Validating Consumption-Based Brief Screening for Youth Alcohol and Drug Problems

描述（由申请人提供）：筛查，结合适当的干预和转诊，有可能显着减少青年的酒精和大麻问题。然而，大多数屏幕表现不佳或尚未在年轻人中验证，或者太长且笨重，无法在忙碌的临床环境中使用。人们对以消费为基础的青少年筛查很感兴趣，这些筛查按发育分级，非常简短，可以检测出当前的物质问题以及未来问题的风险。一个主要的例子是NIAAA的新的儿童和青少年酒精筛查指南，该指南使用有关饮酒频率和朋友饮酒的问题，以确定有酒精问题或有酒精问题风险的青少年。饮酒频率问题的12-18级临界点来自于使用基于DSM-IV结果的代表性横断面全国调查中12-18岁受访者的分析。然而，还需要更多的工作来研究这种基于消费的筛查的同时和预测有效性。我们建议在五项研究中进行二次数据分析（其中三项具有长期纵向数据），以描述8至20岁青年中基于消费的酒精和大麻筛查的有效性。我们将研究酒精和大麻消费筛查问题在儿童，青少年和年轻人中的表现，使用流行病学样本，以及初级保健，成瘾治疗和进入大学的青年研究。我们将研究基于消费的筛查是否不受种族-民族的影响。我们将在拟议的DSM-5酒精和大麻使用障碍标准的背景下研究筛选临界点，但将强调在青年中更常见的较温和形式的物质问题。我们将通过一个网站使新的筛查产品更容易获得，从而传播我们的成果。我们的研究结果将告知NIAAA的持续努力，开发一个在线继续医学教育课程，和一个互动的移动的网络筛选应用程序，基于指南。该项目意义重大，因为它将大大增加科学知识，支持在青年中使用基于消费的酒精和大麻筛查。

DESCRIPTION (provided by applicant): Screening, combined with appropriate intervention and referral, has the potential to significantly reduce alcohol and marijuana problems in youth. However, most screens perform poorly or have not been validated in youth, or are too long and unwieldy to be used in busy clinical settings. There is a great deal of interest in consumption-based youth screens that are developmentally graded and very brief, and that can detect both current substance problems as well as risk for future problems. A primary example is NIAAA's new Alcohol Screening Guide for Children and Adolescents, which uses questions about the frequency of alcohol use, and about friends' drinking, to identify youth that have or are at risk fr alcohol problems. Age-graded cut- points for the alcohol frequency question were derived from analyses of respondents age 12-18 in a representative, cross-sectional national survey using DSM-IV-based outcomes. However, much more work is needed to study the concurrent and predictive validity of such consumption- based screening. We propose to conduct secondary data analyses in five studies (three of which have long-term longitudinal data) to characterize the validity of consumption-based alcohol and marijuana screening in youth aged 8 to 20. We will study the performance of alcohol and marijuana consumption screening questions in children, adolescents and young adults, using epidemiologic samples, and studies of youth in primary care, in addictions treatment, and entering college. We will examine whether consumption-based screening is invariant by race- ethnicity. We will study screening cut-points in the context of proposed DSM-5 criteria for Alcohol and Cannabis Use Disorders, but will emphasize milder forms of substance problems that are more common in youth. We will disseminate our results by making new screening products easily accessed via a web site. Our results will inform NIAAA's ongoing efforts to develop an on-line CME course, and an interactive mobile web screening app, based on the Guide. This project is highly significant because it will greatly increase scientific knowledge supporting use of brief consumption-based alcohol and marijuana screening in youth.