Cross-National Analysis of Alcohol and Injury

拟议项目正在请求资金来合并和分析世界卫生组织 (WHO) 酒精与伤害合作研究的数据，该研究目前正在 11 个国家的急诊室 (ER) 进行，数据来自 33 个急诊室 (仅覆盖 8 个国家)，目前正在酒精研究小组的中心资助下进行分析。 将世卫组织研究的数据添加到现有的合并数据集中，将汇集现有的仅有的两个关于酒精和伤害的数据集（两者都使用类似的数据收集方法和调查问卷），将使伤害案件的数量从 5,274 件增加一倍至 10,774 件，并增加全球地理覆盖范围的国家代表性。 将 WHO 数据添加到目前正在分析的数据中，将增强研究目标，超出目前可以解决的范围，如下：1）更多的伤害案例将有助于进行更细粒度的估计，并使我们能够确定酒精相关伤害发生率和伤害风险以及相关变量随时间和地点的估计的稳定性，因为 8 个国家的数据涵盖 12 年的时间跨度，并且地理范围更有限，而 WHO 数据将全部在六个月内收集并实现全球覆盖； 2) 这些估计也将通过将数据限制在受伤后六小时内到达急诊室的数据而得到加强，这将减少对事件中饮酒和相关变量的回忆中的偏差； 3) 纳入背景数据（社会文化和组织/行政变量，这些变量并未作为最初的 WHO 研究的一部分收集）的分析潜力可以最大化，作为酒精与伤害关联的重要解释因素，涵盖 17 个国家的 44 个 ER 站点； 4) 将提供机会对与 a) 酒精中毒临床评估的有效性和 b) 用于识别 ER 患者饮酒问题的简单筛查工具的性能相关的背景变量的影响进行新的分析（现有数据不可能）。元分析技术将用于检查 ER 站点之间基于个人的关系的一致性。 因果建模和层次线性建模将用于检查上下文变量与个体和事件级别变量对关系的独立影响和交互影响。 诸如此处提出的跨国分析将为美国的酒精伤害关系提供信息，因为美国由许多微观文化组成，这些文化反映了在收集这些数据的许多国家中占主导地位的社会文化和组织/行政背景变量。

The proposed project is requesting funding to merge and analyze data from the World Health Organization (WHO) Collaborative Study of Alcohol and injuries, currently underway in emergency rooms (ERs) in 11 countries, with data from 33 ER sites, which cover only eight countries, and is presently being analyzed under the Alcohol Research Group's Center Grant. The addition of data from the WHO study to the existing merged data set will bring together the only two such data sets of alcohol and injury in existence (both of which used a similar methodology and questionnaire for data collection), and would double the number of injury cases from 5,274 to 10,774, as well as increase country representation to geographic coverage worldwide. The addition of the WHO data to those presently being analyzed will enhance research aims beyond that which can presently be addressed as follows: 1) the larger number of injury cases will facilitate more fine-grained estimates and allow us to determine the stability of estimates regarding the prevalence of alcohol- related injury and risk of injury and related variables, over time and place, since the 8-country data cover a temporal span of 12 years, and is more limited geographically, while the WHO data will all have been collected within a six-month period and achieves global coverage; 2) these estimates will also be enhanced by restriction of the data to those arriving at the ER within six hours of the injury, which will reduce bias in the recall of drinking-in-the-event and related variables; 3) the analytic potential of inclusion of contextual data (socio- cultural and organizational/administrative variables which were not collected as part of the original WHO study) can be maximized as important explanatory factors in associations of alcohol and injury, across 44 ER sites in 17 individual countries; 4) the opportunity will be provided for new analyses (not possible with the data on hand) of the influence of contextual variables related to a) the validity of clinical assessment of alcohol intoxication, and b) the performance of a brief screening instrument for identifying problem drinking among ER patients. Meta-analytic techniques will be used to examine the consistency of individual-based relationships across ER sites. Causal modeling and hierarchical linear modeling will be used to examine the independent effects and interactive effects of contextual variables with individual-and event-level variables on relationships. Cross-national analyses such as those proposed here will inform the alcohol-injury nexus in the U.S., since the U.S. is composed of many micro-cultures which reflect the socio- cultural and organizational/administrative contextual variables dominating many of the countries in which these data were collected.