Alcohol Use Trajectories and Prevention: A US-Sweden Comparison (Admin Supplement

描述（由申请人提供）： 研究表明，青春期后期和成年期（EA;大致包括18-25岁）与药物滥用，滥用和依赖的风险增加有关。尽管在此期间总体风险增加，但在年轻成年期间饮酒轨迹存在相当大的变化（Schulenberg等人，1996; Tucker等人，2005年）。大部分关于EA期间酒精使用和预防的研究都集中在这一时期进入大学的学生身上（Larimer & Cronce，2002），相对较少的研究集中在没有立即进入大学的个体中酒精使用的病因学和预防（白色等人，2005年）的报告。此外，很少有研究比较了国际样本中的酒精使用轨迹和后果，包括影响酒精使用模式轨迹和转变的个人，社会和环境/文化因素。最后，几乎没有研究系统地评估了从高中过渡之前提供的预防干预措施的有效性，作为改变EA过程中轨迹的一种手段。目前的研究旨在通过对美国和瑞典的一组高中生进行纵向研究来解决这些差距，并评估在高中结束时向随机子集（每个国家n=400）提供的基于网络的干预措施，以减少或预防过度饮酒和相关后果。本申请的具体目的是：1）在三元影响理论的指导下，评估美国和瑞典人群中从高中过渡后酒精使用轨迹的个人、同伴、父母、环境和文化预测因素; 2）评估基于网络的交互式反馈和技能干预在四年随访期内减少酒精使用和负面后果的功效; 3）评估干预效果的调节因素，包括个人水平和文化因素; 4）评估干预效果的中介因素。目标将通过对2个地点的2400名青少年进行纵向随访调查来实现：华盛顿州的国王地区和瑞典的斯凯恩地区。青少年将在高中四年级被招募，每年评估两次，为期4年。相关性（见说明）;成年期酒精滥用是一个国际公共卫生问题。这项研究评估了酒精使用的轨迹和预防，使用三重影响理论的框架来评估成年后进入和退出重度饮酒的过渡。国际比较允许从其他因素，包括预科进入大学和达到法律的饮酒年龄，和远端文化因素的影响，美国和瑞典之间的不同，从发展的影响解开。

DESCRIPTION (provided by applicant): Research suggests late adolescence and emerging adulthood (EA; roughly encompassing ages 18-25) are associated with increased risk for development of substance misuse, abuse, and dependence. Despite increased risk overall during this period, there is considerable variability in drinking trajectories during young adulthood (Schulenberg et al., 1996; Tucker et al., 2005). Much of the research on alcohol use and prevention during EA has focused on students who matriculate into college during this period (Larimer & Cronce, 2002), with relatively little research focused on etiology and prevention of alcohol use among individuals who do not immediately matriculate to college (White et al., 2005). Further, little research has compared trajectories of alcohol use and consequences in international samples, including the individual, social, and environmental/cultural factors influencing trajectories and transitions in alcohol use patterns. Finally, almost no research has systematically evaluated efficacy of preventive interventions offered prior to the transition from high school as a means of altering trajectories during EA. The current research is designed to address these gaps, through a longitudinal study of a cohort of high school students in both the US and Sweden, and the evaluation of web-based interventions offered to a random subset (n=400 per country) at the end of high school as a means of reducing or preventing excessive alcohol consumption and related consequences. Specific aims of the current application are: 1) Evaluate intrapersonal, peer, parental, environmental, and cultural predictors of alcohol use trajectories upon the transition from high school in US and Swedish populations, guided by the Theory of Triadic Influence; 2) Evaluate the efficacy of a web-based interactive feedback and skills intervention in reducing alcohol use and negative consequences over a four- year follow-up period; 3) Evaluate moderators of intervention efficacy, including individual-level and cultural factors; and 4) Evaluate mediators of intervention efficacy. Aims will be achieved through a longitudinal follow-up survey of 2400 teens across 2 sites: the King Country region of Washington State and the Skane region of Sweden. Teens will be recruited during their senior year in high school and assessed twice per year for 4 years. RELEVANCE (See instructions); Alcohol misuse during emerging adulthood is an international public health problem. This research evaluates trajectories and prevention of alcohol use, using the framework of the Theory of Triadic Influence to evaluate transitions into and out of heavy drinking across emerging adulthood. The international comparison allows for disentangling of effects of development from other factors including matriculation into college and attaining legal drinking age, and impacts of distal cultural factors which vary between the US and Sweden.