A geographically explicit ecological momentary assessment (GEMA) mixed method for understanding substance use
A geographically explicit ecological momentary assessment (GEMA) mixed method for understanding substance use
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DOI：
10.1016/j.socscimed.2018.02.014
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发表时间：
2018-04-01
影响因子：
5.4
通讯作者：
Ling, Pamela
中科院分区：
文献类型：
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作者：
McQuoid, Julia;Thrul, Johannes;Ling, Pamela
烟草使用越来越集中在边缘化群体中，包括LGBTQ+年轻人。制定有针对性的干预措施以减少与烟草有关的健康差异，需要了解将与烟草使用有关的个人和环境因素与行为联系起来的机制。本文从一种新的混合方法研究中深入探讨了三个案例，该研究旨在确定高危人群中物质使用的情境因素和基于地点的实践。我们将地理上明确的生态瞬间评估（GEMA）与适应的旅行日记访谈方法相结合。参与者（18-26岁的年轻双性恋吸烟者）使用智能手机应用程序报告了30天内不吸烟和吸烟的情况。GEMA调查捕捉了内部和外部情景因素（例如，渴望程度、地点类型、看到其他人吸烟）。通过智能手机GPS收集连续的位置数据。随后，参与者完成了深度访谈，回顾了他们自己的GEMA数据地图。GEMA数据和转录本分别进行分析，并在病例水平上集成在一个矩阵中。使用GEMA地图来指导访谈，讨论参与者的日常吸烟情况和习惯。访谈澄清了参与者对GEMA措施的解释，揭示了吸烟地点和做法的经验和意义。GEMA方法确定了每个参与者最常吸烟的地点/时间（例如，大学下午）。访谈描述了相关的情景因素和对吸烟背景的看法（例如，同龄人对双性恋身份的排斥）以及吸烟在其中的作用（例如，身体上逃离不舒服的环境）。总之，这种混合方法有助于推进定性GIS和其他假设生成方法，这些方法致力于揭示个人在健康行为的日常背景下的丰富经验，同时也为感兴趣的行为（如物质使用）的情境预测因素提供可靠的措施。讨论了该方法的局限性和未来发展方向。
Tobacco use is increasingly concentrated within marginalized groups, including LGBTQ+ young adults. Developing tailored interventions to reduce tobacco-related health disparities requires understanding the mechanisms linking individual and contextual factors associated with tobacco use to behavior. This paper presents an in-depth exploration of three cases from a novel mixed method study designed to identify the situational factors and place-based practices of substance use among high-risk individuals. We combined geographically explicit ecological momentary assessment (GEMA) with an adapted travel diary-interview method. Participants (young adult bisexual smokers, ages 18-26) reported on non-smoking and smoking situations for 30 days with a smartphone app. GEMA surveys captured internal and external situational factors (e.g., craving intensity, location type, seeing others smoking). Continuous locational data was collected via smartphone GPS. Subsequently, participants completed in-depth interviews reviewing maps of their own GEMA data. GEMA data and transcripts were analyzed separately and integrated at the case level in a matrix. Using GEMA maps to guide the interview grounded discussion in participants' everyday smoking situations and routines. Interviews clarified participant interpretation of GEMA measures and revealed experiences and meanings of smoking locations and practices. The GEMA method identified the most frequent smoking locations/times for each participant (e.g., afternoons at university). Interviews provided description of associated situational factors and perceptions of smoking contexts (e.g., peer rejection of bisexual identity) and the roles of smoking therein (e.g., physically escape uncomfortable environments). In conclusion, this mixed method contributes to advancing qualitative GIS and other hypothesis-generating approaches working to reveal the richness of individuals' experiences of the everyday contexts of health behavior, while also providing reliable measures of situational predictors of behaviors of interest, such as substance use. Limitations of and future directions for the method are discussed.