Impact of Services on Problem Drinking Trajectories

服务对问题饮酒轨迹的影响

• 批准号: 6872733
• 负责人: Kevin L. Delucchi
• 金额: $ 46.66万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 1994
• 资助国家: 美国
• 起止时间: 1994-08-01 至 2010-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6872733
• 关键词: alcoholism /alcohol abuse; alcoholism /alcohol abuse therapy; behavioral /social science research tag; clinical research; gender difference; genetic markers; health behavior; health care service availability; health care service evaluation; health care service utilization; health services research tag; high risk behavior /lifestyle; human subject; human therapy evaluation; interview; longitudinal human study; outcomes research; patient oriented research; racial /ethnic difference; relapse /recurrence; self help; social service; social support network; substance abuse epidemiology; therapy compliance

DESCRIPTION (provided by applicant): Fundamental to health services research in the alcohol field is an understanding of the long-term course of problem drinking and how health and human services, including alcohol treatment and self-help, impact that course. The proposed longitudinal study identifies the determinants of 11-year time paths of consumption patterns and changing alcohol-related problems in a representative sample of dependent and problem drinkers drawn from a single county's household population (N=672). No other study of such drinkers has used a probability sampling approach, reflecting the range of problem severity from problem drinkers to those who are alcohol dependent, and followed them regularly for 7 years. This application extends those follow-ups to 9 and 11 years. Time paths, or trajectories, of problem drinking have both theoretical and applied relevance to the alcohol field, where drinking problems are increasingly viewed as chronic, cyclical, and relapsing. The study addresses the underlying roles that a wide spectrum of health and human services play in the long-term course of alcohol problems--in people getting better, staying the same, or progressing to more serious problems over. Analyses use latent curve growth techniques to compare both the shape of trajectories of problem drinking and their determinants. Analyses begin by establishing the ways individual characteristics (including markers of genetic and developmental predispositions towards alcoholism, demographic characteristics, maturation effects, and psychological vulnerabilities, such as psychiatric severity, drug use, and dependence) affect trajectories of problem drinking. We next examine the manner in which social network responses and self-help alter the 11-year course of alcohol problems and the influence of general health and welfare and human services. A final set of analyses builds upon these earlier stages by modeling the persistence and cumulation of specialty alcohol treatment interventions on trajectories of problem drinking and develops integrated causal 'explanations of how social networks, self-help, and interventions by general health and welfare services providers contribute to the long-term effects of alcohol treatment.

描述（由申请人提供）：酒精领域中卫生服务研究的基础是对饮酒的长期过程以及健康和人类服务（包括酒精治疗和自助）的理解。拟议的纵向研究确定了消费模式的11年时间路径的决定因素，并改变了从一个县的家庭人口中得出的依赖和饮酒者的代表性样本中，与酒精有关的问题改变了（n = 672）。没有其他对此类饮酒者的研究使用概率抽样方法，反映出从问题饮酒者到依赖酒精的人的问题严重程度的范围，并定期遵循7年。该应用程序将这些随访扩展到9年和11年。饮酒问题的时间路径或轨迹既有理论上的饮酒和应用于酒精场，饮酒问题越来越被视为慢性，周期性和复发。该研究探讨了各种各样的健康和人类服务在长期饮酒问题中所发挥的潜在作用 - 人们在人们变得更好，保持不变或发展更严重的情况下 问题结束了。分析使用潜在曲线生长技术来比较问题饮用的轨迹及其决定因素的形状。分析首先建立了个体特征的方式（包括对酒精中毒的遗传和发育倾向的标志，人口统计学特征，成熟效应以及心理脆弱性，例如精神病严重程度，药物使用和依赖性）会影响问题饮酒的轨迹。接下来，我们研究社交网络反应和自助的方式改变了酒精问题的11年过程以及一般健康，福利和人类服务的影响。最后一组分析基于 这些较早的阶段是通过对问题饮酒的轨迹进行持久性和累积的建模，并发展了综合因果关系的解释，解释了社交网络，自助和一般健康和福利服务提供者如何对酒精治疗的长期影响做出贡献。