Teen Alcohol Screening in the Pediatric Emergency Care Applied Research Network

儿科紧急护理应用研究网络中的青少年酒精筛查

• 批准号: 8427893
• 负责人: JAMES G LINAKIS
• 金额: $ 83.17万
• 依托单位: RHODE ISLAND HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-09-05 至 2017-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8427893
• 关键词: 17 year old; Accident and Emergency department; Adolescence; Adolescent; Adult; Affect; Age; Alcohol abuse; Alcohol consumption; Alcohol dependence; Alcohol or Other Drugs use; Alcoholism; Alcohols; Anatomy; Applied Research; Behavior; Behavioral; Caring; Childhood; Cigarette; Cognitive; Data; Diagnosis; Drug usage; Early Diagnosis; Early identification; Emergency Care; Enrollment; Ethnic Origin; Frequencies; Future; Gender; Goals; Gold; Health; Institutes; Insurance; Intervention; Marijuana Smoking; Measurement; Measures; Medical; Morbidity - disease rate; Multicenter Trials; Neuropsychology; Participant; Patients; Performance; Persons; Physicians; Population; Primary Health Care; Problem behavior; Public Health; ROC Curve; Race; Recommendation; Research; Research Infrastructure; Risk; Risk Behaviors; Sample Size; Sampling; Sampling Studies; School-Age Population; Screening procedure; Sensitivity and Specificity; Site; Student Dropouts; Surveys; Teenagers; Testing; Visit; Youth; alcohol and other drug; alcohol misuse; alcohol screening; alcohol use disorder; base; brief advice; brief intervention; brief screening; design; drinking; follow-up; high risk; high school; instrument; middle school; mortality; motivational intervention; neurochemistry; novel; response; sex; tool; underage drinking; validation studies

DESCRIPTION (provided by applicant): Alcohol use is a major contributor to the leading causes of adolescent morbidity and mortality and to other health risks, including other substance use and risky behaviors. Adolescent alcohol use may also result in long term cognitive, behavioral, anatomic and neurochemical changes. Additionally, initiating alcohol use in adolescence significantly increases a person's risk for adult alcohol use disorders. Given this considerable public health burden, successfully identifying adolescents at risk for current or future problematic alcohol use is of major importance, as intervention may significantly affect both adolescent and adult alcohol use disorders. The National Institute of Alcohol Abuse and Alcoholism (NIAAA) has developed a novel two-question screening tool for the early detection of alcohol use and problems. Empirically based, the screen may be a powerful predictor of current and future negative consequences of alcohol use. We propose to test the goals of RFA- AA-12-008 by validating the NIAAA two-question screen with 12-17 year olds in 15 U.S. pediatric emergency departments (PED), by pursuing two specific aims: Primary Aim 1) To determine the concurrent, convergent, discriminant, and predictive validity of the two-question screen regarding alcohol misuse, and Secondary Aim 1) To determine the concurrent and predictive validity of the two-question screen regarding other substance use and risky behaviors. The advantage of the PED setting is the ability to capture high risk populations such as school dropouts and those without primary care or insurance, who often use PEDs for their medical care and are missed in other study settings. Employing the Pediatric Emergency Care Applied Research Network (PECARN), we will use a multi-center design to test the concurrent, convergent and predictive validity of the NIAAA two-question screen using established, validated measurement instruments in a very large, diverse sample of youths. Youths 12-17 years (N=8000) presenting to participating PECARN PEDs will be enrolled over a 3.5-year period and will complete the two-question screen and an alcohol and other drug (AOD) and behavior ("criterion") assessment battery. Responses from these youths will be used to assess the concurrent convergent, and discriminant validity of the NIAAA two-question screen. Two subsamples of youths will be derived from the initial sample. The first subsample (N=300) will be re-administered the NIAAA two-question screen, one week after their initial ED visit to assess the test-retest reliability of the NIAAA two-question screen. The second sample (N=2500), will be reassessed at 12 and 24 months after their PED visit with the criterion assessment battery to assess the predictive validity of the two-question screen. This large sample will permit stratified analyses by gender, race, ethnicity and other important demographic variables, which are not possible with single center or smaller sample studies. The proposed research is significant because it rigorously evaluates the ability of the NIAAA two-question screen to predict current and future AOD risks as well as other behavior problems, and will generate very robust, generalizable results. PUBLIC HEALTH RELEVANCE: The contribution of this large, geographically diverse, multi-site study will be to determine if the NIAAA two- question screen is an efficient and valid alcohol screening instrument among US pediatric emergency department patients. This proposal has the potential to validate a screen that can then be used in pediatric emergency departments, which in turn will likely result in earlier identification of and intervention with alcohol- using youths.

描述（由申请人提供）：酒精使用是青少年发病率和死亡率以及其他健康风险（包括其他物质使用和危险行为）的主要原因。青少年饮酒也可能导致长期的认知，行为，解剖和神经化学变化。此外，在青春期开始饮酒会显著增加一个人患成人酒精使用障碍的风险。鉴于这一巨大的公共卫生负担，成功地确定青少年在当前或未来的问题酒精使用的风险是非常重要的，因为干预可能会显着影响青少年和成人酒精使用障碍。美国国家酒精滥用和酒精中毒研究所（NIAAA）开发了一种新的两个问题的筛查工具，用于早期发现酒精使用和问题。根据经验，屏幕可能是一个强大的预测器的当前和未来的负面后果的酒精使用。我们建议通过在15个美国儿科急诊科（PED）的12-17岁奥尔兹中验证NIAAA两个问题筛选来测试RFA- AA-12-008的目标，具体目标如下：主要目的1）确定关于酒精滥用的两个问题筛选的并发、收敛、判别和预测效度，和次要目的1）确定关于其他物质使用和危险行为的两个问题筛选的同时和预测有效性。PED设置的优势是能够捕获高风险人群，例如辍学者和没有初级保健或保险的人，他们经常使用PED进行医疗护理，并且在其他研究设置中被遗漏。采用儿科急诊应用研究网络（PECARN），我们将使用多中心设计，在一个非常大的，不同的青少年样本中，使用已建立的，经过验证的测量仪器，测试NIAAA两个问题屏幕的并发，收敛和预测有效性。参加PECARN PED的12-17岁青少年（N=8000）将在3.5年内入组，并将完成两个问题筛选以及酒精和其他药物（AOD）和行为（“标准”）评估组合。这些年轻人的反应将被用来评估同时收敛，判别效度的NIAAA两个问题屏幕。将从初始样本中抽取两个青年子样本。第一个子样本（N=300）将在初次艾德访视后一周重新进行NIAAA两问题筛选，以评估NIAAA两问题筛选的重测信度。第二份样本（N=2500）将在PED访视后12个月和24个月使用标准评估组合进行重新评估，以评估两个问题筛选的预测有效性。这一大样本将允许按性别、人种、种族和其他重要人口统计学变量进行分层分析，这在单中心或小样本研究中是不可能的。这项研究意义重大，因为它严格评估了NIAAA两个问题屏幕预测当前和未来AOD风险以及其他行为问题的能力，并将产生非常强大的，可推广的结果。 公共卫生相关性：这项大规模的、地理上多样化的、多地点的研究的贡献将是确定NIAAA两个问题的筛选是否是一种有效的酒精 美国儿科急诊科患者的筛查工具。这一提议有可能验证一种可以在儿科急诊科使用的屏幕，这反过来可能会导致更早地识别和干预使用酒精的青少年。