Injury patients’ perceptions of drink-driving: A qualitative assessment of drink-driving behavior in Moshi, Tanzania

Abstract

Background Globally, about 2.3 billion people are current alcohol drinkers, and 283 million have an alcohol use disorder. Alcohol use while driving is a major contributor to road traffic injuries (RTI). We need to understand the culture and perception of drink-driving in this setting to understand why people continue to drink drive and allow policymakers to develop more effective ways to address drink-driving behavior. This study aims to qualitatively determine what injury patients, their families, and community advisory board members in Tanzania believe about drink-driving to help inform policies to address this problem. Methods The semi-structured focus group was designed based on the grounded theory and assessed using thematic analysis. Focus groups participants were a convenience sample of injury patients, their families, and community advisory board (CAB) members. Analysis was iterative throughout the study. All transcripts were coded using a thematic narrative approach. Representative quotes for each theme were then selected based on comparative analysis of coding with input from research team members. Results A total of ten focus groups were conducted (4 patient, 4 family, and 2 CAB) with a total of 104 participants (37 females and 67 males). The normalization of drinking among drivers has allowed this behavior to become ingrained in the culture. Participants expressed notions that passengers are responsible for their own safety, rather than drivers being responsible for their passengers. Most participants believe it is a citizen's duty to inform the police of suspected drink-driving, however there were differing opinions about how effective informed police officers can be in practice. Focus group discussions between all three population

Understanding the Impacts and Perceptions of Alcohol Use in Northern Tanzania: A Mixed-Methods Analysis

“…This analysis is the first of its kind to provide a holistic overview of the harms and benefits of alcohol as perceived by patients in Moshi, Tanzania. Existing literature on Moshi has described the scope of alcohol use in this region (26,28,32,47), examined the determinants of use (48), and explored specific consequences related to alcohol, such as drunk driving (49) and stigma (29,33). Perceptions of alcohol use have been explored (23), but without looking at alcohol-related consequences and exclusively from the perspectives of injury patients.…”

“…Elaborating on these harms, the physical consequences of alcohol use mentioned by our IDI participants have been noted in other Africa-based studies. In sub-Saharan Africa, harmful alcohol use has been previously associated with increased road traffic injuries, drunk driving, and other injurious behaviors (32,49,60,61). In addition, studies in Uganda and South Africa have found an association between sexual and intimate partner violence and alcohol consumption (62,63).…”

Feasibility of a pragmatic randomized adaptive clinical trial to evaluate a brief negotiational interview for harmful and hazardous alcohol use in Moshi, Tanzania

“…The initial proposal for the current study evolved from Dr. Staton’s initial K01 award application to its final form on the basis of years of preliminary research [ 7 , 37 , 42 , 61 – 63 ]. Originally envisioned as a single-stage, two-armed feasibility trial, this feasibility pilot study ultimately featured an adaptive three stages plan and four arms.…”

“We are pleading for the government to do more”: Road user perspectives on the magnitude, contributing factors, and potential solutions to road traffic injuries and deaths in Ghana

“…However, in LMICs, qualitative studies on this subject are scarce with a recent scoping review only identifying 37 such studies published between 2003 and 2017 [13]. Based on this and our literature review, we believe that only ten studies have been conducted in Africa, although it faces the greatest burden and could benefit from studies on interventions to meet population needs [14][15][16][17][18][19][20][21][22][23]. Five studies focused on contributing factors to RTCs or injuries.…”

“…They reported themes relating to risky road user behavior such as drink-driving among motorbike taxis [17], drug use among commercial drivers [23], jaywalking among pedestrians [14,19], and unsafe driving among motorists [15,22]. Other factors included poor road conditions and traffic signs [23], narrow roadways [14], traffic congestion affecting post-crash care [20], and corruption affecting enforcement [15,17]. Only one study focused on engagement for intervention planning by asking participants to share their views on footbridges.…”