Eliciting Perceived Norms About Substance Use

Survey experiment to elicit perceived norms about substance use

Study Overview

• Status: Completed
• Conditions: Alcohol Drinking; Tobacco Use
• Intervention / Treatment: Other: Survey questionnaire

Detailed Description

Health behaviors and health risk behaviors are known to be associated with the extent to which one perceives these behaviors as normative. The canonical example of this phenomenon is taken from the U.S. literature, which has robustly shown that undergraduate students on college campuses tend to drink more heavily and frequently if they believe their classmates drink heavily and frequently, irrespective of their classmates' actual levels and frequency of use. However, there remains little systematic understanding about the best ways to elicit these perceived norms through survey-based research studies. This randomized survey experiment compares different ways of eliciting perceived norms.

• Study Type: Interventional
• Enrollment (Actual): 1531
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Uganda
  • Mbarara, Uganda
    • Mbarara University of Science and Technology

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• All adults who consider Nyakabare their primary place of residence and who are capable of providing consent

Exclusion Criteria:

• Minors younger than 18 years of age, with the exception of emancipated minors
• Persons who do not consider Nyakabare Parish their primary place of residence, e.g., persons who happen to be visiting Nyakabare at the time of the survey or who own a home in Nyakabare but spend most of their time outside the parish
• Persons with psychosis, neurological damage, acute intoxication, or other cognitive impairment (all of which are determined informally in the field by non-clinical research staff in consultation with a supervisor)

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Other
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Double

Number of Arms

3

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Experimental: V1: Binary Response Options; As this is a survey experiment, the "intervention" involves random assignment to a survey questionnaire with specific wording. Each question in this version of the survey questionnaire has binary (yes/no) response options.	Other: Survey questionnaire; Each version of the questionnaire has the same questions about perceived norms about substance use in the community but differs in how the response options are offered.
Experimental: Experimental: V2: Categorical Response Options; As this is a survey experiment, the "intervention" involves random assignment to a survey questionnaire with specific wording. Each question in this version of the survey questionnaire has categorical response options: all or almost all; more than half, but fewer than 90%; fewer than half, but more than 10%; very few, or no one	Other: Survey questionnaire; Each version of the questionnaire has the same questions about perceived norms about substance use in the community but differs in how the response options are offered.
Experimental: Experimental: V3: Open-Ended Numerical Estimate; As this is a survey experiment, the "intervention" involves random assignment to a survey questionnaire with specific wording. Each question in this version of the survey questionnaire permits the study participant to provide an open-ended numerical estimate.	Other: Survey questionnaire; Each version of the questionnaire has the same questions about perceived norms about substance use in the community but differs in how the response options are offered.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Perception of Tobacco Use Frequency Among Men	"According to your perception, have most men in your cell in this parish smoked cigarettes four or more times per week in the past 12 months?" (single item, culturally adapted and developed for this study; categorical response options)	Baseline (The experimental manipulation in this study has to do with which version of the survey the study participant receives, so the time frame for assessment is immediate, and participants are asked about the past 12 months)
Perception of Tobacco Use Frequency Among Women	"According to your perception, have most women in your cell in this parish smoked cigarettes four or more times per week in the past 12 months?" (single item, culturally adapted and developed for this study; categorical response options)	Baseline (The experimental manipulation in this study has to do with which version of the survey the study participant receives, so the time frame for assessment is immediate, and participants are asked about the past 12 months)
Perception of Alcohol Use Frequency Among Men	"According to your perception, have most men in your cell in this parish taken alcohol four or more times per week in the past 12 months?" (single item, culturally adapted and developed for this study; categorical response options)	Baseline (The experimental manipulation in this study has to do with which version of the survey the study participant receives, so the time frame for assessment is immediate, and participants are asked about the past 12 months)
Perception of Alcohol Use Frequency Among Women	"According to your perception, have most women in your cell in this parish taken alcohol four or more times per week in the past 12 months?" (single item, culturally adapted and developed for this study; categorical response options)	Baseline (The experimental manipulation in this study has to do with which version of the survey the study participant receives, so the time frame for assessment is immediate, and participants are asked about the past 12 months)
Perception of Alcohol-Related Blackouts Among Men	"According to your perception, have most men in your cell in this parish been unable to remember what happened the night before at least once as a result of them taking alcohol in the past 30 days?" (single item, culturally adapted and developed for this study; categorical response options)	Baseline (The experimental manipulation in this study has to do with which version of the survey the study participant receives, so the time frame for assessment is immediate, and participants are asked about the past 30 days)
Perception of Alcohol-Related Blackouts Among Women	"According to your perception, have most women in your cell in this parish been unable to remember what happened the night before at least once as a result of them taking alcohol in the past 30 days?" (single item, culturally adapted and developed for this study; categorical response options)	Baseline (The experimental manipulation in this study has to do with which version of the survey the study participant receives, so the time frame for assessment is immediate, and participants are asked about the past 30 days)
Perception of Alcohol-Related Spousal Problems Among Men	"According to your perception, have most men in your cell in this parish quarreled after taking alcohol with their spouse or main partner if they have one in the past 30 days?" (single item, culturally adapted and developed for this study; categorical response options)	Baseline (The experimental manipulation in this study has to do with which version of the survey the study participant receives, so the time frame for assessment is immediate, and participants are asked about the past 30 days)
Perception of Alcohol-Related Spousal Problems Among Women	"According to your perception, have most women in your cell in this parish quarreled after taking alcohol with their spouse or main partner if they have one in the past 30 days?" (single item, culturally adapted and developed for this study; categorical response options)	Baseline (The experimental manipulation in this study has to do with which version of the survey the study participant receives, so the time frame for assessment is immediate, and participants are asked about the past 30 days)
Perception of Alcohol Intoxication Among Men	"According to your perception, have most men in your cell in this parish experienced drunkenness or intoxication on 3 or more days in the past 30 days?" (single item, culturally adapted and developed for this study; categorical response options)	Baseline (The experimental manipulation in this study has to do with which version of the survey the study participant receives, so the time frame for assessment is immediate, and participants are asked about the past 30 days)
Perception of Alcohol Intoxication Among Women	"According to your perception, have most women in your cell in this parish experienced drunkenness or intoxication on 3 or more days in the past 30 days?" (single item, culturally adapted and developed for this study; categorical response options)	Baseline (The experimental manipulation in this study has to do with which version of the survey the study participant receives, so the time frame for assessment is immediate, and participants are asked about the past 30 days)
Perception of Alcohol Use Financial Harms Among Men	"According to your perception, have most men in your cell in this parish had a harmful effect on their household's finances due to them taking alcohol in the past 12 months?" (single item, culturally adapted and developed for this study; categorical response options)	Baseline (The experimental manipulation in this study has to do with which version of the survey the study participant receives, so the time frame for assessment is immediate, and participants are asked about the past 12 months)
Perception of Alcohol Use Financial Harms Among Women	"According to your perception, have most women in your cell in this parish had a harmful effect on their household's finances due to them taking alcohol in the past 12 months?" (single item, culturally adapted and developed for this study; categorical response options)	Baseline (The experimental manipulation in this study has to do with which version of the survey the study participant receives, so the time frame for assessment is immediate, and participants are asked about the past 12 months)
Perception of Alcohol Spending Among Men	"According to your perception, have most men in your cell in this parish spent more than 35,000 USh on any kind of alcohol in the past 12 months?" (single item, culturally adapted and developed for this study; categorical response options)	Baseline (The experimental manipulation in this study has to do with which version of the survey the study participant receives, so the time frame for assessment is immediate, and participants are asked about the past 12 months)
Perception of Alcohol Spending Among Women	"According to your perception, have most women in your cell in this parish spent more than 35,000 USh on any kind of alcohol in the past 12 months?" (single item, culturally adapted and developed for this study; categorical response options)	Baseline (The experimental manipulation in this study has to do with which version of the survey the study participant receives, so the time frame for assessment is immediate, and participants are asked about the past 12 months)
Perception of Alcohol Binge Use Frequency Among Men	"According to your perception, have most men in your cell in this parish taken 6 or more drinks in a single morning, afternoon, or night in the past 12 months?" (single item, culturally adapted and developed for this study; categorical response options)	Baseline (The experimental manipulation in this study has to do with which version of the survey the study participant receives, so the time frame for assessment is immediate, and participants are asked about the past 12 months)
Perception of Alcohol Binge Use Frequency Among Women	"According to your perception, have most women in your cell in this parish taken 6 or more drinks in a single morning, afternoon, or night in the past 12 months?" (single item, culturally adapted and developed for this study; categorical response options)	Baseline (The experimental manipulation in this study has to do with which version of the survey the study participant receives, so the time frame for assessment is immediate, and participants are asked about the past 12 months)

Collaborators and Investigators

• Sponsor: Massachusetts General Hospital
• Collaborators: Mbarara University of Science and Technology
• Investigators: Principal Investigator: Alexander C Tsai, MD, Massachusetts General Hospital

Study record dates

Study Major Dates

• Study Start (Actual): February 10, 2021
• Primary Completion (Actual): August 15, 2022
• Study Completion (Actual): August 15, 2022

Study Registration Dates

• First Submitted: April 1, 2021
• First Submitted That Met QC Criteria: April 2, 2021
• First Posted (Actual): April 6, 2021

Study Record Updates

• Last Update Posted (Actual): June 1, 2026
• Last Update Submitted That Met QC Criteria: May 28, 2026
• Last Verified: May 1, 2026

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Drinking Behavior; Behavior; Alcohol Drinking; Tobacco Use; Health Care Quality, Access, and Evaluation; Investigative Techniques; Epidemiologic Methods; Data Collection; Health Care Evaluation Mechanisms; Quality of Health Care; Public Health; Environment and Public Health; Surveys and Questionnaires
• Other Study ID Numbers: 2013P000395_3

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No