A geographically explicit ecological momentary assessment (GEMA) mixed method for understanding substance use. (April 2018)

• Record Type: Journal Article
• Authors: McQuoid, Julia; Thrul, Johannes; Ling, Pamela
• Is Part Of: Social science & medicine. Volume 202(2018)
• Page Start: 89
• Page End: 98
• Publication Date: 2018-04
• Subjects: Ecological momentary assessment -- Geolocation -- Space-time geography -- Qualitative GIS -- Tobacco -- Health disparities -- United States -- Sexual and gender minorities; Social medicine -- Periodicals; Medical anthropology -- Periodicals; Public health -- Periodicals; Psychology -- Periodicals; Medicine -- Periodicals; Medicine -- Periodicals; Médecine sociale -- Périodiques; Anthropologie médicale -- Périodiques; Santé publique -- Périodiques; Psychologie -- Périodiques; Médecine -- Périodiques; Electronic journals; 362.105
• DOI: 10.1016/j.socscimed.2018.02.014
• Languages: English
• ISSNs: 0277-9536

Abstract

Abstract: 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. Highlights: We describe a novel mixed method for understanding substance use behavior. Mobile tobacco use surveys and GPS data were mapped and guided interviews. Reliable measures of situational factors associated with smoking were collected. Participant experiences of smoking contexts and practices were revealed. In-depth findings on marginalized smokers may inform tailored tobacco interventions.