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）：这项竞争性延续研究建立在并扩展了研究，该研究分析了来自 12 个世卫组织酒精和伤害合作研究、8 个国家的 33 个地点（包括急诊室酒精合作分析项目 (ERCAAP)）的 ER 数据，以及上一个项目期间添加的 13 个国家的 30 个地点的数据，所有研究的数据都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) 按国家/地区水平的饮酒模式、饮酒背景、酒精控制政策和急诊室特征，检查全因伤害前 6 小时内自我报告的饮酒情况和伤害原因（交通、跌倒、亲密伴侣暴力、其他暴力、烧伤、溺水、中毒、自杀未遂）的酒精相关伤害风险； 2) 按伤害原因估计与饮酒量（剂量反应关系）相关的伤害相对风险（RR），比较调整和不调整个人伤害背景的估计值，并比较不同总体水平有害饮酒模式（DDP）、饮酒背景和酒精政策的地区的估计值； 3) 根据伤害原因估计酒精归因分数 (AAF)，结合 ER 数据和一般人群 (GP) 数据，应用基于 ER 的饮酒相关伤害的 RR，并根据个人水平和 GP 惯常饮酒模式数据预测急性饮酒暴露。目标旨在实现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》的目标，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，还将为他们建议的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。将添加来自 16 个国家 44 个急诊室的 21,007 名患者的数据，总计来自覆盖 37 个国家的 119 个急诊室的 43,453 名受伤患者。分层线性建模和案例交叉分析，并将检查背景变量，包括酒精政策以及酒精伤害的个人和事件层面变量 关系，解决了该文献中的一个主要空白。与全科医生数据相结合，该数据集是一种提供必要数量的患者来分析特定酒精政策控制领域和与特定伤害原因相关的变量，调整伤害相关的 RR 偏差的数据集之一。 根据事件的背景，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，该方法有可能外推到具有相似概况（例如人均消费量、DDP）的国家，这些国家没有 ER 研究，但有 GP 模式数据，以及没有暴露数据但有人口和档案数据的 GP。重要的是，这项工作将为美国政策提供信息，有可能导致政策变化，因为美国由许多微观文化组成，这些文化反映在主导许多收集这些数据的国家的背景环境中。