Substance Use and Firearm Injuries among Medicaid-enrolled Youth

项目总结/摘要： 枪支伤害是美国青少年和年轻人（“青年”）死亡的唯一主要原因。 与枪支有关的自杀，杀人和其他伤害的风险在青春期和年轻时上升 成年期，吸毒和酗酒的比率也是如此。药物使用会增加火器伤害的风险， 识别和解决物质使用问题可能是预防枪支相关疾病的关键战略 and mortality.有火器伤害风险的青年通常会出现在医疗机构， 可以采取干预措施，解决物质使用问题，防止今后发生伤害。然而，临床医生， 卫生系统和决策者需要关于此类干预措施的最佳地点和时间的明确数据。 此外，由于长期存在的系统性不平等，有色人种的青年经历不成比例地增加， 火器伤害率和物质参与，以及研究，以减少火器发病率和死亡率，必须 明确关注健康公平。该项目的中心目标是提供一个全面的、全国性的 在4200万医疗补助样本中，物质使用、火器伤害和再伤害之间的联系的图片- 在2016-2020年期间，从美国各地招募了13-25岁的年轻人，并在整个过程中，详细介绍了 减少种族和民族差异。具体目标是：（1）确定与物质使用有关的访问， （2）在发生火器伤害之前，对青年进行检查，重点是这种检查的地点和时间; 在何种程度上，物质使用与意外火器伤害后再伤害的风险有关。该项目将 由一个多元化的青年和家庭咨询委员会指导，为协议的制定、分析、 解释和传播结果，目标是最大限度地提高成果的相关性， 青年，家庭和美国各地的主要利益相关者。利用研究项目作为指导的机会 经验，这个K18职业提升奖将支持PI，斯科特哈德兰博士，在青年专家 药物使用，以发展预防火器伤害领域的新知识和技能。具体来说，他将 获得火器伤害流行病学和政策的基础知识，以及建立和建立伙伴关系的技能 由具有实际经验的个人组成的顾问委员会。该项目由一个跨学科的 导师团队具有跨这些主题的专业知识，以及种族和民族差异， 分析大型数据集。本研究中确定的变量和关联将作为关键投入， 未来，独立进行PI的研究，包括机器学习模型，决策分析， 基于电子健康记录的干预措施。

PROJECT SUMMARY/ABSTRACT: Firearm injuries are the single leading cause of death among adolescents and young adults (“youth”) in the US. Risk for firearm-related suicide, homicide, and other injuries rises during adolescence and into young adulthood, as do rates of drug and alcohol use. Substance use increases the risk of firearm injuries, and identifying and addressing substance use may be a critical strategy for preventing firearm-related morbidity and mortality. Youth at risk for firearm injuries commonly present to healthcare settings, where evidence-based interventions can be delivered to address substance use and prevent future injuries. However, clinicians, health systems, and policymakers need clear data on the optimal location and timing for such interventions. Additionally, owing to longstanding systemic inequities, youth of color experience disproportionately elevated firearm injury rates and substance involvement, and studies to reduce firearm morbidity and mortality must have a clear focus on health equity. The central objective of this project is to provide a comprehensive, national picture of the links between substance use, firearm injuries, and reinjury in a sample of 42 million Medicaid- enrolled youth aged 13-25 from across the US during 2016-2020, and throughout, to detail opportunities to reduce disparities by race and ethnicity. The Specific Aims are to: (1) Identify substance use-related visits in youth prior to a firearm injury, with a focus on the location and timing of such visits; and (2) Determine the extent to which substance use is associated with risk for reinjury after an incident firearm injury. The project will be guided by a diverse Youth and Family Advisory Board to inform protocol development, analysis, interpretation, and dissemination of findings, with a goal of maximizing relevance and delivery of results to youth, families, and key stakeholders across the US. Using the research project as an opportunity for mentored experience, this K18 Career Enhancement Award will support the PI, Dr. Scott Hadland, an expert in youth substance use, to develop new knowledge and skills in the field of firearm injury prevention. Specifically, he will acquire foundational knowledge in firearm injury epidemiology and policy, and skills in building and partnering with an advisory board of individuals with lived experience. The project is supported by an interdisciplinary mentorship team with expertise across these topics, as well as in racial and ethnic disparities, and linkage and analysis of large datasets. The variables and associations identified in this study will serve as critical inputs to future, independently conducted research of the PI, including machine-learning models, decision analysis, and electronic health record-based interventions.