the program. Their mean weekly walking time for recreation increased by about 100 min, and 80% of participants reported that they would continue to walk twice per week upon program completion.

IMPLICATIONS

This practical program is potentially effective and sustainable with respect to mobilizing physically inactive older people.

The effectiveness of a physical activity intervention for seniors

PURPOSE

To determine whether a tailored, 6-month, neighborhood-based, physical activity intervention for people aged 65 to 74 years could increase their total physical activity levels and to identify factors associated with physical activity times.

DESIGN

A longitudinal, prospective, intervention study.

SETTING

Perth, Western Australia.

SUBJECTS

A total of 573 older adults, recruited from 30 intervention (n = 260) and 30 control (n = 313) neighborhoods. Initial response rates were 74% (260/352) in the intervention group and 82% (313/382) in the control group, which provided the 573 adults for participation in the study. A total of 413 participants (177 and 236 in the intervention and control groups, respectively) completed the program.

INTERVENTION

A neighborhood-based physical activity intervention.

MEASURES

A self-reported questionnaire administered at three time points. Physical activity levels were measured using the International Physical Activity Questionnaire. Personal and demographic information, including perceived financial struggle and proximity to friends, were collected.

ANALYSIS

Descriptive statistics, repeated measures analysis of variance, and generalized estimating equations (GEE).

RESULTS

The intervention resulted in a significant increase in total average physical activity times of 2.25 hours per week (p < .001). The GEE analysis confirmed significant increases in physical activity from baseline to midpoint (p = .002) and topostintervention (p = .031). Perception of financial struggle (p = .020) was positively associated with physical activity time spent by participants, whereas having no friends or acquaintances living nearby (p = .037) had a significant negative correlation. The main limitation of this study was the restricted duration of the intervention.

CONCLUSION

The program was successful in increasing weekly mean time for physical activity in seniors and in identifying factors that affect their commitment to physical activities.

Factors influencing the consumption of seafood among young children in Perth: a qualitative study

Background

This formative study sought to explore the factors that influence the consumption of fish and seafood among 4–6 year old children in the Perth metropolitan area. Focus groups were conducted with mothers of young children to gain insights into the enablers and barriers to regular seafood consumption in children, and the knowledge, attitudes and perceptions of their mothers to including seafood as a regular part of their children's diet.

Methods

Purposive sampling techniques were used to select and recruit mothers of children aged between four and six years from within the Perth metropolitan area. A total of seven focus groups were conducted. Thematic content analysis was employed to code data generated and to extract major themes.

Results

Findings indicated that all children of study participants had tried fish and seafood products, with some being exposed to a wide variety from an early age. Across focus groups, several dominant factors were apparent in influencing the frequency and type of seafood purchased and consumed. Perceived cost, freshness, availability/accessibility, and the level of confidence to prepare a meal to suit all family members were significant determinants of whether seafood featured regularly on the household menu. The influence of others in the family (particularly the husband or partner) also tended to impact upon the likelihood of serving fish and seafood, and the types of products mothers were willing to serve.

Conclusion

Findings from this qualitative study indicate that interventions seeking to promote seafood (particularly fish) as an integral part of a healthy diet should address existing negative attitudes and beliefs around the storage and preparation of seafood. The influence of dominant male influences within the family unit should also be considered. Strategies directed at parents and children should include experimental 'hands-on' components to encourage experimentation, particularly focussing on ease of preparation and the variety of lower cost seafood available.

Comparison of 7-day retrospective and prospective alcohol consumption diaries in a female population in Perth, Western Australia--methodological issues

The summer alcohol consumption of women living in metropolitan Perth was measured using both a retrospective and prospective diary. Overall, 1356 women fully completed both the retrospective and prospective alcohol consumption diaries. The prospective diary yielded a significantly higher level (9%) of consumption (p less than 0.00001) compared with the retrospective diary. Although there was no significant difference in the percentage of women drinking at harmful levels (greater than 280 g absolute alcohol per week) between the two diary methods, there did appear to be an important percentage difference (1.9% versus 2.8%) suggesting that the prospective diary did detect a larger percentage of women at risk. This would be both practically and statistically significant in large populations. The heavier the drinker the greater the variability in reported consumption between the two diary weeks. However, it is interesting to note that the direction of the variation depended on which diary was used as the base for classifying women as different types of drinkers. Women who drank at hazardous (140-280 g per week) or harmful (greater than 280 g) levels during the retrospective diary week reported a lower level of consumption during the prospective diary week. Conversely women who drank at hazardous or harmful levels during the prospective diary week reported a lower level of consumption during the retrospective diary week. Possible explanations for these findings are explored and methodological considerations for future studies are discussed.

Alcohol and the cognitive aspects of choice reaction time

In a repeated-measures experiment 18 men and 8 women were given ethanol which raised their mean blood alcohol concentration (BAC) to 0, 21, 50 and 73 mg/100 ml. Using the ERM apparatus (Schuhfried Instruments, Austria), which measures choice reaction time to a task with high cognitive content, it was found that both decision and reaction time increased as a function of rising BAC, and that movement time was not affected.