Emergence and Diffusion of Crack and Related Health Risk Behaviors in Mexico City

墨西哥城裂纹的出现和扩散及相关健康风险行为

基本信息

批准号：
8255477
负责人：
Avelardo Valdez
金额：
$ 17.62万
依托单位：
UNIVERSITY OF SOUTHERN CALIFORNIA
依托单位国家：
美国
项目类别：
财政年份：
2011
资助国家：
美国
起止时间：
2011-04-15 至 2014-03-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8255477
关键词：
Admission activity Adoption Adult Area Behavior Breathing Characteristics Cities Collaborations Country Data Developing Countries Development Diffusion Diffusion of Innovation Drug Addiction Drug abuse Drug usage Elements Epidemic Epidemiologic Studies Epidemiology Ethnography Evaluation Exploratory/Developmental Grant Female Future HIV Health Heterosexuals Human Resources Incidence Individual Infection Injecting drug user Institutes International Intervention Intervention Studies Interview Knowledge acquisition Maintenance Methodology Mexico NIH Program Announcements Neighborhoods Patient Self-Report Pattern Pharmaceutical Preparations Policy Research Population Prevalence Preventive Intervention Process Public Health Recruitment Activity Research Research Personnel Resources Respondent Risk Risk Behaviors Sampling Sexually Transmitted Diseases Smoking Social Characteristics Social Network Social Policies Solvents Structure Surveys System Systems Integration Time Universities Woman addiction base demographics disease transmission drug market experience high risk innovation male metropolitan migration outreach public health relevance response satisfaction sex social theories transmission process

项目摘要

DESCRIPTION (provided by applicant): This application proposes to conduct a social epidemiological study on the emergence and spread of crack in Mexico DF. This application takes advantage of a unique set of resources: 1) The University of Houston, Center for Drug and Social Policy Research scientific and methodological expertise in successfully implementing epidemiological drug studies among hard to reach populations and 2) The National Institute of Psiquiatrma researchers who are considered Mexico's leading drug investigators. Smoking crack is a recent emerging phenomenon in Mexico. Data on treatment admissions indicate that Mexico DF admissions increased from 8% in 2003 to 40% in 2007. This international research collaboration is of importance given the potential for an emerging crack epidemic that can contribute to the rapid transmission of HIV and other health consequences. More importantly, the risk related behaviors associated with the spread of a crack epidemic could have major public health consequences with bi- national implications for Mexico and the U.S. given the highly integrated economies and large scale circular migration patterns. The application proposes to interview 150 adults who self-report crack use within the last 30 days recruited from neighborhoods in three delegations in Mexico DF. Using an ethnographic approach, we will implement an adaptive sampling methodology with elements of field-intensive outreach, Rapid Assessment for Response and Evaluation (RARE) and targeted respondent-driven sampling. Data will be collected using in-depth semi-structured ethnographic interviews and observations including elements of Ecological Momentary Assessment (EMA). Aims are to: 1) Identify and provide a detailed description of the characteristics of the targeted crack using population including socio-demographics, crack and other drug use patterns and practices and health related sexual and drug using risk behaviors; 2) Describe the processes of innovation that have contributed to the emergence of crack use practices and health related high risk sexual and drug using behaviors. Focus will be on the acquisition of knowledge, satisfaction over current drugs or practices, accessibility to new emerging drug market, compatibility with existing drug subcultural norms, complexity, triability, and observability; 3) Document the process of diffusion that has led to the adoption and transmission of crack use practices and related high risk sexual and drug using behaviors within the unique context of a large and densely populated city in a developing country. Focus will be on initiation, progression of use, influence of social networks, and understanding of the social and cultural context; and 4) Examine factors associated with treatment utilization and barriers to treatment as perceived by crack users. Innovations include the application of the Diffusion of Innovation Theory to the dynamics of drug epidemics in a developing country, enhancement of the existing Mexico drug surveillance system and integration of RARE and EMA into street ethnography approaches. PUBLIC HEALTH RELEVANCE: The proposed international research collaboration will conduct a social epidemiological study on the emergence and spread of crack use among adults in Mexico City. Specifically, using analytical constructs from the Diffusion of Innovation Theory and an ethnographic methodological approach we will explore the processes associated with the initiation and rapid spread of crack use and related high risk sexual and drug using behaviors. Findings from this study have important bi-national public health implications and will contribute to the development of a theory based HIV and STI intervention for crack using high risk populations in Mexico.

描述（由申请人提供）：本申请建议对墨西哥DF裂纹的出现和传播进行社会流行病学研究。该应用利用了一系列独特的资源：1）休斯顿大学，药物与社会政策研究中心，在成功地吸引人口的流行病学药物研究方面，科学与方法论专业知识和方法论专业知识； 2）美国国家PSIQUICOITRAMA研究所研究人员被认为是墨西哥领先的药物研究员。吸烟裂纹是墨西哥最近的新兴现象。有关治疗入院的数据表明，墨西哥DF的入院率从2003年的8％增加到2007年的40％。鉴于有可能导致艾滋病毒和其他健康后果的新兴裂纹流行的潜力，这项国际研究合作非常重要。更重要的是，鉴于高度综合经济和大规模的循环迁移模式，与裂纹流行有关的风险相关行为可能对墨西哥和美国产生重大的公共卫生后果。该申请建议采访150名在过去30天内从墨西哥DF的三个代表团中招募的社区中自我报告破解的成年人。使用人种学方法，我们将实施一种自适应抽样方法，其元素密集型外展，快速评估的响应和评估评估（稀有）和有针对性的受访者驱动的采样。将使用深入的半结构民族志访谈和观察结果（包括生态瞬时评估要素（EMA））收集数据。目的是：1）使用人群（包括社会人口统计学，裂缝和其他毒品使用模式和实践）以及使用风险行为（包括社会人口统计学和其他毒品使用模式）以及与健康相关的性和毒品的人群来识别并提供针对目标裂缝特征的详细描述； 2）描述创新过程，这些过程有助于使用行为的裂纹使用实践和与健康相关的高风险性和毒品的出现。重点将放在获取知识，对当前药物或实践的满意度，对新的新兴药物市场的可及性，与现有药物亚文化规范的兼容性，复杂性，可见性和可观察性； 3）记录导致裂纹使用实践和相关高风险性和毒品的传播过程，并在发展中国家一个人口稠密的城市的独特背景下使用行为。重点将放在开始，使用，社交网络的影响以及对社会和文化背景的理解上； 4）检查与裂纹用户所感知的有关治疗利用和治疗障碍相关的因素。创新包括将创新理论扩散到发展中国家药物流行病的动态，增强墨西哥药物监视系统的应用以及将稀有和EMA整合到街头人种志方法中。公共卫生相关性：拟议的国际研究合作将对墨西哥城成年人的裂缝使用的出现和传播进行社会流行病学研究。具体而言，使用创新理论的扩散和人种学方法学方法中的分析结构，我们将探讨与使用裂纹使用和使用行为相关的高风险性和药物相关的过程。这项研究的发现具有重要的双性公共卫生影响，并将有助于开发基于理论的艾滋病毒和STI干预，以利用墨西哥的高风险人群进行破解。