Longitudinal Pathways to the Use of Health Services

描述（由申请人提供）：这一新的赠款申请，这是基于35年的纵向研究（T1-T7）的物质使用，建议确定的决定因素和障碍，在第五个十年的生活，通过绘制纵向途径，以利用服务的成年人在中年早期（目标1）。此外，拟议的研究将评估物质使用（酒精，大麻和烟草）在这个未充分研究的发展时期（目标2）的长期后果。在T8，我们将收集有关中年早期成年人身体和心理社会功能的重要领域的信息（身体疾病，精神疾病和成年角色的功能），并将这些与药物使用史联系起来。从以前的数据收集浪潮中获得了参与者的大量纵向数据，包括青春期（T2，T3），成年期（T4）和青年期（T5，T6和T7）。在T8，将与参与者进行面对面的访谈。将根据调查结果制定心理测量学上的健全标准。主要的数据分析技术将是结构方程建模，增长混合建模和回归。这项研究将使我们能够提供有关促进和阻碍向中年过渡的成年人利用医疗保健服务的因素的关键信息。此外，拟议的研究将深入了解长期使用药物对成年后心理社会和身体功能的累积影响。由于药物滥用和依赖是一种慢性复发性疾病，可能在人的一生中持续存在，因此，前瞻性地研究其在生命过程中的模式和伴随物对公共卫生至关重要。

DESCRIPTION (provided by applicant): This new grant application, which is based on a 35-year longitudinal study (T1-T7) of substance use, proposes to identify the determinants and barriers to health care services utilization in the fifth decade of life by charting the longitudinal pathways to the utilization of services by adults in early midlife (Aim 1). In addition, the proposed research will assess the long-term consequences of substance use (alcohol, marijuana, and tobacco) in this understudied developmental period (Aim 2). At T8, we will gather information about important areas of physical and psychosocial functioning in adults in early midlife (physical diseases, psychiatric disorders, and functioning in adult roles), and relate these to the histories of substance use. Extensive longitudinal data are available on the participants from previous waves of data collection, including adolescence (T2, T3), emerging adulthood (T4), and young adulthood (T5, T6, and T7). At T8, face-to-face interviews will be conducted with the participants. Psychometrically sound scales will be developed from the surveys. The primary data-analytic techniques will be structural equation modeling, growth mixture modeling and regression. This research will enable us to provide crucial information about factors facilitating and barriers impeding the utilization of health care services among adults transitioning to midlife. In addition the proposed research will provide insight into the cumulative impact of prolonged substance use on psychosocial and physical functioning in adulthood. Since substance abuse and dependence are chronic, relapsing diseases, which may persist throughout a person's life, studying their patterns and concomitants prospectively over the life course is of crucial importance to public health.