Development of practical screening tools to support targeted prevention of early, high-risk drinking substance use

项目总结/摘要 青春期早期高风险饮酒和吸毒会带来急性危害和长期危害的风险。 后果NIDA在有针对性的预防计划中投入了大量资源，以减少、延迟或 减轻这些后果。由于目前缺乏一种方法， 准确可靠地确定哪些年轻人将受益于这些计划之前，他们开始实质性的 参与。现有的筛选工具，以量化风险之间的物质初治青年开发， 小，不具代表性的样本，并没有产生准确和可靠的预测，在新的数据。 响应RFA-DA-24-037，利用现有数据加快药物滥用研究的步伐，我们 建议利用前所未有的青少年大脑和认知发展SM（ABCD）研究， 开发并初步验证实用、准确和公平的筛选工具，用于真实的- 世界预防设置。ABCD研究®规模大（N= 11，880），社会人口统计学多样化，跨越21个城市 在美国，衡量青少年物质使用的每一个既定的风险/弹性因素，并将 前瞻性随访10年，使我们能够区分青少年早期，高风险饮酒/吸毒 使用来自同龄人的模式，这些同龄人表现出发育规范性，不频繁和短暂的实验， 物质.因此，没有以前的研究提供了一个更好的机会，发展准确和普遍的 筛选措施，以量化未使用过药物的青年的风险。目标1：开发一个简短，准确， 公平和可推广的筛选措施。根据一个系统的算法， 准确性和消除不公平，我们将建立和完善简短的，基于调查的措施量化风险， 早期高危饮酒和吸毒。目标2：对开发的筛选进行初步验证 对保留数据（n= 5，000）进行加权，以在社会人口统计学上代表所有儿童， 美国人口普查。为了预测这些工具在现实环境中的可能性能，我们将获得无偏估计值 筛选器性能的保持数据，然后进行敏感性分析，探索潜在的限制， 普遍性总之，这些目标有可能提供可以解锁公共卫生的筛查工具。 现有有针对性的预防干预措施在减少早期高危饮酒/吸毒方面的潜力， 以成本效益高的规模实施。这项开发性/探索性研究（R21）利用了现有数据 开发新的测量方法并进行初步验证。如果我们成功地制定出 我们将进一步完善和外部验证， 在随后的R 01范围项目中的措施。

PROJECT SUMMARY/ABSTRACT Early, high-risk drinking and drug use during adolescence conveys risk of both acute harms and long-term consequences. NIDA has invested considerable resources in targeted prevention programs to reduce, delay, or mitigate these outcomes. The public health impact of these programs is limited by the current lack of a method to accurately and reliably identify which youth would benefit from these programs before they initiate substance involvement. Existing screening instruments to quantify risk among substance-naïve youth were developed in small, non-representative samples and have not yielded accurate and reliable predictions in new data. Responding to RFA-DA-24-037, Accelerating the Pace of Drug Abuse Research Using Existing Data, we propose to leverage the unprecedented Adolescent Brain and Cognitive DevelopmentSM (ABCD) Study to develop and conduct a preliminary validation of practical, accurate, and equitable screening tools for use in real- world prevention settings. The ABCD Study® is large (N=11,880), sociodemographically diverse, spans 21 cities across the U.S., measured every well-established risk/resilience factors for adolescent substance use, and will be followed prospectively for 10 years, enabling us to distinguish adolescents with early, high-risk drinking/drug use patterns from peers exhibiting developmentally normative, infrequent, and transient experimentation with substances. Thus, no prior study has offered a better opportunity for developing accurate and generalizable screening measures to quantify risk among substance-naïve youth. Aim 1: Develop a portfolio of brief, accurate, equitable, and generalizable screening measures. Following a systematic algorithm designed to maximize accuracy and eliminate inequities, we will construct and refine brief, survey-based measures quantifying risk for early, high-risk drinking and drug use. Aim 2: Conduct a preliminary validation of the developed screening measures in holdout data (n=5,000) weighted to be sociodemographically representative of all children in the U.S Census. To anticipate the tools’ likely performance in real-world settings, we will obtain unbiased estimates of screener performance in holdout data, then conduct sensitivity analyses probing potential limits on generalizability. Together, these aims have potential to deliver screening tools that can unlock the public health potential of existing targeted preventive interventions to reduce early, high-risk drinking/drug use, enabling wider implementation at cost-effective scale. This developmental/exploratory research (R21) leverages existing data to develop novel measures and conduct a preliminary validation. If we are successful at producing measures that yield accurate and equitable screening decisions in holdout data, we will further refine and externally validate the measure in a subsequent R01-scope project.