{
  "abstract": "Introduction Problematic alcohol use negatively impacts individuals, families and communities. While perceptions regarding alcohol use are likely vital to mitigating problematic alcohol use at the population level, little is known. Perceptions that demarcate normative versus problematic use may be relevant for interventions in communities with normative alcohol use. Our study explores ethnocentric perceptions of alcohol use in a community where alcohol use is historically integrated into its social fabric.Methods Mixed-methods study design using a culturally curated online survey with closed and open-ended responses assessed perceptions regarding alcohol use. Participants were members of the Kodava community: an affluent ethno-linguistic community in Southern India with an international presence. For Kodavas, alcohol consumption is normative and socially sanctioned. We studied perceptions of alcohol use among family members, including factors influencing its use and the impact of problematic alcohol drinking on immediate and extended family in three domains: health, finances and relationships.Results Of 711 total respondents, a small minority of 11.4% (n=81) stated that at least one immediate family member experienced negative impacts of alcohol use. Among respondents who reported on their extended family (n=639), 52.1% (n=333) endorsed at least one member experienced negative impacts. The integration of quantitative and qualitative data elucidates negative impacts of alcohol use within and at the intersections of health, relationships and finances.Conclusions First study to employ social media (WhatsApp) to survey a globally dispersed ethnic community on alcohol use impacts among family members. Interventions tailored to these perceptions, in culturally embedded communities, may improve outcomes. The framework and approach of this study can be replicated globally.",
  "authors": [
    {
      "affiliations": [
        "Mayo Clinic, Phoenix, Arizona, USA"
      ],
      "name": "Harini Chakkera"
    },
    {
      "affiliations": [
        "Mayo Clinic, Rochester, Minnesota, USA"
      ],
      "name": "Richard Butterfield"
    },
    {
      "affiliations": [
        "University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, USA",
        "Johns Hopkins School of Public Health, Baltimore, Maryland, USA"
      ],
      "name": "Srishti Sardana"
    },
    {
      "affiliations": [
        "Lopamudra Medical Center, Manipal, Karnataka, India"
      ],
      "name": "Amrit Mukkatira"
    },
    {
      "affiliations": [
        "Department of Community Medicine, Kasturba Medical College Mangalore, MAHE, Manipal, Karnataka, India"
      ],
      "name": "B Unnikrishnan"
    },
    {
      "affiliations": [
        "Manipal Academy of Higher Education, Kasturba Medical College Mangalore, Mangalore, Karnataka, India"
      ],
      "name": "Sharada Rai"
    },
    {
      "affiliations": [
        "Banner Health, Phoenix, Arizona, USA"
      ],
      "name": "Kariappa Appachu"
    },
    {
      "affiliations": [
        "Banner Health, Phoenix, Arizona, USA"
      ],
      "name": "Roshni Kundranda"
    },
    {
      "affiliations": [
        "Johns Hopkins School of Public Health, Baltimore, Maryland, USA"
      ],
      "name": "Georgia J Michlig"
    }
  ],
  "title": "Ethnocentric perceptions, impacts and influences of problematic alcohol use in a global community sample: a mixed-methods study",
  "uid": "5a5bf464-a90a-577f-a74c-feb55d60f3b1"
}