System dynamics and dynamic systems modeling of adolescent smoking development

青少年吸烟发展的系统动力学和动态系统建模

• 批准号: 8456267
• 负责人: Arielle S. Selya
• 金额: $ 2.88万
• 依托单位: WESLEYAN UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-01-01 至 2014-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8456267
• 关键词: Address; Adolescent; Adolescent Development; Adult; Affect; Age; Award; Behavioral Model; Biological Models; Cessation of life; Chronic; Cigarette; Clinical; Complex; Consult; Data; Development; Disease; Emotional; Etiology; Exposure to; Family; Family member; Feedback; Future; Genetic; Health Policy; Incidence; Individual; Intervention; Knowledge; Life; Link; Literature; Longitudinal Studies; Mental Depression; Methods; Modeling; Nicotine Dependence; Outcome; Parents; Pattern; Prevention; Prevention strategy; Public Health; Recommendation; Regression Analysis; Research; Risk; Risk Factors; Signal Transduction; Simulate; Smoke; Smoker; Smoking; Smoking Behavior; Smoking Status; Staging; Subgroup; Surveys; Symptoms; System; Testing; Time; Tobacco; Training; adolescent smoking; cigarette smoking; depressive symptoms; early onset; environmental tobacco smoke; experience; insight; meetings; non-smoker; peer; preventive intervention; public health relevance; research study; smoking cessation; social

DESCRIPTION (provided by applicant): Cigarette smoking continues to be a serious public health issue that puts a considerable portion of adults in the US at risk for life-threatening diseases. The vast majority of smokers initiate smoking before age 16, underscoring the need to prospectively study the development of smoking behavior in adolescents. Ongoing research has identified several consistent risk factors of adolescent smoking; including parental smoking, peer smoking, depression, and nicotine dependence (particularly early-emerging nicotine dependence). There is ample evidence that many of these risk factors influence each other over time and have time-varying effects on smoking outcomes, yet these relationships cannot be investigated using standard analyses. Thus, a major gap in current knowledge about smoking initiation and progression is the absence of interrelationships among risk factors in most analyses, which can affect the course of smoking behavior. Further, causal relationships cannot be tested using standard regression analyses of observational data. Systems methods, such as system dynamics modeling, are capable of addressing these questions by simulating smoking behavior over time as a system of interconnected, dynamic variables which contains causal links and feedback loops. This proposal contains both a training component and a substantive component which will investigate the development of adolescent smoking behavior. For the training component, the applicant will augment her introductory training in system dynamics modeling by taking a number of formal courses. Further, the applicant will meet throughout the award period with a team of consultants, which consists of experts in traditional system dynamics modeling, the wider family of systems methods, or the field of adolescent smoking. Consulting meetings will bridge the formal training with the substantive component, in that the consultants will supervise the models developed by the applicant and the applicant's interpretation of results. For the substantive component of this proposal, a comprehensive model of smoking development and its major risk factors will be developed incrementally over the Specific Aims. For Aim 1, the positive feedback loop between nicotine dependence and smoking behavior, and its subsequent effect on progression from experimental smoking to regular smoking, will be investigated. This model will be expanded in Aim 2 to include parental smoking's effect on initiation and progression rates and nicotine dependence. Aim 2 has additional smoking statuses (nonsmokers, former smokers) and corresponding transitions (smoking initiation, cessation of experimentation, quitting regular smoking). Aim 3 will investigate the sensitivity of the system to the initial level of nicotine dependence; this will be modeled by adding depression and peer smoking to the model developed in Aim 2. This project will significantly contribute to current understanding of the development of adolescent by elucidating the complex and time-varying interrelationships among risk factors. This project could provide valuable recommendations to public health policy and/or clinical settings by identifying which strategies are likely to be effective targets of prevention or intervention strategies, and the optimal time to employ them. Finally, an accurate, calibrated model of smoking development can be used to inexpensively test potential intervention strategies.

描述（由申请人提供）：吸烟仍然是一个严重的公共卫生问题，使相当一部分美国成年人面临危及生命的疾病风险。绝大多数吸烟者在16岁之前开始吸烟，这强调了前瞻性研究青少年吸烟行为发展的必要性。正在进行的研究已经确定了青少年吸烟的几个一致的风险因素;包括父母吸烟，同伴吸烟，抑郁和尼古丁依赖（特别是早期出现的尼古丁依赖）。有充分的证据表明，许多这些风险因素随着时间的推移相互影响，并对吸烟结果产生随时间变化的影响，但这些关系无法使用标准分析进行调查。因此，目前关于吸烟开始和发展的知识的一个主要差距是在大多数分析中缺乏风险因素之间的相互关系，这可能会影响吸烟行为的过程。此外，因果关系不能使用标准的回归分析的观测数据进行测试。系统方法，如系统动力学建模，能够解决这些问题，模拟吸烟行为随着时间的推移，作为一个系统的相互关联，动态变量，其中包含因果关系和反馈回路。该建议包括培训部分和实质性部分，后者将调查青少年吸烟行为的发展。对于培训部分，申请人将通过参加一些正式课程来加强她在系统动力学建模方面的入门培训。此外，申请人将在整个颁奖期间与一个顾问团队会面，该团队由传统系统动力学建模，更广泛的系统方法或青少年吸烟领域的专家组成。咨询会议将在正式培训与实质性培训之间架起桥梁，咨询人将监督申请方开发的模型以及申请方对结果的解释。对于本提案的实质性组成部分，将根据具体目标逐步制定吸烟发展及其主要风险因素的综合模型。对于目标1，将研究尼古丁依赖和吸烟行为之间的正反馈回路，以及其对从实验性吸烟到常规吸烟的进展的后续影响。该模型将在目标2中扩展，以包括父母吸烟对启动和进展率以及尼古丁依赖的影响。目标2有额外的吸烟状态（不吸烟者，前吸烟者）和相应的过渡（吸烟开始，停止实验，戒烟）。目标3将研究系统对尼古丁依赖初始水平的敏感性;这将是 通过在目标2中开发的模型中添加抑郁和同伴吸烟来建模。该项目将通过阐明风险因素之间复杂和随时间变化的相互关系，大大有助于目前对青少年发展的理解。该项目可以通过确定哪些策略可能是预防或干预策略的有效目标以及采用它们的最佳时间，为公共卫生政策和/或临床环境提供有价值的建议。最后，一个准确的，校准的吸烟发展模型可以用来廉价测试潜在的干预策略。