Development and validation of the OHCITIES instrument: Assessing alcohol urban environments in the Heart Healthy Hoods project
Presenting Author: Usama Bilal, MD, MPH, PhD, Drexel University Urban Health Collaborative
ABSTRACT
Background: There is a need for valid and reliable measures to characterize alcohol urban environment and better understand how its associates with individual alcohol consumption.
Objectives: This paper describes the development and validation of OHCITIES, an instrument characterizing alcohol urban environment in terms of availability, promotion and signs of consumption.
Methods: This study involved: 1) Developing the conceptual framework for alcohol urban environment by means of literature reviewing; 2) Pilot testing and redesigning the instrument; 3) Instrument digitalization; 4) Instrument validation. Data for the validating the instrument was collected in seven census sections in Madrid in 2016 by two observers.
Results: We collected information on 92 on-premises and 24 off-premises alcohol outlets identified in the studied areas about availability, accessibility and promotion of alcohol. Most percent-agreement values for alcohol measures in on- and off-premises alcohol outlets were greater than 80%, and inter-rater and test-retest reliability values were generally above 0.80. Observers identified 26 streets and 3 public squares within the 7 census sections studied with signs of alcohol consumption. Intra-class correlation coefficient between observers for any type of signs of alcohol consumption was 0.50 (95% CI -0.09 – 0.77). Few items promoting alcohol unrelated to alcohol outlets were found on public spaces.
Implications: The OHCITIES instrument is a valid instrument to characterize alcohol urban environment. This instrument might be used to understand how alcohol environment associates with alcohol behaviors and its related health outcomes, and can help in the design and evaluation of policies to reduce the harm caused by alcohol.
Authors: Usama Bilal, MD, MPH, PhD; Xisca Sureda, MPH, PhD; Albert Espelt, MPH, PhD; Joan R Villalbí; Alba Cebrecos; Lucía Baranda; Jamie Pearce, MS, PhD; and Manuel Franco, MD, PhD.