Alcohol, firearms, and adolescent gunshot injury risk

描述（由申请人提供）：枪伤是10-19岁非洲裔美国男性的主要死因，也是青少年总体死亡的第二大原因。大多数被枪杀的青少年是在袭击中被枪杀的（60%），每一次致命的枪击袭击，就有7名青少年需要急诊科（艾德）治疗非致命的袭击性枪击创伤。此外，每天有70多名青少年因非枪支武器造成的非致命性攻击性伤害需要艾德治疗。然而，对青少年中枪支和其他武器造成的攻击性伤害的流行病学知之甚少。通过使用流行病学时空建模方法，我们开发并试点测试了一种创新的便携式技术，用于动态映射青少年的活动，从而可以非常准确地估计他们每分钟接触酒精和枪支的情况。为了确定枪伤风险，我们建议进行一项基于人群的病例对照研究。将在费城市中心2家医院的艾德急诊室就诊的10-19岁青少年与随机选择的10-19岁对照受试者进行比较。作为次要目的，非枪击伤害的青少年将被招募为第二个病例组，并与相同样本的对照受试者进行比较，以确定非枪支伤害的风险。将使用便携式计算机绘图技术对每例病例和对照受试者进行访谈，以创建一个动态图形，该图形提供受试者在受伤当天（病例）或1-4天前随机指定（对照）如何、何时、与谁以及在何处行走或以其他方式从一个地点到另一个地点和从一项活动到另一项活动的记录。每个受试者将被问及他或她当天使用酒精和枪支的情况，以及他或她周围的其他人当天如何使用酒精和枪支（例如，人们在街角喝酒;枪支放在家里）。我们将沿着叙述性数据链接到地图的次要数据将识别额外的暴露和混淆因素，包括街道、建筑物和社区的特征。Logistic回归分析将调查饮酒和/或携带枪支的青少年，和/或日常活动发生在富含酒精和/或枪支的环境中的青少年，是否面临被枪支击中或在非枪支袭击中受伤的不同风险。这项研究将有助于确定青少年如何在时间和空间上受到日常活动的限制，从而确定特定的地点和时间的增强，减少，攻击性伤害的风险。

DESCRIPTION (provided by applicant): Gunshot injury is the leading cause of death in 10-19 year old African American males and the second leading cause of adolescent death overall. Most adolescents who are killed with guns are shot during assaults (60 percent) and for each gunshot assault that is fatal, 7 adolescents require emergency department (ED) treatment for non-fatal assaultive gunshot trauma. Additionally, each day more than 70 adolescents require ED treatment for non-fatal assaultive injuries inflicted with non-gun weapons. Nevertheless, little is known about the epidemiology of assaultive injury from guns and other weapons among adolescents. By using an epidemiological space-time modeling approach, we have developed and pilot-tested an innovative, portable technology for dynamically mapping the activities of adolescents thereby allowing very accurate estimation of their exposure to alcohol and firearms on a minute-to-minute basis. To determine gunshot injury risk, we propose conducting a population-based case-control study. Adolescents 10-19 years of age presenting to the ED of 2 inner-city Philadelphia hospitals for assault-related gunshot injuries will be compared with a randomly selected, population-based sample of control subjects 10-19 years old. As a secondary aim, adolescents presenting for non-gunshot assault injuries will be enrolled as a second case group and compared with the same sample of control subjects to determine non-gun injury risk. Each case and control subject will be interviewed using portable, computerized mapping technology to create a dynamic graphic that provides a minute-by-minute record of how, when, with whom, and where the subject spent time as he or she walked or otherwise traveled from location to location and from activity to activity on the day of the injury (cases) or 1-4 days earlier designated randomly (controls). Each subject will be asked about his or her use of alcohol and firearms that day, and about how other people around him or her used alcohol and firearms that day (e.g., people drinking alcohol on street corners; firearms kept at home). Secondary data we will link, along with the narrative data, to the map will identify additional exposure and confounding factors including characteristics of streets, buildings, and neighborhoods. Logistic regression analyses will investigate whether adolescents who consume alcohol and/or carry firearms, and/or whose daily activities occur in surroundings rich in alcohol and/or firearms, face a differential risk of being shot with a firearm or injured in a non-gun assault. This study will help to identify how adolescents are restricted in time and space by their daily activities, thereby identifying particular locations and times of enhanced, and reduced, assaultive injury risk.