Development and Initial Testing of Measures of Acceptability of Intoxication using a Mixed Methods Approach

VicHealth, as part of a Victorian Government initiative to reduce the alcohol and drug toll in Victoria, wanted to develop a measure of acceptability of intoxication in order to track the alcohol culture in Victoria. In order to do so, one must determine how to ask about intoxication. Most prior research either provides a definition of intoxication (e.g. 5 standard drinks on a single occasion; more than 2 standard drinks an hour), or else assumes that the term, ‘intoxication’ or ‘drunk’ is universally understood to mean a particular level of intoxication. However, both limited research and anecdotal evidence suggests that most people do not think about intoxication in these terms.

This paper discusses the development and initial testing of measures of acceptability of intoxication using a mixed methods approach.

Results from the qualitative component revealed most people: (1) do not talk about levels of intoxication in terms of number of drinks; (2) talk about levels of intoxication in terms of behaviours; (3) generally agree on the types of behaviours associated with various stages of intoxication; (4) do not, however, necessarily agree on the terminology for these types of intoxicated behaviours.

As a result of this qualitative analysis, the following approach to asking about intoxication was taken in the survey. Participants were: (1) asked to rate behaviours associated with various levels of intoxication on an 11-point scale anchored at either end with 0 as completely sober and 10 as passed out; (2) reminded of their rating for one of the behaviours – ‘losing your balance’ – and asked to choose a term for that level of intoxication; (3) asked questions about acceptability of intoxication, using their preferred term for the level of intoxication they associated with ‘losing your balance’.

The resulting set of questions was pre-tested using cognitive testing followed by full pilot testing. From the main survey, we confirmed that participants provided similar ratings for ‘losing your balance’ – about 8 on the 11-point scale (mean=8.2; SD = 3.74). From the pre-testing we found that participants were comfortable with this novel approach to asking about intoxication and felt it more accurately captured the notion of intoxication compared with either asking about number of drinks or using a predetermined term.

We tentatively conclude that this approach to asking survey questions about intoxication is a superior approach to previous methods. More research is needed, however, particularly comparing approaches, to confirm this.