Real Time Methods for Quantifying Exposure to Illicit Drugs & Psychosocial Stress

描述（由申请人提供）：药物使用暴露和心理社会压力的评估是复杂的，因为它们往往是短暂的，难以准确回忆。评估它们之间的因果关系，以及它们的遗传和环境决定因素，由于因果关系的复杂性和构成“环境”的难以捉摸的性质而变得复杂。在拟议的研究中，我们将通过生态瞬间评估（EMA）近乎实时地评估药物使用和心理社会压力，参与者使用手持电子日记记录发生的事件，并根据全天随机定时提示报告最近或正在发生的事件。我们还将通过让参与者携带全球定位系统（GPS）设备来跟踪他们的位置，以可能的空间分辨率为几米，从而保持报告事件发生地点的实时记录。拓宽环境因素的定义，我们将评估“社区水平”的药物暴露和压力，根据专门开发的指数，药物环境指数（DEI）和社区社会心理危害指数（NPH），每一个都基于从公共来源获得的客观统计数据，独立于自我报告。为了进行比较，还将通过回顾性音频计算机辅助结构访谈（ACASI）和生物标本（毛发和汗液）评估药物使用暴露，并通过ACASI和生理测量（心率和适应负荷）评估应激。该项目代表了NIDA校内研究项目（EMA已经用于多种药物依赖的门诊患者）和约翰霍普金斯ALIVE研究人员之间的合作（跟踪一个具有良好特征的药物滥用者社区队列，其中大多数人没有接受治疗）。随着NIDA的开发工作与ALIVE的现场试验相联系，预计结果将是一套可在现场部署的、最先进的工具，这对于未来研究影响药物使用和压力的基因-环境相互作用是必不可少的。

DESCRIPTION (provided by applicant): Assessment of exposure to drug use and psychosocial stress is complicated by the fact that each is often transient and difficult to recall accurately. Assessment of their causal connections with one another, and of their genetic and environmental determinants, is complicated by the complexity of the causal connections and by the elusive nature of what constitutes the "environment." In the proposed study, we will assess drug use and psychosocial stress in near-real time through Ecological Momentary Assessment (EMA), in which participants use handheld electronic diaries to record events as they occur and to report recent or ongoing events in response to randomly timed prompts throughout the day. We will also maintain real-time records of where the reported events occurred by having participants carry Global Positioning System (GPS) devices to track their whereabouts with a likely spatial resolution of several meters. Broadening the definition of environmental factors, we will evaluate 'neighborhood-level' exposures to drugs and stress measured in terms of specially developed indices, the Drug Environment Index (DEI) and the Neighborhood Psychosocial Hazards index (NPH), each based on objective statistical data available from public sources and independent of self-report. For comparison, drug use exposure will also be assessed through retrospective audio-computer assisted structure interview (ACASI) and from biological specimens (hair and sweat), and stress will be assessed through ACASI and physiological measures (heart rate and allostatic load). The project represents a collaboration between the NIDA Intramural Research Program (where EMA is already in use with polydrug-dependent outpatients) and Johns Hopkins ALIVE Study investigators (following a well- characterized community cohort of drug abusers, most of who are not in treatment). Following developmental work at NIDA linked to field trials in ALIVE, the result is expected to be a set of field- deployable, state-of-the-art tools indispensable to future studies of gene-environment interactions affecting drug use and stress.