Alcohol, firearms, and adolescent gunshot injury risk

酒精、枪支和青少年枪伤风险

• 批准号: 7124342
• 负责人: DOUGLAS J WIEBE
• 金额: $ 66.5万
• 依托单位: UNIVERSITY OF PENNSYLVANIA
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-09-20 至 2009-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7124342
• 关键词: African American; adolescence (12-20); alcoholic beverage consumption; alcoholism /alcohol abuse; behavioral /social science research tag; clinical research; emergency health services; epidemiology; human subject; injury; middle childhood (6-11); socioenvironment; violence; violence prevention

DESCRIPTION (provided by applicant): Gunshot injury is the leading cause of death in 10-19 year old African American males and the second leading cause of adolescent death overall. Most adolescents who are killed with guns are shot during assaults (60 percent) and for each gunshot assault that is fatal, 7 adolescents require emergency department (ED) treatment for non-fatal assaultive gunshot trauma. Additionally, each day more than 70 adolescents require ED treatment for non-fatal assaultive injuries inflicted with non-gun weapons. Nevertheless, little is known about the epidemiology of assaultive injury from guns and other weapons among adolescents. By using an epidemiological space-time modeling approach, we have developed and pilot-tested an innovative, portable technology for dynamically mapping the activities of adolescents thereby allowing very accurate estimation of their exposure to alcohol and firearms on a minute-to-minute basis. To determine gunshot injury risk, we propose conducting a population-based case-control study. Adolescents 10-19 years of age presenting to the ED of 2 inner-city Philadelphia hospitals for assault-related gunshot injuries will be compared with a randomly selected, population-based sample of control subjects 10-19 years old. As a secondary aim, adolescents presenting for non-gunshot assault injuries will be enrolled as a second case group and compared with the same sample of control subjects to determine non-gun injury risk. Each case and control subject will be interviewed using portable, computerized mapping technology to create a dynamic graphic that provides a minute-by-minute record of how, when, with whom, and where the subject spent time as he or she walked or otherwise traveled from location to location and from activity to activity on the day of the injury (cases) or 1-4 days earlier designated randomly (controls). Each subject will be asked about his or her use of alcohol and firearms that day, and about how other people around him or her used alcohol and firearms that day (e.g., people drinking alcohol on street corners; firearms kept at home). Secondary data we will link, along with the narrative data, to the map will identify additional exposure and confounding factors including characteristics of streets, buildings, and neighborhoods. Logistic regression analyses will investigate whether adolescents who consume alcohol and/or carry firearms, and/or whose daily activities occur in surroundings rich in alcohol and/or firearms, face a differential risk of being shot with a firearm or injured in a non-gun assault. This study will help to identify how adolescents are restricted in time and space by their daily activities, thereby identifying particular locations and times of enhanced, and reduced, assaultive injury risk.

描述（由申请人提供）：枪击伤害是10-19岁的非洲裔美国男性死亡的主要原因，也是青少年死亡的第二大主要原因。大多数被枪支杀死的青少年在袭击中被枪杀（60％），对于致命的每一次枪击袭击，有7个青少年需要急诊科（ED）治疗非致命的攻击枪伤创伤。此外，每天有70多名青少年需要ED治疗，以治疗非致命的攻击性伤害。尽管如此，对青少年枪支和其他武器的攻击性伤害的流行病学知之甚少。通过使用流行病学时空建模方法，我们已经开发了并进行了试点测试的创新的便携式技术，以动态绘制青少年的活动，从而可以非常准确地估计其在微小的基础上对酒精和枪支的暴露。为了确定枪击伤害风险，我们建议进行基于人群的病例对照研究。向2家市中心费城医院的ED呈现10-19岁的青少年，将与攻击相关的枪伤受伤进行比较，将其与10 - 19岁的随机选择的，基于人群的对照受试者样本进行比较。作为次要目的，出现针对非枪击突击伤害的青少年将被招募为第二个病例组，并将其与相同的对照对象样本进行比较，以确定非枪支损伤风险。每个案例和控制对象将使用便携式计算机化的映射技术进行访谈，以创建动态图形，从而提供一分钟的记录，记录如何，何时，与谁，与主体一起度过的时间，因为他或她走路或其他位置或以其他方式从地点到位置到活动，并在受伤之日（案例）或1-4天提前指定的随机时间（对照）。将询问每个主题那天他或她对酒精和枪支的使用，以及那天他或她周围的其他人如何使用酒精和枪支（例如，人们在街角上喝酒；枪支放在家里）。我们将与叙述数据一起链接到地图的二级数据将确定其他曝光和混淆因素，包括街道，建筑物和社区的特征。逻辑回归分析将调查食用酒精和/或携带枪支的青少年，以及/或日常活动发生在富含酒精和/或枪支的周围环境中，面临着被枪支枪击或在非枪支袭击中受伤的差异风险。这项研究将有助于确定青少年如何通过日常活动在时间和空间中限制，从而确定特定位置以及增强和减少的攻击性伤害风险。