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: 8602925
• 负责人: JAMES G LINAKIS
• 金额: $ 10万
• 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/8602925
• 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; 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; screening; 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.

说明(申请人提供)：酒精使用是导致青少年发病率和死亡率以及其他健康风险的主要原因，包括其他物质使用和危险行为。青少年饮酒还可能导致长期的认知、行为、解剖和神经化学变化。此外，在青春期开始饮酒显著增加了一个人患成年酒精使用障碍的风险。鉴于这一巨大的公共卫生负担，成功识别当前或未来有问题饮酒风险的青少年是非常重要的，因为干预措施可能会对青少年和成年人的酒精使用障碍产生重大影响。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，屏幕可能是目前和未来酒精使用的负面后果的有力预测。我们建议测试RFA-AA-12-008的目标，通过对美国15个儿科急诊科(PED)的12-17岁儿童进行NIAAA两问题筛查的验证，追求两个具体目标：主要目的1)确定两问题筛查关于酒精滥用的并发、收敛、判别和预测有效性，次要目的1)确定两问题筛查关于其他物质使用和危险行为的并发和预测有效性。儿科病房设置的优势是能够涵盖高危人群，如辍学和没有初级保健或保险的人，他们经常使用儿科病房进行医疗护理，而其他研究环境中没有这些人群。利用儿科急救应用研究网络(PECARN)，我们将使用多中心设计来测试NIAAA两个问题筛选的并发、收敛和预测有效性，使用建立的、经过验证的测量工具，在非常大的、不同的青少年样本中。12-17岁(N=8000)向参与PECARN PED的青少年将在3.5年内登记，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”)评估单元。这些年轻人的回答将被用来评估NIAAA两个问题筛选的同时收敛和区分有效性。将从初始样本中提取两个青年亚样本。第一个样本(N=300)将在首次ED访问一周后重新接受NIAAA两问题筛查，以评估NIAAA两问题筛查的重测可靠性。第二个样本(N=2500)将在PED就诊后12个月和24个月用Criteria评估组重新评估，以评估两个问题筛查的预测有效性。这一大样本将允许按性别、种族、民族和其他重要的人口统计变量进行分层分析，这是单中心或较小样本研究无法实现的。这项拟议的研究具有重要意义，因为它严格评估了NIAAA两个问题筛查预测当前和未来AOD风险以及其他行为问题的能力，并将产生非常稳健的、可推广的结果。