Teen Alcohol Screening in the Pediatric Emergency Care Applied Research Network

儿科紧急护理应用研究网络中的青少年酒精筛查

基本信息

批准号：
8539739
负责人：
JAMES G LINAKIS
金额：
$ 62.53万
依托单位：
RHODE ISLAND HOSPITAL
依托单位国家：
美国
项目类别：
财政年份：
2012
资助国家：
美国
起止时间：
2012-09-05 至 2017-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8539739
关键词：
17 year old Accident and Emergency department Adolescence Adolescent Adult Affect Age Alcohol abuse Alcohol consumption Alcohol dependence Alcohol or Other Drugs use Alcoholism Alcohols Anatomy Applied Research Behavior Behavioral Caring Childhood Cigarette Cognitive Data Diagnosis Drug usage Early Diagnosis Early identification Emergency Care Enrollment Ethnic Origin Frequencies Future Gender Goals Gold Health Institutes Insurance Intervention Marijuana Smoking Measurement Measures Medical Morbidity - disease rate Multicenter Trials Neuropsychology Participant Patients Performance Persons Physicians Population Primary Health Care Problem behavior Public Health ROC Curve Race Recommendation Research Research Infrastructure Risk Risk Behaviors Sample Size Sampling Sampling Studies School-Age Population Sensitivity and Specificity Site Student Dropouts Surveys Teenagers Testing Visit Youth alcohol and other drug alcohol misuse alcohol screening alcohol use disorder base brief advice brief intervention brief screening design drinking follow-up high risk high school instrument middle school mortality motivational intervention neurochemistry novel response screening sex tool underage drinking validation studies

项目摘要

DESCRIPTION (provided by applicant): Alcohol use is a major contributor to the leading causes of adolescent morbidity and mortality and to other health risks, including other substance use and risky behaviors. Adolescent alcohol use may also result in long term cognitive, behavioral, anatomic and neurochemical changes. Additionally, initiating alcohol use in adolescence significantly increases a person's risk for adult alcohol use disorders. Given this considerable public health burden, successfully identifying adolescents at risk for current or future problematic alcohol use is of major importance, as intervention may significantly affect both adolescent and adult alcohol use disorders. The National Institute of Alcohol Abuse and Alcoholism (NIAAA) has developed a novel two-question screening tool for the early detection of alcohol use and problems. Empirically based, the screen may be a powerful predictor of current and future negative consequences of alcohol use. We propose to test the goals of RFA- AA-12-008 by validating the NIAAA two-question screen with 12-17 year olds in 15 U.S. pediatric emergency departments (PED), by pursuing two specific aims: Primary Aim 1) To determine the concurrent, convergent, discriminant, and predictive validity of the two-question screen regarding alcohol misuse, and Secondary Aim 1) To determine the concurrent and predictive validity of the two-question screen regarding other substance use and risky behaviors. The advantage of the PED setting is the ability to capture high risk populations such as school dropouts and those without primary care or insurance, who often use PEDs for their medical care and are missed in other study settings. Employing the Pediatric Emergency Care Applied Research Network (PECARN), we will use a multi-center design to test the concurrent, convergent and predictive validity of the NIAAA two-question screen using established, validated measurement instruments in a very large, diverse sample of youths. Youths 12-17 years (N=8000) presenting to participating PECARN PEDs will be enrolled over a 3.5-year period and will complete the two-question screen and an alcohol and other drug (AOD) and behavior ("criterion") assessment battery. Responses from these youths will be used to assess the concurrent convergent, and discriminant validity of the NIAAA two-question screen. Two subsamples of youths will be derived from the initial sample. The first subsample (N=300) will be re-administered the NIAAA two-question screen, one week after their initial ED visit to assess the test-retest reliability of the NIAAA two-question screen. The second sample (N=2500), will be reassessed at 12 and 24 months after their PED visit with the criterion assessment battery to assess the predictive validity of the two-question screen. This large sample will permit stratified analyses by gender, race, ethnicity and other important demographic variables, which are not possible with single center or smaller sample studies. The proposed research is significant because it rigorously evaluates the ability of the NIAAA two-question screen to predict current and future AOD risks as well as other behavior problems, and will generate very robust, generalizable results.

描述（由申请人提供）：饮酒是导致青少年发病和死亡以及其他健康风险（包括其他物质使用和危险行为）的主要原因。青少年饮酒还可能导致长期的认知、行为、解剖和神经化学变化。此外，在青春期开始饮酒会显着增加一个人患成人酒精使用障碍的风险。鉴于这一巨大的公共卫生负担，成功识别当前或未来有酒精使用问题风险的青少年至关重要，因为干预措施可能会显着影响青少年和成人酒精使用障碍。美国国家酒精滥用和酒精中毒研究所 (NIAAA) 开发了一种新颖的两问题筛查工具，用于及早发现酒精使用情况和问题。根据经验，屏幕可能是当前和未来饮酒负面后果的有力预测因素。我们建议通过对 15 个美国儿科急诊科 (PED) 的 12-17 岁儿童验证 NIAAA 两问题筛查来测试 RFA-AA-12-008 的目标，并追求两个具体目标：主要目标 1) 确定关于酒精滥用的两个问题筛选的并发、收敛、判别和预测有效性，以及次要目标 1) 确定两个问题的并发和预测有效性筛查其他物质使用和危险行为。 PED 设置的优点是能够捕获高风险人群，例如辍学者和没有初级保健或保险的人，他们经常使用 PED 进行医疗护理，而在其他研究环境中被遗漏。利用儿科紧急护理应用研究网络 (PECARN)，我们将使用多中心设计，使用已建立的、经过验证的测量仪器，在一个非常大的、多样化的样本中测试 NIAAA 两个问题屏幕的并发、收敛和预测有效性。年轻人。参加 PECARN PED 的 12-17 岁青少年 (N=8000) 将在 3.5 年的时间内进行登记，并完成两个问题的筛查以及酒精和其他药物 (AOD) 和行为（“标准”）评估。这些年轻人的回答将用于评估 NIAAA 两问题筛选的同时收敛性和判别有效性。将从初始样本中派生出两个青少年子样本。第一个子样本 (N=300) 将在首次 ED 就诊一周后重新进行 NIAAA 两问题筛查，以评估 NIAAA 两问题筛查的重测可靠性。第二个样本 (N=2500) 将在 PED 就诊后 12 和 24 个月使用标准评估组进行重新评估，以评估双问题筛查的预测有效性。这个大样本将允许按性别、种族、民族和其他重要的人口变量进行分层分析，这是单中心或较小样本研究不可能实现的。拟议的研究意义重大，因为它严格评估了 NIAAA 两问题筛查预测当前和未来 AOD 风险以及其他行为问题的能力，并将产生非常稳健、可推广的结果。