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）：本申请拟对墨西哥DF地区裂缝的出现和传播进行社会流行病学研究。该应用程序利用了一组独特的资源：1) 休斯顿大学毒品和社会政策研究中心在难以接触的人群中成功实施流行病学药物研究的科学和方法专业知识，以及 2) 国家 Psiquiatrma 研究所的研究人员被认为是墨西哥领先的毒品调查员。吸食可卡因是墨西哥最近出现的一种现象。有关治疗入院的数据表明，墨西哥 DF 入院人数从 2003 年的 8% 增加到 2007 年的 40%。鉴于新出现的强效流行病可能会导致艾滋病毒的快速传播和其他健康后果，这项国际研究合作非常重要。更重要的是，考虑到高度一体化的经济和大规模的循环移民模式，与快克流行病传播相关的风险相关行为可能会对公共卫生产生重大影响，对墨西哥和美国产生两国影响。该申请计划采访 150 名成年人，他们在过去 30 天内自我报告使用过可卡因，这些成年人是从墨西哥DF 的三个代表团的社区招募的。我们将采用民族志方法，实施自适应抽样方法，其中包括实地密集外展、快速响应评估 (RARE) 和有针对性的受访者驱动抽样。将使用深入的半结构化人种学访谈和观察来收集数据，包括生态瞬时评估（EMA）的要素。目的是： 1) 识别并详细描述目标快克吸毒人群的特征，包括社会人口统计、快克和其他吸毒模式和做法以及与健康相关的性和吸毒风险行为； 2) 描述导致可卡因使用行为以及与健康相关的高风险性行为和吸毒行为出现的创新过程。重点将放在知识的获取、对当前药物或实践的满意度、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、可试验性和可观察性； 3) 记录在发展中国家人口稠密的大城市的独特背景下导致可卡因使用做法以及相关高风险性行为和吸毒行为的采用和传播的传播过程。重点将放在启动、使用的进展、社交网络的影响以及对社会和文化背景的理解上； 4) 检查与处理利用相关的因素以及裂缝用户认为的处理障碍。创新包括将创新扩散理论应用于发展中国家的毒品流行动态、加强现有的墨西哥毒品监测系统以及将 RARE 和 EMA 纳入街头民族志方法。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吸毒的出现和传播进行社会流行病学研究。具体来说，我们将利用创新扩散理论的分析结构和人种学方法论，探索与快克使用的起始和快速传播以及相关的高风险性行为和吸毒行为相关的过程。这项研究的结果对两国公共卫生具有重要意义，并将有助于制定基于理论的艾滋病毒和性传播感染干预措施，以针对墨西哥高危人群。