Substance Use in Reservists Social and Environmental Influences

描述（由申请人提供）：在社会生态框架的指导下，本申请将考虑个人层面的风险因素（例如，抑郁症状）和社会的影响（例如，伙伴/同伴行为）和环境（例如，生活压力）因素 美国预备役士兵的物质使用变化。药物滥用是退伍军人中最常见的健康问题1，药物使用与创伤有关，无论是在战斗中5还是在家里。2这些问题在预备役中引起了高度关注，因为他们有更多的饮酒问题5和与部署后的现役士兵有关的人际冲突。6目前有一半以上的军队已婚，1重要的是要检查预备役军人的影响潜力，或被他/她的伴侣影响。我们之前的研究，2-6和其他人，7-10提供的证据表明，伴侣的影响是健康积极或消极变化的有力预测因素。我们还发现，同龄人网络参与了成年人酒精使用的变化11，物质使用塑造了同龄人网络。12社会/环境的影响可能是特别突出的后备役军人和他们的合作伙伴，因为社交网络在部署过程中的变化。这些经历可能会加强同伴群体的影响力，特别是如果战友在部署后在同伴网络中。因此，拟议的研究将审查个人和更广泛的社会环境影响（例如，关系，社区和社会）之间的关联压力和物质使用的预备役军人和他们的合作伙伴。使用多波设计，预备役军人及其伴侣（N = 400对夫妇）将在2年内接受3次评估（即，基线，第1年，第2年）。参与者将使用先进的触摸屏音频计算机辅助面试进行评估。使用先进的纵向分析（例如，多层次和GEE模型），该提案将审查：1）在预备役士兵及其伴侣中，物质使用（酒精、烟草和处方药的非医疗使用）随时间的变化，抑郁症状），关系（例如，伙伴和同伴物质使用），社区（例如，工作场所/部署）和社会（例如，规范）因素; 2）压力/创伤之间的关系（例如，对抗暴露/生活压力）和物质使用;以及3）物质使用如何融入关系影响婚姻攻击和解体。重要的是，夫妇中的每个成员都将提供独立的数据。本研究的创新之处在于：1）关注个体、伙伴和同伴的影响; 2）关注预备役军人 和他们的合作伙伴;和3）适用于一个适应社会生态模型的储备人口。这项拟议的研究是重要的，因为它将增加我们对社会的有限知识（例如，伙伴/同伴影响）和环境（例如，压力/创伤）的风险因素 预备役军人面临的物质使用问题。从这一概念上和方法上严格的研究中获得的知识将有助于制定有效的二级预防和干预战略，以解决军人夫妇面临的复杂问题。

DESCRIPTION (provided by applicant): Guided by a social ecological framework, this application will consider individual-level risk factors (e.g., depressive symptoms) and the influence of social (e.g., partner/peer behaviors) and environmental (e.g., life stress) factors on changes in substance use in US Reserve Soldiers. Substance abuse is the most common health problem among veterans1 and substance use is linked to trauma, either in combat5 or at home.2 These issues are of heightened concern among the Reserve as they have more drinking problems5 and interpersonal conflict relative to active duty soldiers post-deployment.6 With more than half of the Military currently married, 1 it is important to examine the potential o a Reservist to influence, or be influenced, by his/her partner. Our previous research, 2-6 and that of others, 7-10 provides evidence that partner influences are powerful predictors of positive or negative changes in health. We also have found that peer networks are involved in changes in alcohol use among adults11 and that substance use shapes the peer network.12 Social/environmental influences may be particularly salient for Reservists and their partners as social networks change during deployments. These experiences are likely to strengthen the influence of a peer group, particularly if fellow soldiers are within one's peer networks post-deployment. Thus, the proposed study will examine individual and broader social environmental influences (e.g., relationship, community, and societal) on the association between stress and substance use for Reservists and their partners. Using a multi-wave design, Reservists and their partners (N = 400 couples) will be assessed 3 times over 2 years (i.e., baseline, Year 1, Year 2). Participants will be assessed using state-of-the-science Touch Screen Audio Enabled Computer Assisted Interviews. Using advanced longitudinal analyses (e.g., multilevel and GEE models), this proposal will examine: 1) changes in substance use (alcohol, tobacco, and nonmedical use of prescription drugs) over time in Reserve Soldiers and their partners on the basis of individual (e.g., depressive symptoms), relationship (e.g., partner and peer substance use), community (e.g., workplace/deployments) and societal (e.g., norms) factors; 2) the relation between stress/trauma (e.g., combat exposure/life stress) and substance use; and 3) how the integration of substance use into the relationship impacts marital aggression and dissolution. Importantly, each member of the couple will provide independent data. The proposed study is innovative in: 1) its focus on individual, partner, and peer influences; 2) its focus on Reservists and their partners; and 3) the application of an adapted social ecological model to a Reservist population. The proposed study is significant because it will add to our limited knowledge about the social (e.g., partner/peer influences) and environmental (e.g., stress/trauma) risk factors for substance use that are faced by Reservists. The knowledge gained from this conceptually and methodologically rigorous study will enhance the development of effective secondary prevention and intervention strategies to address the complex issues faced by military couples.