Understanding college drinking: Assessing dose response from survey self-reports
Understanding college drinking: Assessing dose response from survey self-reports
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DOI：
10.15288/jsa.2003.64.500
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发表时间：
2003-07-01
期刊：
影响因子：
--
通讯作者：
Saltz, RF
中科院分区：
文献类型：
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作者：
Gruenewald, PJ;Johnson, FW;Saltz, RF
目的：酒精研究人员面临的最困难的挑战之一是评估与特定饮酒水平（一杯，两杯或三杯或更多）相关的特定风险。在这篇文章中，提出了一种基于模型的方法，提供了具体的措施，剂量，暴露和风险有关的饮酒，并使充分评估的剂量-反应关系，使用调查数据。方法：从2,102名大学生中收集的关于饮酒模式和相关问题的调查数据使用数学模型进行了分析，该模型为每个受访者提取了可分离的剂量（每次饮酒的次数）和暴露（次数）。估计了二次风险模型的约束类，其将每个剂量的暴露单位（例如，喝五杯饮料的次数）到问题结果（例如，宿醉次数）。由此产生的剂量-反应函数提供了在给定饮酒水平下每次饮酒时产生的问题的估计率。通过重新整合剂量反应与饮酒暴露的人群分布来估计人群风险。结果如下：饮酒暴露在大学饮酒者中的分布在两种饮料的模态剂量下明显达到峰值，人口统计学群体之间的轻度和重度饮酒存在差异。多变量分析显示，重度饮酒的相对比例在白色男性新生中最大，与居住环境无关。大多数饮酒问题表现出明显的剂量反应关系的饮酒水平。然而，人群风险通常是单峰的，许多问题报告在适度饮酒水平（两到三杯）。结论：分布在大量饮酒者和饮酒场合，学生报告的问题最常发生在适度饮酒水平（两到三杯）。然而，大量饮酒仍然与许多饮酒问题有实质性的关系。这些观察结果鼓励大学饮酒的观点，支持与中度和重度饮酒相关的干预措施。
Objective: One of the most difficult challenges confronting alcohol researchers is the assessment of specific risks associated with specific drinking levels (one, two or three or more drinks). In this article, a model-based method is presented that provides specific measures of dose, exposures and risks related to drinking and enables adequate assessment of dose-response relationships using survey data. Method: Survey data collected from 2,102 college students on drinking patterns and related problems were analyzed using a mathematical model that extracts separable measures of dose (number of drinks consumed per occasion) and exposures (numbers of occasions) for every respondent. A constrained class of quadratic risk models was estimated that relates units of exposure at each dose (e.g., number of occasions drinking five drinks) to problem outcomes (e.g., number of hangovers). The resulting dose-response functions provided an estimate of the rate of problems produced on each occasion of drinking at a given drinking level. Population risks were estimated by reintegrating dose response with the population distribution of drinking exposures. Results: The distribution of drinking exposures among college drinkers was markedly peaked at a modal dose of two drinks, with variations in light and heavy drinking between demographic groups. Multivariate analyses showed that relative rates of heavier drinking were greatest among white male freshmen and unrelated to residential settings. Most drinking problems showed a marked dose-response relationship to drinking levels. Population risks, however, were typically unimodal, with many problems reported at moderate drinking levels (two or three drinks). Conclusions: Distributed across a large number of drinkers and drinking occasions, problems reported by students occurred most often at moderate drinking levels (two to three drinks). Nevertheless, heavier drinking remained substantively related to many drinking problems. These observations encourage a view of college drinking that supports interventions related to both moderate and heavy drinking.