Understanding Risk Factors, Including Substance Use, for Recurrent Assault Related Injury

了解反复袭击相关伤害的风险因素，包括药物使用

• 批准号: 10413818
• 负责人: Lea Marineau
• 金额: $ 4.68万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-02-10 至 2024-02-09
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10413818
• 关键词: 12 year old; Address; Adult; Age; Alcohol consumption; Alcohols; Area; Baltimore; Benzodiazepines; Caring; Cause of Death; Cessation of life; Characteristics; Chronic Disease; Cocaine; Communication Research; Complex; Data; Development; Diagnosis; Drug Addiction; Drug Use Disorder; Drug usage; Education; Family; Fellowship; Firearms; Future; Goals; Health Services Accessibility; Healthcare Systems; Homicide; Hospitals; Household; Improve Access; Incidence; Income; Individual; Injury; Injury Severity Score; Institution; Intervention; Interview; Knowledge; Marijuana; Maryland; Measures; Medical; Mental disorders; Mentorship; Methods; National Institute of Drug Abuse; Neighborhoods; Observational Study; Opioid; Outcome; Patient Self-Report; Patients; Persons; Pharmaceutical Preparations; Prevalence; Public Health; Recurrence; Reporting; Research; Research Personnel; Risk; Risk Factors; Shock; Societies; Socioeconomic Status; Specific qualifier value; Strategic Planning; Structure; Substance Use Disorder; Time; Toxicology; Training; Trauma; United States; Universities; Violence; Violent injury; Work; age group; aged; alcohol comorbidity; analytical method; assault; base; black men; career; cocaine use; comorbidity; data registry; demographics; design; experience; gender disparity; improved; injured; intervention program; male; multidisciplinary; peer; prevent; psychologic; racial disparity; response; sedative; substance use; substance use treatment; trauma centers; violence victimization; weapons

PROJECT SUMMARY The goal of the proposed fellowship is to prepare the applicant for an independent research career focused on improving access to treatment for substance use disorders, especially those provided to assault-injured individuals; and to inform hospital-based violence intervention programs in preventing repeat violent injury. Violence and substance use have become public health crises in the US, demanding an urgent health care systems response. There are large gender and racial disparities in rates of violence among Black males. The prevalence of drug and alcohol use is immense in the US, and has been shown to be strongly associated with violence. However, there is limited research describing the complex relationship and intersection between drug/alcohol use and assault-related injury, especially recurrent injury. Additionally, limited studies have examined specific substance use types and violence victimization, specifically assault-related injuries requiring medical care and recurrent injury. Many of the relevant studies have relied on self-reported drug use rather than objective measures such as toxicology reports. Additionally, multiple studies have shown alcohol to be associated with violence and there is evidence to support the association between cocaine use and violence among adults, however results have been mixed regarding other drug types (e.g., marijuana, opioids, sedatives) and violence. The purpose of this study is to further understand patient (including drug/alcohol use & comorbid diagnoses), neighborhood, and injury-related factors associated with recurrent assault-related injury among adults aged 18 to 34 years who present to a hospital in Baltimore, MD with a blunt force, cutting/piercing, or firearm assault-related injury. The specific aims of this study are: Aim 1: Examine if patient (drug/alcohol use, comorbid diagnoses, demographics, and socioeconomic status), neighborhood (neighborhood violence, alcohol outlets, household education, household income, vacant houses, and drug arrests), and injury-related factors (injury severity score and mechanism of injury) at the time of presentation to the hospital for a blunt force, cutting/piercing, or firearm assault-related injury are predictive of recurrent assault-related injury. Aim 2: Describe experiences with violence and drug/alcohol use in individuals who have experienced a past year repeat assault-related injury and had a positive toxicology screen at the time of injury. Aim 3: Describe how the themes surrounding violence and drug/alcohol use revealed in Aim 2 further explain and extend the identified risk factors in Aim 1. This study is directly responsive to NIDA's Strategic Plan to determine the impact of drug use and addiction on individuals, families, peers, and society; specifically, the impact of substance use disorders on public health outcomes. The knowledge gained from this study will inform future interventions directed at improving access to effective substance use treatment among assault-injured people, potentially reducing risk for recurrent injury.

项目摘要 拟议的奖学金的目的是为申请人做好准备的独立研究生涯的准备 改善药物使用障碍的治疗机会，尤其是提供攻击危机的治疗方法 个人并告知基于医院的暴力干预计划，以防止反复暴力伤害。 暴力和药物使用已成为美国的公共卫生危机，要求紧急医疗保健 系统响应。黑人男性暴力率的性别和种族差异很大。这 在美国，药物和饮酒的患病率很大，并且已被证明与 暴力。但是，有限的研究描述了复杂的关系和相交 毒品/酒精使用和与攻击有关的伤害，尤其是复发性伤害。此外，有限的研究具有 检查了特定的药物使用类型和暴力受害，特别是与袭击相关的伤害 医疗和反复伤害。许多相关的研究都依赖于自我报告的药物使用而不是 比毒理学报告等客观措施。此外，多项研究表明酒精为 与暴力有关，有证据支持可卡因使用与暴力之间的关联 但是，在成年人中，关于其他药物类型的结果（例如大麻，阿片类药物， 镇静剂）和暴力。这项研究的目的是进一步了解患者（包括药物/酒精 使用与合并诊断），邻里和与伤害相关的因素相关的因素 18至34岁的成年人在马里兰州巴尔的摩的一家医院出席医院 用钝力，切割/刺穿或与枪支攻击相关的伤害。这项研究的具体目的是： 目标1：检查患者是否（毒品/酒精使用，合并诊断，人口统计和社会经济状况）， 邻里（邻里暴力，酒精渠道，家庭教育，家庭收入，空缺 当时的房屋和毒品逮捕）以及与伤害有关的因素（伤害严重程度评分和伤害机制） 向医院出示钝力，切割/刺穿或与枪支攻击相关的伤害是预测的 反复发作的攻击相关伤害。目标2：描述暴力和毒品/酒精使用的经历 经历了过去一年的重复袭击相关伤害并患有阳性毒理学的个人 受伤时筛选。目标3：描述如何使用暴力和毒品/酒精的主题 在目标2中揭示了进一步解释并扩展了目标1中确定的风险因素。这项研究直接 响应NIDA的战略计划，以确定吸毒和成瘾对个人，家庭， 同龄人和社会；具体而言，物质使用障碍对公共卫生结果的影响。这 从这项研究中获得的知识将为未来的干预措施提供旨在改善有效访问权限的干预措施 袭击受伤的人中使用药物治疗，可能会降低复发性伤害的风险。