Building the evidence for adolescent substance use preventive care at well-visits from mid-adolescence to young adulthood using the longitudinal NEXT study

使用纵向 NEXT 研究，为从青春期中期到成年早期的访视建立青少年药物使用预防护理的证据

• 批准号: 10642111
• 负责人: Arik V Marcell
• 金额: $ 10万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-04-01 至 2025-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10642111
• 关键词: Building; evidence; adolescent; substance; use

ABSTRACT Substance use (SU) is one of the most common causes of preventable death, injury, and disability, yet we currently have evidence gaps for the benefit of SU preventive care for adolescents in primary care. Given the median onset age for trying substances is under age 15, clinicians need to ask and advise adolescents about SU throughout adolescence. We know little about the extent to which substance using adolescents are engaged in well-visits over time, the proportion of adolescents who are asked and advised annually about SU at well-visits over time, and the extent to which being asked and advised about SU during adolescence is related to future SU initiation prevention or reduction over time. The proposed study’s goals are to examine longitudinal associations of adolescents’ SU preventive care and SU behaviors from mid-adolescence through young adulthood and disparities in SU preventive care by adolescents’ background, social determinant, and other health need factors. We hypothesize that adolescents being asked and advised about smoking, alcohol, and other drug use at well-visits will be associated with subsequent prevention of SU initiation in non-users and SU reduction in prior users. We will address this research gap by conducting longitudinal data analyses using the NIH NEXT Study collected from 2010-2017 (ages 15-23). This proposal expands on our prior work which showed most adolescents were engaged in well-visits from ages 5-9 (mid-childhood) through 10-17 (mid- adolescence). Building on these findings, our specific aims are to: 1) document the extent to which substance using adolescents are engaged in well-visits over time, 2) describe how often adolescents are regularly asked and advised about each and all three SU types over time, and 3) examine the extent to which being asked and advised about SU is related to subsequent SU initiation prevention or reduction over time, and describe across aims disparities by adolescents’ background, social determinant, and other health need factors. INNOVATION: Our proposed project will be the first study to examine longitudinal associations of adolescents’ preventive care receipt about SU and SU behaviors from adolescence through young adulthood, notorious times for SU onset and well-visit decline, using analytic approaches that have not been used in the field of adolescent health services research. We will use an existing non-clinical based national longitudinal dataset that has measured longitudinal data on well-visits, SU behaviors, and SU preventive care receipt across developmental periods. This type of rich data has never been previously used to inform practice. PUBLIC HEALTH SIGNIFICANCE: Our study will identify vulnerable adolescents for outreach who are persistently not engaged or become disengaged from well-visits and among those engaged who have missed SU preventive care opportunities. Findings will identify the extent to which being asked and advised about SU at well-visits occurs from adolescence to young adulthood and demonstrate the longitudinal benefit of SU screening and advising during adolescence on young adulthood SU, contributing to quality of evidence that is currently lacking.

摘要 物质使用（SU）是可预防的死亡，伤害和残疾的最常见原因之一，但我们 目前，在初级保健中对青少年进行SU预防保健的益处方面存在证据差距。鉴于 尝试物质的中位发病年龄在15岁以下，临床医生需要询问并建议青少年 整个青春期。我们对青少年吸毒的程度知之甚少， 随着时间的推移，每年询问和建议有关SU的青少年的比例 随着时间的推移，以及在青春期被问及和建议关于SU的程度， 与未来SU启动预防或随时间减少相关。这项研究的目的是检查 从青春期中期到青春期中期，青少年SU预防保健和SU行为的纵向关联 青少年的背景，社会决定因素， 其他健康需求因素。我们假设，青少年被问及和建议吸烟，酗酒， 和其他药物的使用将与随后预防非使用者开始SU相关， 减少先前用户的SU。我们将通过使用以下方法进行纵向数据分析来解决这一研究差距： NIH NEXT研究收集了2010-2017年（15-23岁）。这项建议扩展了我们先前的工作， 研究表明，大多数青少年在5-9岁（童年中期）到10-17岁（童年中期）期间都进行了油井访问。 青春期）。在这些发现的基础上，我们的具体目标是：1）记录实质性 使用青少年参与随时间的井访问，2）描述青少年定期被问到的频率 并建议每一个和所有三个SU类型随着时间的推移，和3）检查被问到的程度， 关于SU的建议与后续SU开始预防或随时间减少有关，并在 针对青少年的背景，社会决定因素和其他健康需求因素的差异。创新： 我们提出的项目将是第一个研究纵向协会的青少年预防保健 从青春期到成年早期，关于SU和SU行为的接收，SU发作的时间众所周知 和井访问量下降，使用尚未在青少年健康领域使用的分析方法， 服务研究。我们将使用现有的基于非临床的国家纵向数据集， 纵向数据，以及访问，SU的行为，和SU预防保健接收跨越发展时期。 这种类型的丰富数据以前从未用于指导实践。公共卫生意义： 我们的研究将确定弱势青少年的外展谁是持续不参与或成为 脱离井访问和那些从事谁错过了SU预防保健机会。 调查结果将确定在油井访视时被询问和建议SU的程度， 青春期到青年期，并证明SU筛查和建议的纵向益处， 青春期对青年期SU的影响，有助于目前缺乏的证据质量。