Alcohol and Tobacco Use and Desistance Among Asian Americans: A Lifecourse Examination of Critical Periods and Subgroup Disparities

这项拨款申请是对年流行病学和预防研究项目公告的回应。 酒精研究（PA-18-391），要求国家发布的探索性和发展性研究 酒精滥用和酒精中毒研究所。该申请提出了对数据的二次分析， 国家青少年到成人健康纵向研究（添加健康），以检查何时以及为什么亚洲 美国人在整个生命过程中（从12岁到43岁）都大量使用酒精和烟草。在 除了探索酒精和烟草共同使用的模式外，我们还将扩大对酒精的调查， 和烟草使用进入成年期，重点关注与亚裔美国人相关的风险和弹性因素， 体验.首先，这项研究将描述酒精浓度升高和持续的纵向趋势， 从青少年到成年的烟草使用和共同使用。然后，我们将确定风险和弹性预测因素， 多级（即，个人，家庭，人际关系和邻里）的亚裔美国人， 长期持续使用酒精和烟草我们通过使用时变效应进行创新 建立模型，以确定具体的年龄和发育期，为预防性干预提供信息， 我们除了现有的发展研究。第三个分析将使用适度调解来解决如何 背景风险可能会影响行为，通过确定抑郁是否有助于解释风险的关联， 酒精和烟草的使用和共同使用。我们将研究是否在多个层面的保护因素 缓冲个人与之互动的环境的有害影响。最后，我们复制关键分析 目的：1）将亚裔美国人与美国主要种族/族裔群体（非西班牙裔白人、西班牙裔和黑人）进行比较 以确定机制是该人群独有的还是跨群体共有的，以及2）评估 亚裔美国人亚组差异（按性别、出生地和种族），以解决组内异质性 酒精和烟草的使用模式。 该项目的目标与NIH当前的知识生成战略计划直接相关 制定干预措施，以减少与酒精和烟草有关的健康差距。本探索性研究 将通过允许确定某些特定环境和机制，为预防科学提供信息。 与亚裔美国人持续使用酒精和烟草以及共同使用相关的发展时期。的 这项研究还将在先前研究的基础上，通过延长对重度酒精和烟草使用的生命过程检查， 以及关注亚裔美国人的共同使用。正如节目预告中所说， 研究对于建立知识库以制定与文化相关的预防性干预措施至关重要 解决不同社区的使用和滥用问题。未来的项目将旨在帮助翻译这项研究 调查结果纳入社区为基础的，多层次的干预措施，在特定背景下的风险亚裔美国人。

This grant application responds to the program announcement for studies of Epidemiology and Prevention in Alcohol Research (PA-18-391) calling for exploratory and developmental research issued by the National Institute on Alcohol Abuse and Alcoholism. The application proposes a secondary analysis of data from the National Longitudinal Study of Adolescent to Adult Health (Add Health) to examine when and why Asian Americans engage in heavy alcohol and tobacco use and co-use across the lifecourse (from ages 12-43). In addition to exploring patterns of alcohol and tobacco co-use, we will extend the investigation of alcohol and tobacco use into adulthood with a focus on risk and resiliency factors relevant to the Asian American experience. First, the study will provide descriptions of longitudinal trends of elevated and sustained alcohol and tobacco use and co-use from adolescence to adulthood. Then, we will identify risk and resiliency predictors at multiple levels (i.e., individual, family, interpersonal, and neighborhood) for Asian Americans that are associated with sustained alcohol and tobacco use and co-use over time. We innovate by employing time-varying effect modeling to determine specific ages and developmental periods for informing preventive interventions, setting us apart from extant developmental research. The third analyses will use moderated mediation to address how contextual risks may influence behavior by ascertaining whether depression helps to explain associations of risk exposures on alcohol and tobacco use and co-use. We will examine whether protective factors at multiple levels buffer the deleterious effects of the contexts with which individuals interact. Finally, we replicate key analyses to: 1) compare Asian Americans to major US racial/ethnic groups (non-Hispanics Whites, Hispanics, and Blacks) to determine whether mechanisms are unique to this population or common across groups, and 2) assess for Asian American subgroup differences (by gender, nativity, and ethnicity) to address within-group heterogeneity in alcohol and tobacco use patterns. The objectives of this project are directly relevant to the NIH’s current strategic plan to generate knowledge for intervention development to reduce health disparities related to alcohol and tobacco. This exploratory study will inform prevention science by permitting the identification of specific contexts and mechanisms within certain developmental periods relevant to sustained alcohol and tobacco use and co-use among Asian Americans. The study will also build on prior research by extending the lifecourse examination of heavy alcohol and tobacco use into adulthood and by focusing on co-use in Asian Americans. As noted in the program announcement, this research is critical for establishing a knowledge base in developing culturally relevant preventive interventions to address use and misuse in diverse communities. Future projects will be designed to help translate the study findings into community-based, multilevel interventions for at-risk Asian Americans within specific contexts.