ESTIMATING COMPARATIVE EFFECTIVENESS OF ALCOHOL INTERVENTIONS FOR YOUNG ADULTS

评估酒精干预措施对年轻人的比较效果

• 批准号: 9604545
• 负责人: Eun-Young Mun
• 金额: $ 37.66万
• 依托单位: UNIVERSITY OF NORTH TEXAS HLTH SCI CTR
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-04-20 至 2022-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9604545
• 关键词: ESTIMATING; COMPARATIVE; EFFECTIVENESS; ALCOHOL; INTERVENTIONS

Project Summary The prevention of excessive drinking and related negative consequences by underage drinkers and college students is an important objective for Healthy People 2020. This resubmission application is aimed at extending an R01 grant (R01 AA019511) in response to PA-15-295, “Screening and brief alcohol interventions in underage and young adult populations (R01).” The previous R01 focused on methodological developments for pooling and analyzing individual participant data (IPD) from 24 studies (N = 24,336 at baseline; 12,630 randomized) to examine the efficacy of brief motivational interventions (BMIs) for college students. Deploying newly developed methods to combine and analyze IPD, the resulting large, pooled data set showed that BMIs for college students may not be as powerful as prior reviews suggest, pointing to the need to better understand why some interventions succeed while others fail. Our previous research on IPD was limited in terms of its study-level sample size (24 studies) as well as its population representation. Moreover, recently published traditional meta-analyses have found overall intervention effects, contradicting our findings. The proposed research expands and enhances our earlier work by using the cutting-edge methodology with a comprehensive set of data with the end goal of providing an authoritative summary of the alcohol intervention field for adolescents and young adults. Beyond simply focusing on the omnibus question of “any effect,” our research is aimed at testing which interventions are better and exploring how to individualize intervention strategies to meet different needs of the individual for greater benefit (i.e., precision medicine). We will combine aggregated data (e.g., means, SDs) from approximately 350 independent brief alcohol intervention trials and IPD from 49 trials. Of these, aggregated data from 303 samples and IPD from 24 studies have already been secured with the support of two separate R01s (AA020286 to Tanner-Smith and AA019511 to Mun). We will maximize the scale and depth of the existing clinical data via the following state-of-the-art synthesis approaches: network meta-analysis (meta-regression) and multivariate meta-analysis, and their extensions for IPD. In a major extension of prior work, the proposed investigation will (1) respect the natural hierarchy of the data (i.e., participants nested within studies); (2) simultaneously accommodate multiple interventions (networks instead of any two pairs of interventions); (3) explain effect heterogeneity (i.e., strong to weak intervention effects) by examining factors at the individual- and study-level, as well as cross-level; and (4) allow joint analysis of multiple related outcomes (e.g., alcohol use and problems) by borrowing strength from one another. Our transdisciplinary team of leading experts, many of whom led the earlier, successful research will generate new evidence that will be “scalable” so that new trial data can straightforwardly be accommodated to evaluate their relative efficacy compared to existing interventions. This research can help establish future research priority areas, guide the design of future trials, and develop recommendations for practitioners’ clinical practice.

项目摘要 未成年饮酒者和大学生过量饮酒及其相关不良后果的预防 学生是2020年健康人的重要目标。此次重新提交申请旨在 根据PA-15-295“筛查和简短的酒精干预”，延长R 01补助金（R 01 AA 019511） 在未成年人和年轻人群体中（R 01）。上一个R 01侧重于方法学发展 用于汇总和分析来自24项研究的个体受试者数据（IPD）（基线时N = 24，336; 随机），以检查简短的动机干预（BMI）的有效性，为大学生。部署 新开发的联合收割机和分析IPD的方法，由此产生的大型汇总数据集显示BMI 对于大学生来说，这可能不像之前的评论所建议的那样强大，指出需要更好地理解 为什么有些干预成功而另一些失败。我们以前对IPD的研究局限于其 研究水平样本量（24项研究）及其人群代表性。此外，最近出版的 传统的荟萃分析发现了总体干预效果，与我们的研究结果相矛盾。拟议 研究扩展和加强我们早期的工作，通过使用先进的方法，全面 一组数据，最终目标是提供酒精干预领域的权威总结， 青少年和年轻人。除了简单地关注“任何影响”这个综合性问题外，我们的研究还 旨在测试哪些干预措施更好，并探索如何个性化干预策略， 满足个人的不同需求以获得更大的利益（即，精准医学）。我们将联合收割机 数据（例如，平均值，SD）来自约350项独立的简短酒精干预试验，IPD来自49项 审判其中，来自303个样本的汇总数据和来自24项研究的IPD已经获得， 支持两个独立的R 01（AA 020286至Tanner-Smith和AA 019511至Mun）。我们将最大限度地 通过以下最先进的综合方法对现有临床数据进行规模和深度分析：网络 荟萃分析（荟萃回归）和多元荟萃分析，以及它们对IPD的扩展。在一个主要 现有工作的扩展，所提出的调查将（1）尊重数据的自然层次结构（即， 参与者嵌套在研究中）;（2）同时容纳多种干预措施（网络代替 任何两对干预）;（3）解释效应异质性（即，强到弱的干预效果）， 在个人和研究层面以及跨层面检查因素;（4）允许联合分析 多个相关结果（例如，酒精的使用和问题），借由从彼此的力量。我们 由领先专家组成的跨学科团队，其中许多人领导了早期的成功研究，将产生新的 证据将是“可扩展的”，以便新的试验数据可以直接容纳，以评估其 与现有干预措施相比，这项研究可以帮助建立未来的研究重点 领域，指导未来试验的设计，并为从业者的临床实践提出建议。