Building the evidence for adolescent substance use preventive care at well-visits from mid-adolescence to young adulthood using the longitudinal NEXT study

使用纵向 NEXT 研究，为从青春期中期到成年早期的访视建立青少年药物使用预防护理的证据

• 批准号: 10642111
• 负责人: Arik V Marcell
• 金额: $ 10万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-04-01 至 2025-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10642111
• 关键词: Building; evidence; adolescent; substance; use

ABSTRACT Substance use (SU) is one of the most common causes of preventable death, injury, and disability, yet we currently have evidence gaps for the benefit of SU preventive care for adolescents in primary care. Given the median onset age for trying substances is under age 15, clinicians need to ask and advise adolescents about SU throughout adolescence. We know little about the extent to which substance using adolescents are engaged in well-visits over time, the proportion of adolescents who are asked and advised annually about SU at well-visits over time, and the extent to which being asked and advised about SU during adolescence is related to future SU initiation prevention or reduction over time. The proposed study’s goals are to examine longitudinal associations of adolescents’ SU preventive care and SU behaviors from mid-adolescence through young adulthood and disparities in SU preventive care by adolescents’ background, social determinant, and other health need factors. We hypothesize that adolescents being asked and advised about smoking, alcohol, and other drug use at well-visits will be associated with subsequent prevention of SU initiation in non-users and SU reduction in prior users. We will address this research gap by conducting longitudinal data analyses using the NIH NEXT Study collected from 2010-2017 (ages 15-23). This proposal expands on our prior work which showed most adolescents were engaged in well-visits from ages 5-9 (mid-childhood) through 10-17 (mid- adolescence). Building on these findings, our specific aims are to: 1) document the extent to which substance using adolescents are engaged in well-visits over time, 2) describe how often adolescents are regularly asked and advised about each and all three SU types over time, and 3) examine the extent to which being asked and advised about SU is related to subsequent SU initiation prevention or reduction over time, and describe across aims disparities by adolescents’ background, social determinant, and other health need factors. INNOVATION: Our proposed project will be the first study to examine longitudinal associations of adolescents’ preventive care receipt about SU and SU behaviors from adolescence through young adulthood, notorious times for SU onset and well-visit decline, using analytic approaches that have not been used in the field of adolescent health services research. We will use an existing non-clinical based national longitudinal dataset that has measured longitudinal data on well-visits, SU behaviors, and SU preventive care receipt across developmental periods. This type of rich data has never been previously used to inform practice. PUBLIC HEALTH SIGNIFICANCE: Our study will identify vulnerable adolescents for outreach who are persistently not engaged or become disengaged from well-visits and among those engaged who have missed SU preventive care opportunities. Findings will identify the extent to which being asked and advised about SU at well-visits occurs from adolescence to young adulthood and demonstrate the longitudinal benefit of SU screening and advising during adolescence on young adulthood SU, contributing to quality of evidence that is currently lacking.

抽象的 药物使用 (SU) 是可预防的死亡、伤害和残疾的最常见原因之一，但我们 鉴于初级保健中 SU 预防性护理对青少年的益处，目前尚缺乏证据。 尝试药物的中位发病年龄在 15 岁以下，需要通过扩音器向青少年询问并提供相关建议 我们对青少年使用药物的程度知之甚少。 随着时间的推移，参与健康访问的青少年每年被询问和建议有关 SU 的比例 随着时间的推移，被询问和建议有关 SU 的程度 与未来 SU 启动预防或随着时间的推移减少相关。拟议研究的目标是检查。 青少年的 SU 预防保健和从青春期中期到 SU 行为的纵向关联 青少年的背景、社会决定因素和青少年的成年早期以及 SU 预防保健方面的差异 我们力求向青少年询问有关吸烟、饮酒、 和其他药物在井访视时的使用将与随后预防非使用者中 SU 的启动有关， 我们将通过使用纵向数据分析来解决这一研究差距。 NIH NEXT 研究收集自 2010 年至 2017 年（15 岁至 23 岁）。该提案扩展了我们之前的工作。 研究表明，大多数青少年从 5-9 岁（童年中期）到 10-17 岁（中期）都参与过良好的探访。 基于这些发现，我们的具体目标是：1）记录物质的程度。 使用青少年随着时间的推移进行的良好访问，2) 描述青少年被定期询问的频率 并随着时间的推移就所有三种 SU 类型提供建议，以及 3) 检查被询问的程度以及 关于 SU 的建议与随后的 SU 启动预防或随着时间的推移减少有关，并描述 针对青少年背景、社会决定因素和其他健康需求因素的差异： 我们提出的项目将是第一个研究青少年预防保健纵向关联的研究 关于 SU 和从青春期到成年早期的 SU 行为的收据，SU 出现的臭名昭著的时期 使用尚未在青少年健康领域使用过的分析方法来减少访问量下降 我们将使用已测量的现有非临床国家纵向数据集。 有关健康访问、SU 行为和跨发育时期 SU 预防性护理接受情况的纵向数据。 此类丰富的数据以前从未用于指导实践。 我们的研究将确定弱势青少年进行外展活动，这些青少年一直没有参与或成为 脱离健康探访的人以及错过 SU 预防性护理机会的参与人员。 调查结果将确定在井访时被询问和建议有关 SU 的程度 青春期到青年期，并展示 SU 筛查和建议的纵向效益 青春期对青年期的 SU，有助于提高目前缺乏的证据质量。