Improving measurement of harms from others’ drinking: A key informant study on type and severity of harm

Abstract

Aims: Survey items for measuring harms experienced from others' drinking (AHTO) have been developed primarily to measure type of harm and not severity. However, some type of harms may produce more negative effects than others. We aimed to compare the perceived severity of a comprehensive list of AHTO items to assess consistency in subjective ratings of severity, facilitate a more nuanced analysis and identify strategies to improve measurement of AHTO in epidemiological surveys. Methods: Thirty-six leaders of national alcohol surveys (conducted between 1997 and 2016) from 23 countries rated the typical severity of negative effects on the victim of each of 48 types of AHTO using a scale from zero (no negative effect) to 10 (very severe negative effect). The survey leaders were also asked to provide open-ended feedback about each harm and the severity-rating task generally. Results: Of 48 harm items, five were classified as extreme severity (mean rating ≥ 8), 17 as high (≥ 6 < 8), 25 as moderate (≥ 4 < 6), and one as low (≤ 4). We used two-way random effects models to estimate absolute agreement intraclass correlation coefficients (AA-ICC) and consistency of agreement intraclass correlation coefficients (CA-ICC). Results showed that there was fair to excellent absolute agreement and consistency of agreement among experts’ ratings of the severity of harms from others’ drinking (single measures CA-ICC = 0.414, single measures AA-ICC = 0.325; average CA-ICC = 0.940, average AA-ICC = 0.914). Harms to children, and harms causing physical, financial, practical, or severe emotional impacts were rated most severe. Conclusions: When designing new AHTO surveys and conducting analyses of existing data, researchers should pay close attention to harms with high perceived severity to identify effective ways to prevent severe AHTO and reduce the negative health and social impacts of AHTO. By inquiring into experts' views on survey items, this analysis involves a first scoping of the sort of questions that should be taken into consideration. In-depth analyses of specific sub-sets of harms and qualitative interviews with victims of severe AHTO are likely to help along this work in the future.

Severe harm from others' drinking: A population‐based study on sex differences and the role of one's own drinking habits

“…The present findings, thus, add to the literature by demonstrating an elevated risk for women also regarding severe AHTO, that is harms likely to have a considerable impact on the victim's health and social wellbeing [10]. The most severe types of harm from others' drinking rated by alcohol researchers and policy experts in a key informant survey were physical, financial, practical and severe emotional harm [22]. One possible explanation for the higher prevalence of severe AHTO among women is that women are more aware of others' behaviour than men and, therefore, report problems more frequently in surveys.…”

Concepts and conditions for knowledge production

“…This is also true for the article on experts’ views on how to develop surveys on alcohol’s harm to others (AHTO). Stanesby and colleagues (2020) problematise the agenda of measurements by arguing that the amount of measurements of different kinds of harms (for example “caused by stranger”, “caused by co-worker”, or “affecting victim under 17 years”) does not provide much information as long as we do not know their relative value in terms of amount of harm. This is why we should make a distinction between aspects that are more problematic and those that are less so.…”

“…In this issue, readers can enhance their understanding of gendered relationships to substances (Rolando et al, 2020), preferences of beverages (Lintonen, Ahtinen & Konu , 2020), definitions of those in need of help (Stanesby et al, 2020), and maternal alcohol intake during and after pregnancy (McDonald & Watson, 2020). These are all examples of the kind of moving targets that we are dealing with in social science research.…”

Improving measurement of harms from others' drinking: Using item‐response theory to scale harms from others' heavy drinking in 10 countries

“…The strength of this study was that it attempted to rate many harms along a severity scale. However, the experts commented that rating severity was difficult, since the harm experience was not described in a specific setting, the gender of victim and perpetrator was not given, and because the nature of the victim‐perpetrator‐relationship was unclear [1]. So, although these studies have begun to attempt a ranking of AHTO items, there remains a need to base rankings on the assessments of the general population.…”

“…Research on alcohol's harms to others (AHTO) has grown substantially in recent years [1], the wide spectrum of AHTO includes harms at the societal level, such as economic costs to society [2], traffic accidents [3], violence and physical abuse [4], foetal alcohol spectrum disorder [5] and crime, as well as public order and safety [6]. Another area of harm comes from official police registries on drinkers' harms to the family (including child abuse) [7,8].…”