Initiation and Progression through Early Drinking Milestones in Underage Drinkers

描述（由申请人提供）：这是一份申请，用于资助PI正在进行的前瞻性研究“未成年饮酒者早期饮酒里程碑的开始和进展”（R01 AA016838）的竞争性续期。最初资助周期的目的是确定界定饮酒阶段的里程碑（例如，第一次充分饮酒，大量饮酒），并检查风险因素在多大程度上解释了开始和通过里程碑进展的可变性。基础研究的参与者在中学注册（N= 1023），并在3年期间使用密集（每月）基于网络的狭窄重点评估与具有更广泛内容的半年度评估相结合的方式进行评估。迄今为止，该研究对非特异性和酒精相关的风险因素以及早期饮酒进行了令人难以置信的丰富评估。样品保留率非常高，具有出色的回复率。这项更新研究的目的是在高中时期继续评估这一有价值的队列，在这一时期，大多数青少年都经历了从任何使用到早期表现为酒精依赖综合症的酗酒阶段。这也是青少年经历重要发展转变的时期，如青春期和获得驾驶执照。在这个资助期间，我们直接从多波、队列顺序的基础设计转变为发展驱动的设计，让参与者按照相同的时间表进行季度评估，直到12年级（或同等学历）。在研究结束时，每个参与者将提供15到29个季度的波浪，跨越6年级到12年级。基于网络的调查将继续评估饮酒里程碑以及一系列个人层面和环境风险因素。此外，这项更新研究将利用对“饮酒前体”的丰富评估，为早期饮酒体验提供支持，并帮助确定其轨迹。这些饮酒前体，包括与酒精相关的认知和饮酒意愿，随着个体通过接触与酒精相关的规范（包括娱乐媒体和社交网络中提到的酒精）间接或直接通过个人饮酒经历对酒精的熟悉而改变。更新的研究还评估了重要的发展转变和发展结果相关的青春期晚期。在整个青春期期间获得有关酒精涉入的全面数据，提供了一个无与伦比的机会，可以明确比较早发和晚发的青少年，并评估开始酗酒的风险因素是否与沿酒精涉入维度的其他过渡阶段的风险因素不同。收集的细粒度数据对于阐明个人内部变化至关重要，不仅涉及结果和风险因素，而且还涉及时间作为这些关联的重要调节因素。研究结果将通过确定未成年青少年饮酒进展、维持和持续的可调整阶段特定风险因素，为预防工作提供信息。

DESCRIPTION (provided by applicant): This is an application to fund a competitive renewal for the PI's ongoing prospective study "Initiation and Progression through Early Drinking Milestones in Underage Drinkers" (R01 AA016838). The aims under the initial funding cycle, which focused on the period of early-to-mid adolescence, were to identify milestones demarcating drinking stages (e.g., first full drink, heavy drinking) and to examine the extent to which risk factors explain variability in initiation and progression through milestones. Participans in the base study were enrolled in middle school (N=1,023) and assessed over a 3-year period using a combination of intensive (monthly) web-based assessments of narrow focus complemented by semi-annual assessments with broader content. To date, the study has an incredibly rich assessment of nonspecific and alcohol-related risk factors as well as early alcohol involvement. Sample retention is exceptionally high, with outstanding response rates. The purpose of this renewal study is to continue to assess this valuable cohort through the high school years, a time during which the majority of youth progress through stages marked by increasing involvement with alcohol ranging from any use to early manifestation of the alcohol dependence syndrome. It is also a time during which youth undergo important developmental transitions such as puberty and attainment of a driver's license. In this funding period, we directly shift from a multi-wave, cohort-sequential foundational design to a developmentally driven design that places participants on the same schedule with quarterly assessments through 12th grade (or equivalent). By study end, each participant will provide between 15 and 29 quarterly waves spanning the 6th- 12th grade years. Web-based surveys will continue to assess drinking milestones as well as an array of individual-level and contextual risk factors. In additio, the renewal study will leverage a rich assessment of "drinking precursors" that provide the scaffolding that support early drinking experiences and help to determine its trajectory. These drinking precursors, which include alcohol-related cognitions and willingness to drink, change as individuals gain familiarity with alcohol either indirectly through exposure to alcohol-related norms (including alcohol references in entertainment media and social networking) or directly, through personal experience with alcohol. The renewal study also assesses important developmental transitions and developmental outcomes relevant to late adolescence. Having a full spectrum of data on alcohol involvement across the full span of adolescence provides an unparalleled opportunity to explicitly compare youth with early versus late onset and to evaluate whether risk factors for initiation to differ from risk factors for other transitions along the dimension of alcohol involvement. The fine grained data collected are critical for illuminating within- person change, not only with regard to outcomes and risk factors, but also for timing as an important moderator of these associations. Findings will inform prevention efforts by identifying modifiable stage-specific risk factors for progression, maintenance, and desistence of drinking in underage youth.