Unraveling the dynamic between alcohol use and consequences in college women: Modern perspectives on the menstrual cycle, advanced statistics, and team science strategies

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PROJECT SUMMARY/ABSTRACT Despite consuming less total volume of alcohol over the lifespan than men, women who drink alcohol are at increased risk for experiencing a myriad of alcohol-related physical diseases, psychiatric disorders, social consequences, and victimization. Yet, research to uncover biological determinants of these health disparities, such as hormonal fluctuations that occur across women’s menstrual cycles, has been inconclusive. This application seeks to bring contemporary best practices for improving rigor of menstrual studies to the field of alcohol studies. In line with Goal 1 of the 2019-2023 Trans-NIH Strategic Plan, “Advancing Science for the Health of Women,” this application will use novel analytical approaches to unravel the dynamics between women’s individual menstrual cycle patterns, alcohol use, and proximal consequences. Findings may identify female-specific factors (e.g., hormonal contraceptive use) and vulnerable time points (e.g., certain menstrual phases) whereby risk for alcohol use and related consequences may be heightened. The proposed study will augment an ongoing 2-year longitudinal study (R01AA027017) aimed at characterizing the effects of college drinking and related health behaviors on cardiovascular health. The parent study includes two in-person laboratory sessions and weekly e-surveys that gauge the prior week’s alcohol use behaviors. The proposed study leverages the sample, survey data, and allostatic load conceptual framework from the parent study’s female participants and adds the use of a menstrual tracking smartphone application and ovulation verification across 3 menstrual cycles to examine whether alcohol use (Aim 1) and consequences (Aim 2) are influenced by the menstrual cycle, and whether the association between them varies across multiple cycles (Aim 3). The proposed study also seeks to expand the parent’s study’s assessment of alcohol consequences to more comprehensively assess risk levels of given drinking episodes. Hierarchical linear modeling and time-varying effect models will be used to evaluate the dynamics of alcohol use and consequences and examine hormonal contraception (an often-excluded factor) as a moderator. The applicant is applying through the NIAAA F31 mechanism to specifically expand her opportunities to obtain extensive training in alcohol studies (Training Goal 1), which will complement her prior training in physiology, and establish an independent line of research at the intersection of alcohol studies and women’s health. To complete the proposed study, the applicant will receive additional training in menstrual study theory and design (Goal 2), intensive longitudinal data analysis (Goal 3), and professional development (Goal 4). The research and training plan will lay the foundation for the applicant’s future line of research to examine biopsychosocial factors that contribute to the development of alcohol use problems and physical disease in women across the lifespan. Receiving the NRSA F31 fellowship will relieve the applicant from her time-intensive teaching assistant position to effectively double her time available to conduct research and establish a strong professional network within the field of alcohol studies.