Cross-national Analysis of Alcohol and Injury

酒精和伤害的跨国分析

• 批准号: 9249434
• 负责人: CHERYL J CHERPITEL
• 金额: $ 41.51万
• 依托单位: PUBLIC HEALTH INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2002
• 资助国家: 美国
• 起止时间: 2002-07-01 至 2019-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9249434
• 关键词: Accident and Emergency department; Acute; Address; Advertising; Affect; Alcohol consumption; Alcoholic Beverages; Alcohols; American; Area; Australia; Automobile Driving; Burn injury; Characteristics; Communities; Community Actions; Consumption; Country; Coupled; Data; Data Set; Dose; Economic Development; Emergency Department patient; Environment; Event; Gap Junctions; General Population; Grant; Guidelines; Health Professional; Hour; Individual; Injury; Intervention; Intramural Research Program; Label; Laws; Linear Models; Literature; Marketing; Methodology; Modeling; Morbidity - disease rate; National Institute on Alcohol Abuse and Alcoholism; Near Drowning; Organization and Administration; Pan American Health Organization; Patient Self-Report; Patients; Pattern; Poisoning; Policies; Population Attributable Risks; Prevention strategy; Price; Privatization; Probability Samples; Public Health; Relative Risks; Research; Risk; Self-Injurious Behavior; Services; Site; Suicide attempt; Testing; Violence; Work; World Health; World Health Organization; alcohol availability; alcohol epidemiology; alcohol research; alcohol risk; alcohol-related injury; base; burden of illness; data archive; drinking; drinking behavior; economic cost; falls; injured; instrumentation; intimate partner violence; knowledge base; public health relevance; public policy on alcohol; response; social; trauma centers

DESCRIPTION (provided by applicant): This competing continuation builds on and extends research which analyzed ER data from the 12-site WHO Collaborative Study on Alcohol and Injuries, 33 sites in 8 countries comprising the Emergency Room Collaborative Alcohol Analysis Project (ERCAAP), and 30 sites in 13 countries added in the previous project period, data from studies all of which used similar methodology and instrumentation on probability samples of ER patients. Study aims are to: 1) examine risk of alcohol-related injury for self-reported consumption within 6 hours prior to all-cause injury and by injury cause (traffic, falls, intimate partner violence, other violence, burns, near drowning, poisoning, attempted suicide) by country/region level drinking patterns, context of drinking, alcohol control policy, and ER-level characteristics; 2) estimate relative risk (RR) of injury related to alcohol consumption volume (dose-response relationship) by cause of injury, comparing estimates with and without adjusting for individual-level injury context, and comparing estimates across regions of varying aggregate level detrimental drinking pattern (DDP), drinking context and alcohol policies; 3) estimate alcohol attributable fraction (AAF) by cause of injury, combining ER data and general population (GP) data, applying ER-based RR of injury related to drinking and predicted acute drinking exposure based on both individual-level and GP usual drinking pattern data. Aims address objectives of the Global Strategy to Reduce the Harmful Use of Alcohol, endorsed by the World Health Assembly in May 2010, in strengthening the knowledge base on the magnitude and determinants of alcohol-related harm, and, among other aims, will inform five of their 10 recommended policy target areas: community action, drinking-driving, alcohol availability, marketing of alcoholic beverages and pricing. Data will be added on 21,007 patients from 44 ER sites in 16 countries, cumulating in 43,453 injured patients from 119 ER sites covering 37 countries. Hierarchical linear modeling and case-crossover analysis and will examine contextual variables, including alcohol policy with individual and event-level variables on the alcohol-injury nexus, addressing a major gap in this literature. Coupled with GP data, this data set is one of a kind in providing the requisite number of patients to analyze specific alcohol policy control domains and variables in relation to specific causes of injury, adjust bias in RR of injury related to context of the event, and apply a new ER-based approach to estimating AAF by injury cause, based on both ER and GP drinking pattern data, which has the potential for extrapolation to countries with similar profiles (e.g., per capita consumption, DDP), for which ER studies are not available but GP pattern data are, and for GPs for which there are no exposure data, but where demographic and archival data are available. This work will, importantly, inform U.S. policy, potentially leading to policy change, as the U.S. is composed of many micro-cultures reflected in the contextual environment dominating many of the countries in which these data were collected.

描述（申请人提供）：这一竞争性的延续建立在并扩展了研究的基础上，该研究分析了来自12个地点的世卫组织酒精和损伤合作研究的ER数据，包括急诊室酒精合作分析项目（ERCAAP）的8个国家的33个地点，以及前一个项目期间增加的13个国家的30个地点，所有研究均使用类似的方法和仪器对ER患者的概率样本进行分析。研究目的是：1）检查在全因损伤前6小时内和按损伤原因自我报告的饮酒量的酒精相关损伤风险（交通、福尔斯、亲密伴侣暴力、其他暴力、烧伤、溺水、中毒、自杀未遂），按国家/地区一级饮酒模式、饮酒背景、酒精控制政策和ER一级特征分类; 2）估计与饮酒量相关的伤害相对危险度（RR）（剂量-反应关系），比较调整和不调整个人水平伤害背景的估计值，并比较不同总体水平有害饮酒模式（DDP）地区的估计值，3）结合ER数据和一般人群（GP）数据，应用基于ER的与饮酒相关的损伤RR和基于个人水平和GP通常饮酒模式数据的预测急性饮酒暴露，按损伤原因估计酒精归因分数（AAF）。这些目标涉及2010年5月世界卫生大会核可的《减少有害使用酒精全球战略》的目标，即加强关于酒精相关危害的程度和决定因素的知识基础，除其他目标外，还将为10个建议的政策目标领域中的5个领域提供信息：社区行动、酒后驾驶、酒精供应、酒精饮料的营销和定价。将增加来自16个国家44个急诊中心的21，007例患者的数据，累积来自37个国家119个急诊中心的43，453例受伤患者。分层线性模型和病例交叉分析，并将检查上下文变量，包括酒精政策与个人和事件水平变量对酒精伤害 nexus，解决这一文献中的一个主要空白。再加上GP数据，该数据集是一种提供必要数量的患者，以分析特定的酒精政策控制领域和与特定损伤原因相关的变量，调整损伤相关RR的偏倚， 事件的背景，并应用一种新的基于ER的方法，根据ER和GP饮酒模式数据，按伤害原因估计AAF，这有可能外推到具有相似特征的国家（例如，人均消耗量（DDP），ER研究不可用，但GP模式数据可用，GP无暴露数据，但人口统计学和档案数据可用。重要的是，这项工作将为美国的政策提供信息，可能导致政策变化，因为美国是由许多微观文化组成的，这些微观文化反映在收集这些数据的许多国家的背景环境中。