Drug Use and Sexual Risk Behaviors Among Emerging Adults in the ER

急诊室新成人的吸毒和性危险行为

基本信息

批准号：
9317453
负责人：
Erin E. Bonar
金额：
$ 19.01万
依托单位：
UNIVERSITY OF MICHIGAN AT ANN ARBOR
依托单位国家：
美国
项目类别：
财政年份：
2013
资助国家：
美国
起止时间：
2013-08-01 至 2018-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9317453
关键词：
Accident and Emergency department Address Adolescent Adult Affect African African American Age Alcohol consumption Alcohol or Other Drugs use Alcohols Area Behavior Car Phone Centers for Disease Control and Prevention (U.S.)Characteristics Childhood Cognition Cognitive Communication Communities Community Healthcare Computers Control Groups Data Data Collection Development Drug Prescriptions Drug usage Elements Emergency Department-based Intervention Emergency department visit Enhancement Technology Enrollment Evaluation Event Female Gender Goals Grant HIV HIV Infections HIV risk Healthcare Human immunodeficiency virus test Illicit Drugs Incidence Individual Injection of therapeutic agent Injury Intervention Intoxication K-Series Research Career Programs Knowledge Lead Learning Marijuana Measures Medical Medicine Mentors Mentorship Motivation Multiple Partners Participant Patient Self-Report Patients Pharmaceutical Preparations Pharmacology Prevention Preventive Preventive Intervention Primary Health Care Privacy Process Prospective Studies Provider Randomized Randomized Controlled Trials Reading Recruitment Activity Reporting Research Research Training Resources Risk Risk Behaviors Risk Reduction Safe Sex Sampling Self Efficacy Series Sexually Transmitted Diseases Surveys Techniques Technology Testing Text Time Training Underinsured United States National Institutes of Health age group base behavior influence brief intervention career college comparison group condoms effective intervention efficacy testing emerging adult follow up assessment follow-up human subject injection drug use intervention program male motivational enhancement therapy novel patient oriented research programs prospective reduced substance use responsible research conduct sex sex risk skills social social cognitive theory stem therapy design transmission process treatment as usual trial design university student

项目摘要

This mentored career development award seeks to combine a program of focused research, mentorship, and didactics to provide advanced training which will facilitate my transition into an independent patient-oriented research career focusing on developing, delivering, and evaluating technology-enhanced interventions targeting substance use (including illicit drugs and non-medical use of prescription drugs) and HIV risk reduction (HIV-related sexual risk behaviors [HIV SRBs]; e.g., inconsistent condom use, multiple partners, sex while intoxicated; and prevention of injection drug use) among at-risk emerging adults (EAs). Research regarding substance use and HIV SRBs among EAs has generally focused on alcohol use among college students from campus settings; however, substance use and HIV (and other associated Sexually Transmitted Infections) disproportionately occur among young people living in urban, low-resource communities, particularly African Americans. At the daily and event-level, substance use and HIV SRBs may be influenced by social cognitive factors (e.g., motivations for substance use/HIV SRBs, self-efficacy to engage in safe sex/not use substances) in addition to the pharmacology of specific substances. However, daily process data focusing on social cognitive factors, substance use, and HIV SRBs among EAs, especially those from noncampus settings, is lacking, yet would be highly informative to the development of tailored substance use and HIV risk reduction brief interventions for EAs. The Emergency Department (ED) is a critical venue for accessing at-risk EAs engaging in substance use and HIV risk behaviors. Research shows high rates of substance use and HIV SRBs among EA patients in the ED, yet no intervention exists for EAs in this setting. The ED may be the only opportunity to intervene with these young people because EAs in urban, low-resource settings often lack a primary care provider during the transition from pediatric to adult medicine, may be un-insured or under-insured, and may not be involved in a traditional college campus setting. Further the use of technology (e.g., mobile phones) is relatively ubiquitous among this age group, and most prefer technology-based communication (e.g., text messaging), therefore interventions for EAs may be enhanced by this type of technology. My career goals are to develop expertise: 1) in the use of technology to assess daily relationships between social cognitive factors, substance use (i.e., illicit drugs, including injection, and non-medical use of prescription drugs), and HIV SRBs among EAs; and 2) in the development and evaluation of substance use and HIV SRB interventions, applicable in low-resource community and healthcare settings such as the urban ED, through the integration of novel technologybased communication. Aims of the proposed training plan are to: 1) Increase knowledge of the content areas of social cognitive factors, substance use, HIV SRBs, and related consequences (e.g., HIV/STI, injury) among EAs, 2) Learn techniques for using technology to assess and analyze daily-level data regarding social cognitive factors, substance use, and HIV SRBs among EAs, 3) Acquire skills to develop, implement, and evaluate a technology-augmented intervention for substance use and HIV SRBs among EAs in the ED, and 4) Further training in the responsible conduct of research with human subjects. These training aims are closely aligned with specific research aims: 1) Among EAs recruited from an ED setting, conduct prospective, longitudinal, daily data collection using mobile text message-based assessment for substance use (i.e., illicit drugs and prescription drugs used non-medically)and HIV risk behaviors (primarily SRBs, but also injection drug use) including measuring critical social cognitive factors that may underlie the relationships between substance use and HIV risk (e.g., motives for substance use/risky sex, self-efficacy related to condom use), and 2) Based on findings from the prospective study conducted in research Aim 1, develop and pilot test a tailored intervention (e.g., substances used, partner type, social cognitive factors, and gender) for EA patients in the ED focusing on reducing substance use and HIV SRBs, which will be enhanced through the use of mobile phone text messages targeting substance use and HIV SRBs. I will accomplish these research and training goals through close mentorship from a team with expertise in these content areas, didactic coursework, and directed readings.

这个指导的职业发展奖旨在结合一个集中的计划研究，指导和教学法提供高级培训，这将有助于我过渡到独立的面向患者的研究职业，重点是发展，交付和评估针对药物使用的技术增强干预措施（包括非法药物和处方药的非医学使用）和降低HIV风险（与HIV相关的性风险行为[HIV SRB]；例如，使用避孕套不一致，多重伴侣，醉酒时性行为；并防止注射药物使用）新兴成年人（EA）。 EA中有关药物使用和HIV SRB的研究通常专注于校园环境中大学生的饮酒；但是，药物使用和艾滋病毒（以及其他相关的性传播感染）居住在城市，低资源社区中的年轻人中的不成比例发生，特别是非裔美国人。在日常和事件级，物质使用和艾滋病毒 SRB可能受社会认知因素的影响（例如，实质动机使用/艾滋病毒SRB，自我效能感从安全性/不使用物质）。特定物质的药理学。但是，每天关注社会的过程数据 EA中的认知因素，药物使用和HIV SRB，尤其是非坎普的认知因素缺乏设置，但对于发展量身定制的药物使用和HIV风险降低了EA的简短干预措施。这急诊室（ED）是访问高风险EA的关键场所药物使用和艾滋病毒风险行为。研究表明，使用物质使用率很高， ED患者中的EA患者中的HIV SRB，但在这种情况下不存在EAS的干预措施。 ED可能是与这些年轻人进行干预的唯一机会，因为EAS 在城市中，低资源环境通常在过渡期间缺乏初级保健提供者从小儿到成人药物，可能没有保险或没有保险，并且可能不是参与传统的大学校园环境。进一步使用技术（例如，手机）在这个年龄段中相对无处不在，最喜欢基于技术的沟通（例如，文本消息传递），因此EAS的干预措施这种类型的技术可能会增强。我的职业目标是发展专业知识： 1）使用技术评估社会认知因素之间的日常关系，药物使用（即非法药物，包括注射和非医学使用处方毒品）和EA中的HIV SRB； 2）在开发和评估中药物使用和HIV SRB干预措施，适用于低资源社区，通过集成基于新技术沟通。拟议培训计划的目的是：1）增加知识社会认知因素，物质使用，HIV SRB及相关的内容领域 EAS中的后果（例如HIV/STI，伤害），2）学习用于使用的技术评估和分析有关社会认知因素的每日数据的技术， EAS中的药物使用和HIV SRB，3）获得开发，实施和实施技能评估技术使用技术的干预措施，并在 EAS中的EAS和4）进一步培训与人类的负责任进行研究主题。这些培训目标与特定的研究目的紧密一致：1） EAS从ED环境，导致前瞻性，纵向，每日数据收集招募使用基于移动文本的信息评估用于物质使用（即非法药物和处方药在非医疗上使用）和HIV风险行为（主要是SRB，也是注射药物的使用）包括测量可能是基础的关键社会认知因素物质使用和艾滋病毒风险之间的关系（例如，物质动机使用/有风险的性，与使用避孕套有关的自我效能）和2）根据来自在研究目标1中进行的前瞻性研究，开发和试点测试量身定制干预（例如，使用的物质，伴侣类型，社会认知因素和性别）对于ED的EA患者，专注于减少药物使用和HIV SRB，这将通过使用针对物质使用的手机短信来增强和HIV SRB。我将通过接近完成这些研究和培训目标来自具有专业知识的团队的指导，在这些内容领域，教学课程和定向阅读。