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（由申请人提供）：这一竞争性的延续建立并扩展了研究，该研究分析了来自世卫组织酒精与伤害合作研究的12个地点、包括急诊室酒精合作分析项目（ERCAAP）的8个国家的33个地点和上一个项目期间增加的13个国家的30个地点的ER数据，这些研究的数据都使用了类似的方法和仪器对ER患者的概率样本进行分析。研究的目的是：1)根据国家/地区水平的饮酒模式、饮酒背景、酒精控制政策和er水平特征，检查在全因伤害前6小时内自我报告饮酒的酒精相关伤害风险，并按伤害原因（交通、跌倒、亲密伴侣暴力、其他暴力、烧伤、接近溺水、中毒、企图自杀）进行分析；2)根据损伤原因估计与酒精消费量（剂量-反应关系）相关的损伤的相对风险（RR），比较有和没有调整个人水平损伤背景的估计值，并比较不同地区总水平有害饮酒模式（DDP）、饮酒背景和酒精政策的估计值；3)根据损伤原因估算酒精归因分数（AAF），结合ER数据和一般人群（GP）数据，应用基于ER的饮酒相关损伤RR，并根据个人水平和GP通常饮酒模式数据预测急性饮酒暴露。目标涉及2010年5月世界卫生大会批准的《减少有害使用酒精全球战略》的各项目标，即加强关于酒精相关危害的程度和决定因素的知识库，除其他目标外，还将为其建议的10个政策目标领域中的5个提供信息：社区行动、酒后驾驶、酒精供应、酒精饮料营销和定价。将增加来自16个国家44个急诊室的21007名患者的数据，累积来自37个国家119个急诊室的43453名受伤患者的数据。分层线性建模和病例交叉分析，并将检查上下文变量，包括酒精政策与酒精损伤的个人和事件水平变量