Mediators and Moderators of a Neighborhood Experiment on Alcohol Use

邻里酒精使用实验的中介者和调节者

基本信息

批准号：
9212070
负责人：
THERESA LOUISE OSYPUK
金额：
$ 18.3万
依托单位：
UNIVERSITY OF MINNESOTA
依托单位国家：
美国
项目类别：
财政年份：
2016
资助国家：
美国
起止时间：
2016-02-01 至 2019-01-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9212070
关键词：
Adolescence Adolescent Adult Adverse effects Affect Alcohol consumption Alcohol dependence Alcohol or Other Drugs use Alcohols Child Childhood Cities Complement Crime Data Data Analyses Data Compromising Data Set Dependence Development Disease Economics Elements Exhibits Experimental Designs Exposure to Family Female Female Adolescents Foundations Fright Health Heavy Drinking Household Heads Housing Individual Intervention Investments Knowledge Lead Life Low income Machine Learning Male Adolescents Mediating Mediation Mediator of activation protein Mental Health Methods Minority Modeling Modification Mothers Neighborhoods Outcome Outcome Measure Pathway interactions Pharmaceutical Preparations Policies Population Poverty Randomized Research Research Personnel Residential Mobility Risk Safety Sampling Shapes Son Stress Subgroup Techniques Testing Translations Victimization Weight Youth alcohol availability alcohol prevention base boys contextual factors density of AOD outlets design drinking early drinking excessive drinking in adolescence experience experimental study follow-up girls innovation learning strategy low socioeconomic status lower income families next generation novel public health relevance secondary analysis social therapy design transmission process underage drinking volunteer voucher

项目摘要

DESCRIPTION (provided by applicant): Excessive drinking in adolescence disrupts healthy development and leads to adverse social, economic and health consequences later in life. Although existing research focuses primarily on individual-level causes, neighborhood context is increasingly recognized as an upstream determinant of alcohol use. Yet since most prior neighborhood research on health has not been experimental, it is potentially biased, and weakens the foundation for policy translation. Our study proposes a secondary analysis of newly-available data from a social experiment of voluntary neighborhood relocation using housing vouchers in 5 cities (the Moving to Opportunity, MTO, Study), to test whether, how, and why random assignment of an offer to move to a low- poverty neighborhood over a 15 year period influenced the alcohol use, excessive drinking, and alcohol dependence of adolescents and their mothers. We will complement existing data with additional neighborhood- level data to enrich the dataset and test multilevel hypotheses. MTO is the only available large-scale study that has randomly assigned families to receive different neighborhood housing contexts, to support strong causal inferences of how early-life neighborhood context shapes alcohol use. When launched, MTO was one of the most promising policies to reverse the damaging effects of neighborhood poverty for minority families. But health researchers have had limited access to MTO data, compromising the scientific payoff of the $70+ million investment. Since residential mobility experiments like MTO are rare, expensive, and since MTO profoundly affected substance use, it is crucial to probe its effects. We propose new secondary data analyses with newly available 15 year follow-up data from this RCT, using novel methods to test mediation and moderation, applied to alcohol outcome measures that have not been examined prior. We apply innovative methods for assessing mediation (i.e., weight-based causal methods) and effect modification (i.e., machine learning techniques). Aside from the RCT design for strong causal inference of how early-life neighborhood changes influence excessive drinking, we also leverage one of the few longitudinal intervention designs sampling both mothers and their children, to illuminate familial transmission of drinking as it emerges in adolescence. Our R21 project builds on a productive, interdisciplinary team, experienced with the MTO study, and proposes 3 aims: to test how moving to a low-poverty neighborhood in the MTO experiment influenced excessive drinking and alcohol dependence; to examine if the MTO experimental effect on excessive drinking and alcohol dependence was less beneficial for more vulnerable families; to test whether effects of moving to a low-poverty neighborhood in MTO for excessive drinking and alcohol dependence were mediated by individual-level stress; family-level context; or neighborhood-level stress, alcohol availability, or alcohol norms. The results will enrich our understanding of neighborhood and family context as a cause of excessive drinking and alcohol use in adolescents and adults, and inform the next generation of alcohol prevention policy.

描述（由适用提供）：青少年过量饮酒会破坏健康的发展，并导致生活后期不利的社会，经济和健康后果。尽管现有的研究主要集中在个人级别的原因上，但越来越多的邻里环境被认为是饮酒的上游。然而，由于在邻里对健康的大多数研究之前都没有实验性研究，因此它可能存在偏见，并削弱了政策翻译的基础。我们的研究提议对5个城市的住房优惠券（迁移到机会，MTO，研究）的社会实验进行了对新可用数据的次要分析，以测试是否，如何以及为何随机分配要约在15年内转移到低矮的社区，从而影响了饮酒，饮酒，饮酒，饮酒，饮酒，饮酒，以及他们的饮酒，他们的饮酒，他们的饮酒和依赖性，他们的饮酒和依赖性人数过多。我们将使用其他邻里级别数据补充现有数据，以丰富数据集并测试多级假设。 MTO是唯一一项随机分配家庭接受不同邻里住房环境的大型研究，以支持对早期居民如何塑造酒精饮酒的强烈因果推断。推出时，MTO是扭转社区贫困对少数族裔的破坏性影响的最有前途的政策之一。但是健康研究人员获得了MTO数据的访问量有限，这损害了700亿美元投资的科学回报。由于MTO这样的居民流动性实验稀有，昂贵，并且由于MTO对药物的影响深远，因此对于探测其影响至关重要。我们提出了新的二级数据分析，并使用该RCT的新可用的15年随访数据，使用新颖的方法来测试调解和适度，应用于尚未在未经研究的酒精结局指标上进行。我们应用创新方法来评估中介（即基于体重的因果方法）和效果修改（即机器学习技术）。除了针对早期生活变化如何影响过量饮酒的RCT设计，除了有力的因果推断外，我们还利用了少数几种纵向干预设计来取样母亲及其子女，以阐明青少年饮酒的家庭传播。我们的R21项目建立在MTO学习的富有成效的跨学科团队的基础上，并提出了3个旨在：测试MTO实验中迁移到低贫困社区的如何影响饮酒和酒精依赖性；检查MTO对过度饮酒和酒精依赖的实验作用是否对更脆弱的家庭有益；为了测试迁移到MTO中饮酒和酒精依赖性过多的贫困邻里的影响是否是由个体水平的压力介导的；家庭级别的背景；或邻居级别的压力，酒精供应或酒精规范。结果将使我们对邻里和家庭环境的理解丰富，这是青少年和成年人过量饮酒和饮酒的原因，并为下一代预防酒精的政策提供了信息。