Underage Drinking: Building Health Care System Responses

未成年人饮酒：建立医疗保健系统应对措施

• 批准号: 7162288
• 负责人: JAMES A. HALL
• 金额: $ 51.75万
• 依托单位: UNIVERSITY OF IOWA
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-09-30 至 2009-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7162288
• 关键词: Internet; adolescence (12-20); alcoholic beverage consumption; alcoholism /alcohol abuse; alcoholism /alcohol abuse prevention; alcoholism /alcohol abuse therapy; behavioral /social science research tag; clinical research; cooperative study; early /brief intervention /therapy; health science research support; health services research tag; human subject; human therapy evaluation; patient oriented research; pediatrics; rural area; rural health

DESCRIPTION (provided by applicant): The overall mission of this proposed program is to develop a research infrastructure in primary health care settings in rural Iowa so that interventions can be evaluated to address underage drinking. Our infrastructure will include a central research office at the University of Iowa (Center for Addictions Research), a primary care setting for youth only (Adolescent Health & Resource Center or AHRC) and several cooperating primary health care clinics that are members of the University of Iowa Community Medical Services (UICMS) system. In Phase 1, we will begin with 5 UICMS clinics and the AHRC, and then, as our infrastructure becomes more efficient, we will add the remaining UICMS clinics for Phase 2. Additionally, we will develop an innovative Video Doctor computer application, which will consist of two main components: (1) the GAPS (Guidelines for Adolescent Preventive Services) screening system and (2) the Video Doctor - a computerized video clips of physicians giving age-appropriate motivational feedback about alcohol consumption - based on responses to screening items. The GAPS program was developed by the American Medical Association and used in many Adolescent Medicine clinics. The Video Doctor will be developed in the first 6 months of our project and then subjected to extensive and sequential review by youth in three age categories (10-12 years; 13 - 15 years; and 16 - 18 years) participating in Positive Youth Development groups. Finally, after the beta version has been developed, this intervention will be pilot tested in our primary health care clinics with each age group. Based on the results from Phase 1, we will then develop an application for a Phase 2 study that includes a more rigorous design and additional sites. To accomplish the goals of this develop project, we have developed interdisciplinary support for our infrastructure improvement plan and for our proposed pilot study. In summary, we propose to develop a research infrastructure by (1) partnering with primary health care clinics in the UICMS system, (2) providing training for the clinic staff about alcohol abuse issues and health services research skills, and (3) developing an age appropriate Video Doctor computer application which can be used easily in primary health care settings. This project focuses on a significant public health problem - underage drinking in rural Iowa. In many of our rural communities, many adolescents describe a culture of binge drinking - especially on the weekends. However, these episodes of alcohol consumption often lead to fairly negative consequences ranging from school absence, conflict with parents, physical violence, unprotected sexual activity and use of other illegal substances. We argue that our primary care clinics can have a positive impact on this culture of alcohol consumption by underage drinkers through a combination of primary prevention and early intervention.

描述（由申请人提供）：该拟议计划的总体任务是在爱荷华州农村的初级卫生保健机构中开发研究基础设施，以便评估干预措施以解决未成年人饮酒问题。我们的基础设施将包括爱荷华大学的一个中央研究办公室（成瘾研究中心）、一个仅供青少年使用的初级保健机构（青少年健康与资源中心或 AHRC）以及几个合作的初级保健诊所，这些诊所是爱荷华大学的成员。爱荷华州社区医疗服务 (UICMS) 系统。在第一阶段，我们将从 5 个 UICMS 诊所和 AHRC 开始，然后，随着我们的基础设施变得更加高效，我们将为第二阶段添加剩余的 UICMS 诊所。此外，我们将开发一个创新的视频医生计算机应用程序，它将包括两个主要部分： (1) GAPS（Guidelines for 青少年预防服务）筛查系统和（2）视频医生 - 医生根据对筛查项目的反应提供适合年龄的饮酒动机反馈的计算机视频剪辑。 GAPS 计划由美国医学会开发，并在许多青少年医学诊所使用。视频医生将在我们项目的前 6 个月内开发出来，然后由参与积极青少年发展的三个年龄段（10-12 岁；13-15 岁；16-18 岁）的青少年进行广泛和连续的审查组。最后，在开发出测试版本后，该干预措施将在我们的初级卫生保健诊所针对每个年龄段进行试点测试。根据第一阶段的结果，我们将开发第二阶段研究的应用程序，其中包括更严格的设计和其他站点。为了实现该开发项目的目标，我们为基础设施改善计划和拟议的试点研究提供了跨学科支持。总之，我们建议通过以下方式开发研究基础设施：(1) 与 UICMS 系统中的初级卫生保健诊所合作，(2) 为诊所工作人员提供有关酒精滥用问题和卫生服务研究技能的培训，以及 (3) 开发适合年龄的视频医生计算机应用程序，可以在初级卫生保健环境中轻松使用。该项目重点关注一个重大的公共卫生问题——爱荷华州农村地区的未成年人饮酒。在我们的许多农村社区，许多青少年都描述了一种酗酒的文化——尤其是在周末。然而，这些饮酒事件往往会导致相当负面的后果，包括缺课、与父母发生冲突、身体暴力、无保护的性活动和使用其他非法物质。我们认为，我们的初级保健诊所可以通过初级预防和早期干预相结合，对未成年饮酒者的饮酒文化产生积极影响。