Substance use, violence and HIV risk: Age-specific risk factors and drivers of comorbidity.

药物使用、暴力和艾滋病毒风险：特定年龄的风险因素和合并症的驱动因素。

• 批准号: 8843571
• 负责人: REBECCA M. CUNNINGHAM
• 金额: $ 7.76万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-02-01 至 2017-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8843571
• 关键词: Accounting; Address; Adolescence; Adolescent; Adult; Affect; Age; Alcohol or Other Drugs use; Alcohols; Behavior; Behavioral; Biological; Communities; Comorbidity; Computer software; Data; Dependence; Development; Developmental Process; Drug Prescriptions; Environment; Etiology; Exposure to; Family Violence; Funding; HIV risk; Human; Individual; Intervention; Knowledge; Link; Longitudinal Studies; Marijuana; Medical; Methods; Modeling; National Institute of Drug Abuse; Neighborhoods; Odds Ratio; Outcome; Pattern; Pharmaceutical Preparations; Population; Predisposition; Problem behavior; Process; Psychological Stress; Public Health; Research; Research Personnel; Risk; Risk Behaviors; Risk Factors; Role; Social Development; Societies; Specific qualifier value; Statistical Methods; Statistical Models; Tobacco; Violence; Work; age related; base; behavioral outcome; cognitive development; cost; demographics; density of AOD outlets; effective intervention; emerging adult; experience; improved; insight; interest; peer; peer influence; public health relevance; social; social norm; substance use prevention; weapons

 DESCRIPTION: This proposal describes a plan to further study the determinants and consequences of substance use using data from a longitudinal study of urban adolescents. Previous studies investigating substance use and its associated comorbidities often focus on individual-level risk and protective factors. More recent work has envisioned individuals as part of a socio-ecological context, which motivates studying the effects of neighborhood- and community-level risk and protective factors and we intend to build on this on two ways. First, The transition from adolescence to adulthood is a period of rapid biological, cognitive and social development, presenting the possibility that the way an individual reacts to his or her environment, and therefore the effect it has, is age-dependent. Specifically, due to age-specific developmental and societal context, it is likely that rates of substance use, what variables operate as risk/protective factors for substance use, and the level of comorbidity between substance use and other negative behaviors are all age-dependent. Second, the same socio-ecological context that been found to modulate substance use rates may also affect the link between substance use and other negative behaviors. These dynamics have gone unexplored to this point and their exploration is the purpose of this proposal. To address this first gap, we propose using varying coefficient regression models to explore how the effects of individual- and community- level risk factors for substance use change with age. This will tell us not only what risk/protective factors for substance use are important, but when they are most important. To address the second gap, we will derive a previously unexplored statistical model of the dependence between two binary variables (e.g. substance use and weapon violence). In this model - whose implementation will be made freely available as an R package - we will use a combination of Bayesian and composite likelihood approaches to isolate estimation of the odds ratio - and how it changes as a function of predictor variables - without the need to estimate parameters of secondary interest, such as means or temporal autocorrelation parameters. Within this framework, we will determine the factors that increase/decrease the level of comorbidity between substance use and related negative behaviors, as well as how these relationships change with age.

 描述：该提案描述了一项利用城市青少年纵向研究的数据进一步研究药物使用的决定因素和后果的计划，这些研究通常侧重于个人层面的风险和保护因素。将个人设想为社会生态环境的一部分，这激发了研究邻里和社区层面的风险和保护因素的影响，我们打算在此基础上通过两种方式进行研究：首先，从青春期到成年的过渡是一个时期。快速的生物、认知和社会发展，表明个人对其环境的反应方式及其所产生的影响可能与年龄有关。具体来说，由于特定年龄的发展和社会背景，很可能是这样。物质使用率、哪些变量可作为物质使用的风险/保护因素，以及物质使用和其他负面行为之间的共病程度都取决于年龄。其次，已发现调节物质的社会生态环境相同。使用率也可能影响物质使用和物质使用之间的联系到目前为止，这些动态尚未得到探索，为了解决第一个差距，我们建议使用不同的系数回归模型来探索个人和社区层面的风险因素的影响。这不仅会告诉我们物质使用的哪些风险/保护因素很重要，而且会告诉我们什么时候它们最重要。为了解决第二个差距，我们将得出一个先前未探索的两个二元之间依赖性的统计模型。变量（例如物质使用和武器在这个模型中（其实现将作为 R 包免费提供），我们将使用贝叶斯和复合似然方法的组合来隔离比值比的估计 - 以及它如何作为预测变量的函数变化 - 没有。需要估计次要参数，例如平均值或时间自相关参数，我们将确定增加/减少物质使用和相关负面行为之间共病水平的因素，以及这些关系如何随时间变化。年龄。