Initiation and Progression through Early Drinking Milestones in Underage Drinkers

未成年饮酒者早期饮酒里程碑的开始和进展

• 批准号: 8137151
• 负责人: Kristina Melia Jackson
• 金额: $ 74.09万
• 依托单位: BROWN UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-09-30 至 2013-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8137151
• 关键词: 21 year old; Academic achievement; Acceleration; Address; Adolescent; Age; Alcohol abuse; Alcohol consumption; Alcohol dependence; Alcohol or Other Drugs use; Behavior; Characteristics; Complement; Development; Event; Exhibits; Expectancy; Feeling; Goals; Growth; Health behavior; Heavy Drinking; Individual; Individual Differences; Knowledge; Leisure Activities; Maintenance; Maps; Mental Health; Modeling; Nature; Outcome; Population; Prevention; Prevention strategy; Problem behavior; Recruitment Activity; Regulation; Research; Research Personnel; Rhode Island; Risk; Risk Factors; Sampling; Schools; Secondary Schools; Severities; Staging; Survival Analysis; Techniques; Theoretical model; Time; United States; Youth; adverse outcome; alcohol involvement; alcohol related problem; alcohol risk; alcohol use disorder; alcohol use initiation; binge drinking; career; drinking; early alcohol use; early drinking; early onset; emotional distress; experience; family influence; high risk drinking; improved; legal drinking age; meetings; multilevel analysis; peer influence; physical conditioning; prognostic; public health relevance; response; theories; underage drinker; underage drinking; underage drinking reduction

DESCRIPTION (provided by applicant): Although the legal drinking age in the United States is age 21, underage drinking is highly prevalent. Early onset of alcohol use is associated with increased risk of a number of subsequent adverse outcomes, including later heavy or problem drinking, likelihood of developing an alcohol use disorder, other substance involvement, and behavioral problems. Yet, there is a gap in our knowledge regarding what happens between first drink and the development of alcohol-related problems. Most research fails to characterize the very early course of alcohol involvement as it unfolds. The goal of the proposed study is to explore characteristics of the early drinking career including sequencing of, attainment of, and progression through what we term "drinking-related milestones." These include landmark events such as ever drinking, feeling high or drunk, regular drinking, binge drinking, and experience of alcohol-related problems of varying severity. The normative ordering of and progression through early drinking milestones will be described, with consideration of inter- and intra-individual variability. Because the importance of given risk factors and moderating influences may vary according to the stage of an individual's drinking trajectory, we will explain inter-individual differences in intra-individual change by determining the influence of individual (e.g., behavior regulation, expectancies, leisure activity) and contextual (e.g., family and peer influence, availability of alcohol) risk factors on onset and progression. Examination of these risk factors will be guided by an overarching theoretical model that draws on theories of substance use and health behavior. In addition, we will explore the extent to which both early initiation of alcohol use and a course characterized by rapid progression are associated with various outcomes such as academic achievement, substance use, and alcohol problems. To address these aims, 1,000 6th through 8th graders recruited from Rhode Island secondary schools will be assessed over a three-year period using a combination of relatively intensive (i.e., frequent) assessments of a narrow focus complemented by less frequent assessments that are broader in terms of content. The sample will be enriched by oversampling youth at risk for drinking. Specific aims will be addressed primarily using techniques of item response theory modeling, multilevel modeling, survival analysis, latent growth modeling, and latent transition analysis. When the specific aims are met, we will better be able to understand the prognostic significance of age of first drink and we will be able to isolate the unique influence of early drinking course on adverse outcomes. The proposed study will permit researchers to accurately pinpoint the stage at which an adolescent first exhibits risk for problematic drinking. The current application offers a more nuanced study that will finely map what happens between initiation and later use. Our findings will inform prevention efforts by identifying modifiable stage- specific risk factors for progression, maintenance, and regression (or desistence) of drinking during adolescence. Public Health Relevance: Early use of alcohol is associated with increased risk of a number of subsequent adverse outcomes, including heavy or problem drinking, likelihood of developing an alcohol use disorder, other substance involvement, and behavioral problems. It is only by understanding the early course of alcohol use that we can implement successful prevention strategies to reduce underage drinking and ultimately improve the mental and physical health of our population.

描述（由申请人提供）：尽管美国的合法饮酒年龄为21岁，但未成年人饮酒非常普遍。早期饮酒的早期发作与随后发生多种不良后果的风险增加有关，包括后来的大量或饮酒问题，患者使用饮酒障碍，其他物质参与以及行为问题的可能性。然而，关于第一次饮料和与酒精有关的问题的发展之间发生的情况，我们的知识存在差距。大多数研究未能表征其不断发展的早期酒精参与过程。拟议的研究的目的是探索早期饮酒职业的特征，包括对我们称为“饮酒相关的里程碑”的测序，成就和进步。其中包括具有里程碑意义的事件，例如饮酒，高温或醉酒，定期饮酒，暴饮暴食以及与酒精有关的严重性问题的经历。考虑到个体间和个体内变异性，将描述通过早期饮酒里程碑的规范顺序和进展。由于给定的危险因素和调节影响的重要性可能会根据个人饮酒轨迹的阶段而有所不同，因此我们将通过确定个人（例如行为调节，期望，休闲活动）和上下文（例如，家庭和peer和家人的影响，酒精的可用性，酒精的可用性）的风险因素和进步的风险因素和良好的风险因素和构成正面的风险因素，通过确定个人（例如行为调节，期望，休闲活动）的影响来解释个体内部变化的个体差异。这些危险因素的检查将由一个总体理论模型来指导，该模型借鉴了药物使用和健康行为的理论。此外，我们将探讨早期饮酒和以快速发展为特征的课程的程度与各种结果有关，例如学术成就，使用物质和酒精问题。为了解决这些目标，将在三年的时间内评估从罗德岛中学招募的1,000至8年级学生，使用相对密集的（即频繁）评估狭窄的焦点，并通过内容较少的评估来补充。该样本将通过过度采样的饮酒风险来丰富样本。具体目标将主要使用项目响应理论建模，多级建模，生存分析，潜在生长建模和潜在过渡分析的技术来解决。当满足具体目标时，我们将最好能够理解第一次饮料时代的预后意义，并且我们将能够隔离早期饮酒课程对不良结果的独特影响。拟议的研究将允许研究人员准确地指出青少年首次表现出有问题饮酒风险的阶段。当前的应用程序提供了一项更加细微的研究，可以很好地绘制启动和以后使用之间发生的情况。我们的发现将通过确定青春期饮酒的进展，维持和回归（或避免）的可修改阶段特定风险因素来为预防工作提供依据。公共卫生相关性：早期使用酒精与随后发生多种不良后果的风险增加，包括大量或饮酒问题，患者使用饮酒障碍，其他物质参与以及行为问题。只有通过了解早期的饮酒过程，我们才能实施成功的预防策略，以减少未成年人的饮酒并最终改善我们人口的身心健康。