Longitudinal Pathways to the Use of Health Services

使用卫生服务的纵向途径

• 批准号: 8606452
• 负责人: JUDITH S BROOK
• 金额: $ 62.1万
• 依托单位: NEW YORK UNIVERSITY SCHOOL OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-02-01 至 2016-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8606452
• 关键词: Address; Adolescence; Adult; Affect; Age; Alcohol consumption; Alcohol or Other Drugs use; Alcohols; Applications Grants; Area; Behavioral Model; Caring; Chronic; Communities; Complex; Conscious; Data; Data Collection; Development; Disease; Equation; Face; Family; Family Relationship; Friends; Goals; Growth; Health; Health Services; Health Services Needs; Individual; Intervention; Interview; Knowledge; Life; Life Cycle Stages; Light; Link; Longevity; Longitudinal Studies; Maps; Marijuana; Marijuana Smoking; Mediating; Mental Health; Mental disorders; Mission; Modeling; National Institute of Drug Abuse; Neighborhoods; Outcome; Parent-Child Relations; Participant; Pathway interactions; Pattern; Personality Disorders; Persons; Physical Function; Prevention; Preventive; Psychopathology; Public Health; Recording of previous events; Recurrent disease; Relapse; Research; Resources; Role; Sampling; Sleep Disorders; Social Functioning; Spouses; Subgroup; Substance Addiction; Substance abuse problem; Supported Employment; Surveys; Symptoms; Techniques; Testing; Time; Tobacco; Tobacco use; base; early onset; emerging adulthood; emotional abuse; experience; health care service utilization; information gathering; insight; middle age; physical abuse; physical conditioning; prevent; psychologic; psychosocial; reduced substance use; service utilization; social; sound; therapy development; young adult

DESCRIPTION (provided by applicant): This new grant application, which is based on a 35-year longitudinal study (T1-T7) of substance use, proposes to identify the determinants and barriers to health care services utilization in the fifth decade of life by charting the longitudinal pathways to the utilization of services by adults in early midlife (Aim 1). In addition, the proposed research will assess the long-term consequences of substance use (alcohol, marijuana, and tobacco) in this understudied developmental period (Aim 2). At T8, we will gather information about important areas of physical and psychosocial functioning in adults in early midlife (physical diseases, psychiatric disorders, and functioning in adult roles), and relate these to the histories of substance use. Extensive longitudinal data are available on the participants from previous waves of data collection, including adolescence (T2, T3), emerging adulthood (T4), and young adulthood (T5, T6, and T7). At T8, face-to-face interviews will be conducted with the participants. Psychometrically sound scales will be developed from the surveys. The primary data-analytic techniques will be structural equation modeling, growth mixture modeling and regression. This research will enable us to provide crucial information about factors facilitating and barriers impeding the utilization of health care services among adults transitioning to midlife. In addition the proposed research will provide insight into the cumulative impact of prolonged substance use on psychosocial and physical functioning in adulthood. Since substance abuse and dependence are chronic, relapsing diseases, which may persist throughout a person's life, studying their patterns and concomitants prospectively over the life course is of crucial importance to public health.

描述（由申请人提供）：这项新的拨款申请基于一项为期 35 年的物质使用纵向研究 (T1-T7)，旨在通过以下方式确定生命第五个十年利用医疗保健服务的决定因素和障碍：绘制中年早期成年人利用服务的纵向路径（目标 1）。此外，拟议的研究将评估物质使用（酒精、大麻和烟草）在这个尚未充分研究的发育时期的长期后果（目标 2）。在 T8，我们将收集有关中年早期成年人身体和心理社会功能重要领域的信息（身体疾病、精神疾病和成人角色功能），并将这些信息与物质使用史联系起来。从之前的数据收集浪潮中可以获得有关参与者的广泛纵向数据，包括青春期（T2、T3）、成年初期（T4）和成年早期（T5、T6 和 T7）。在T8，将对参与者进行面对面采访。心理测量学上的合理量表将从调查中制定。主要的数据分析技术是结构方程建模、增长混合建模和回归。这项研究将使我们能够提供有关促进和阻碍成年人过渡到中年的医疗保健服务的因素和障碍的重要信息。此外，拟议的研究还将深入了解长期物质使用对成年期心理社会和身体功能的累积影响。由于药物滥用和依赖是慢性复发性疾病，可能会持续一生，因此在生命过程中前瞻性地研究其模式和伴随物对于公共卫生至关重要。