National Study of Risk Factors for Adolescent Drug Use

近年来，了解和预防青少年药物使用和其他健康风险行为的战略越来越多地体现在风险和保护因素框架中。基于这一框架的流行病学预防方法需要评估个人或群体的风险和保护因素水平，然后选择和实施将有效降低风险因素升高和/或加强保护因素的具体战略。虽然过去二十年来的研究已经确定了青少年使用药物的许多相互关联的风险因素，但很少有研究同时以具有全国代表性的大样本审查了一系列全面的假定风险和因素。由于这些研究在目标人群、样本量、测量方法和其他方法学特征方面存在差异，对先前研究结果的整合受到了阻碍。拟议的研究旨在通过对青少年家庭人口及其父母进行单一的、具有全国代表性的横断面调查，并检查跨多个领域的一套全面的假设风险因素，来提高我们对青少年药物使用风险因素的理解。为此，我们将利用1999年全国药物滥用家庭调查（NHSDA）。NHSDA的大样本将使研究人员能够评估风险/保护因素与广泛的物质和物质使用阶段的物质使用之间的关系，并检查这些关系如何随年龄、性别、种族/民族群体和其他人口变量而变化。多元逻辑建模程序将应用于这些目的。尽管1999年NHSDA的横断面性质排除了对待调查关系中变量的时间顺序的明确评估，但拟议的研究将提供一个强有力的经验基础，在此基础上建立广泛的风险和保护因素与青少年物质使用行为之间存在、强度和稳健性的关联。

Strategies for understanding and preventing adolescent substance use and other health risk behaviors have in recent years become increasingly couched in a risk and protective factor framework. Epidemiologically- based prevention approaches rooted in this framework seel to assess the levels of risk and protective factors in individuals or groups and then select and implement specific strategies that will effectively reduce elevated risk factors and/or enhance protective factors. Although research has identified numerous and interrelated risk factors for substance use among youth over the past two decades, very few studies have simultaneously examined comprehensive sets of putative risk and factors with large and nationally representative samples. The integration of findings from prior studies has been hampered by differences across these studies with respect to their target populations and sample sizes, measures, and other methodological features. The proposed study seeks to advance our understanding of risk factors for adolescent substance use by utilizing a single, nationally representative cross-sectional survey of the adolescent household population and their parents and examining a comprehensive set of hypothesized risk factors across multiple domains. We will utilize the 1999 National Household Survey on Drug Abuse (NHSDA) for this purpose. The large NHSDA sample will enable the investigators to assess the relationship between risk/protective factors and substance use for a broad range of substances and stages of substance use, and to examine how these relationships vary by age, gender, racial/ethnic group, and other demographic variables. Multivariate logistic modeling procedures will be applied for these purposes. Although the cross-sectional nature of the 1999 NHSDA precludes definitive assessment of temporal ordering of the variables within the relationships to be investigated, the proposed study will provide a strong empirical basis on which to establish the existence, strength, and robustness of the associations between an expansive set of risk and protective factors and adolescent substance use behaviors.