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：该提案描述了一项计划，以进一步研究使用城市青少年纵向研究的数据，进一步研究药物使用的后果。先前研究药物使用及其相关合并症的研究通常集中在个人级别的风险和受保护因素上。最近的工作将个人设想为社会生态环境的一部分，这动机研究了社区和社区级别的风险和保护因素的影响，我们打算以两种方式建立在这方面。首先，从青少年到成年的过渡是一个快速的生物学，认知和社会发展的时期，它表明了个人对自己或她的环境的反应方式，因此其影响是年龄依赖的。具体而言，由于特定年龄的发展和社会环境，物质使用率，哪些变量作为使用物质使用的风险/保护因素的作用以及药物使用和其他负面行为之间的合并症水平都是依赖年龄的。其次，发现调节物质使用率的相同社会生态环境也可能影响物质使用与其他负面行为之间的联系。到目前为止，这些动态已经出乎意料，他们的探索是该提议的目的。为了解决第一个差距，我们建议使用不同的核心回归模型来探索个人和社区级别危险因素对药物使用的影响如何随着年龄的增长而变化。这不仅会告诉我们什么风险/保护因素很重要，而且在最重要的时候。为了解决第二个差距，我们将得出两个二进制变量之间依赖性的以前意外的统计模型（例如，物质使用和武器暴力）。在此模型中（其实现将作为R软件包免费提供），我们将使用贝叶斯和复合可能性方法的组合来隔离估计优势比的估计，以及它如何随着预测变量的函数而变化 - 而无需估计次要利益的参数，例如均值或临时自发性误差参数。在此框架内，我们将确定增加/降低物质使用和相关负面行为之间合并症水平的因素，以及这些关系如何随着年龄的增长而变化。