@article{81ef740dc73d4d599680fdd5125e93d7,
title = "Overestimation of alcohol consumption norms as a driver of alcohol consumption: a whole-population network study of men across eight villages in rural, southwestern Uganda",
abstract = "Background and aims: Little is known about how perceived norms about alcohol consumption may influence high alcohol consumption rates in Uganda. This study estimated the accuracy of perceived norms about men's alcohol consumption and estimated the association between perceived norms and personal alcohol consumption. Design: Cross-sectional, whole-population, sociocentric social network study. Setting: Eight rural villages in Rwampara District, southwestern Uganda in 2016–18. Participants: A total of 719 men aged 18 years and older (representing 91% of permanent resident men). Measurements: Self-reported frequent (≥ 4 days per week) and heavy alcohol consumption (six or more drinks on one occasion, more than three occasions of intoxication, or spending an excessive amount on alcohol). Participants also reported whether they thought most other men in their village engaged in frequent and heavy alcohol consumption (perceived norms). Using the network study design, we calculated alcohol consumption behavior within villages and social networks. Perceived norms were compared with aggregated self-reports. Multivariable Poisson regression models were used to estimate the association between perceived norms and individual behavior. Findings: Throughout villages, frequent and heavy alcohol consumption ranged from 7 to 37%. However, 527 (74%) participants perceived, contrary to fact, that most other men in their villages frequently consumed alcohol, and 576 (81%) perceived that most others heavily consumed alcohol. Overestimation of alcohol consumption by others was pervasive among socio-demographic subgroups and was present irrespective of the actual consumption behavior at the village level and within social networks. Men who misperceived these alcohol consumption behaviors as being common were more likely to engage in frequent [adjusted relative risk (aRR) = 3.98; 95% confidence interval (CI) = 1.69–9.34) and heavy (aRR = 4.75; 95% CI = 2.33–9.69) alcohol consumption themselves. Conclusions: Most men in eight rural Ugandan villages incorrectly thought that frequent and heavy alcohol consumption were common among men in their villages. These misperceived norms had a strong positive association with individual drinking behavior.",
keywords = "Alcohol consumption, Uganda, alcohol use, binge drinking, descriptive norms, misperception, perceived norms, social networks, social norms, sub-Saharan Africa",
author = "Perkins, {Jessica M.} and Bernard Kakuhikire and Charles Baguma and Jordan Jurinsky and Rasmussen, {Justin D.} and Satinsky, {Emily N.} and Elizabeth Namara and Phionah Ahereza and Viola Kyokunda and Perkins, {H. Wesley} and Hahn, {Judith A.} and Bangsberg, {David R.} and Tsai, {Alexander C.}",
note = "Funding Information: This study was funded by Friends of a Healthy Uganda and U.S. National Institutes of Health (NIH) R01MH113494 and R01MH125667. J.M.P. acknowledges salary support from NIH K01MH115811. We thank the HopeNet cohort study participants, without whom this research would not be possible. We also thank members of the HopeNet study team for research assistance; in addition to the named study authors, HopeNet and other collaborative team members who contributed to data collection and/or study administration during all or any part of the study were as follows: Owen Alleluya, Patience Ayebare, Dickson Beinomugisha, Bridget Burns, Patrick Gumisiriza, Clare Kamagara, Justus Kananura, Allen Kiconco, Juliet Mercy, Patrick Lukwago Muleke, Rhina Mushagara, Rumbidzai Mushavi, Elijah Musinguzi, Moran Owembabazi, Immaculate Ninsiima, Mellon Tayebwa and Dagmar Vo{\v r}echovsk{\'a}. We also thank Roger Hofmann of West Portal Software Corporation (San Francisco, CA, USA), for developing and customizing the CASIC Builder software program used for survey administration. We also thank Claire Evans who contributed research assistance in finalizing the manuscript. Funding Information: This study was funded by Friends of a Healthy Uganda and U.S. National Institutes of Health (NIH) R01MH113494 and R01MH125667. J.M.P. acknowledges salary support from NIH K01MH115811. We thank the HopeNet cohort study participants, without whom this research would not be possible. We also thank members of the HopeNet study team for research assistance; in addition to the named study authors, HopeNet and other collaborative team members who contributed to data collection and/or study administration during all or any part of the study were as follows: Owen Alleluya, Patience Ayebare, Dickson Beinomugisha, Bridget Burns, Patrick Gumisiriza, Clare Kamagara, Justus Kananura, Allen Kiconco, Juliet Mercy, Patrick Lukwago Muleke, Rhina Mushagara, Rumbidzai Mushavi, Elijah Musinguzi, Moran Owembabazi, Immaculate Ninsiima, Mellon Tayebwa and Dagmar Vo?echovsk?. We also thank Roger Hofmann of West Portal Software Corporation (San Francisco, CA, USA), for developing and customizing the CASIC Builder software program used for survey administration. We also thank Claire Evans who contributed research assistance in finalizing the manuscript. Publisher Copyright: {\textcopyright} 2021 Society for the Study of Addiction.",
year = "2022",
month = jan,
doi = "10.1111/add.15615",
language = "English (US)",
volume = "117",
pages = "68--81",
journal = "Addiction",
issn = "0965-2140",
publisher = "Wiley-Blackwell",
number = "1",
}