Substance Use and Firearm Injuries among Medicaid-enrolled Youth

参加医疗补助的青少年的药物使用和枪伤

• 批准号: 10811094
• 负责人: Scott Evan Hadland
• 金额: $ 56.37万
• 依托单位: MASSACHUSETTS GENERAL HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-30 至 2025-09-29
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10811094
• 关键词: Acceleration; Accident and Emergency department; Address; Adolescence; Adolescent; Adolescent and Young Adult; Adult; Age; Alcohol consumption; Alcohols; Applications Grants; Asian; Automobile Driving; Award; Black race; COVID-19 pandemic; Canada; Cannabis; Caring; Cause of Death; Cessation of life; Cocaine; Country; County; Data; Databases; Death Rate; Decision Analysis; Development; Diagnosis; Disparity; Drug usage; Early Intervention; Electronic Health Record; Enrollment; Epidemiology; Ethnic Origin; Evidence based intervention; Family; Firearms; Funding; Future; Goals; Gun injury; Health; Health care facility; Health system; Heroin; Hispanic; Homicide; Income; Indigenous; Individual; Inequity; Information Systems; Injury; Inpatients; Intervention; K-18 conjugate; Knowledge; Knowledge acquisition; Lead; Link; Literature; Location; Longitudinal Studies; Medicaid; Mentors; Mentorship; Morbidity - disease rate; National Institute of Drug Abuse; Not Hispanic or Latino; Outpatients; Persons; Pharmaceutical Preparations; Policies; Policy Maker; Population; Prevalence; Principal Investigator; Race; Recurrence; Research; Research Personnel; Research Project Grants; Risk; Risk Factors; Sampling; Scientist; Suicide; Surveys; Testing; Time; United States National Institutes of Health; Vehicle crash; Visit; Youth; addiction; adolescent substance use; age group; aged; alcohol involvement; binge drinking; career; children of color; disparity reduction; ethnic disparity; experience; health care settings; health equity; illicit drug use; injury prevention; large datasets; machine learning model; marijuana use; mortality; people of color; prevent; prevention service; protocol development; racial difference; racial disparity; skills; substance use; young adult

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.

项目摘要/摘要： 枪支受伤是美国青少年和年轻人（“青年”）的唯一主要原因。 在青少年和年轻人中，与枪支相关的自杀，凶杀和其他伤害的风险增加 成年，毒品和酒精的使用率也是如此。药物使用会增加枪支受伤的风险，并 识别和解决使用物质的使用可能是防止枪支相关发病率的关键策略 和死亡率。通常在医疗保健环境中出现有枪支伤害风险的年轻人，在这里证据 可以提供干预措施以解决药物使用并防止将来的伤害。但是，临床医生， 卫生系统和决策者需要有关此类干预措施的最佳位置和时机的清晰数据。 此外，由于长期存在的全身性不平等，有色的青年经验不成比例地提高 枪支伤害率和物质参与，以及降低枪支发病率和死亡率的研究 明确关注健康平等。该项目的核心目标是提供一个全面的国家 在4200万Medicaid样本中，药物使用，枪支损伤和重伤之间的联系的图片 - 在2016 - 2020年期间从美国和整个美国招募了13-25岁的青年，以详细介绍机会 减少种族和种族的分配。具体目的是：（1）确定与物质使用相关的访问 枪支受伤之前的青年，重点是此类访问的位置和时机； （2）确定 事故枪支受伤后，使用物质使用与重伤风险有关的程度。该项目将 受到潜水青年和家庭顾问委员会的指导，以告知协议开发，分析， 解释和调查结果的传播，目的是最大化相关性和结果 美国的青年，家庭和主要利益相关者。利用研究项目作为指导的机会 经验，这个K18职业增强奖将支持PI，Scott Hadland博士，专家 使用药物，以发展预防枪支伤害领域的新知识和技能。具体来说，他会的 获得枪支伤害的基础知识流行病学和政策，以及建立和合作的技能 与具有现场经验的个人的顾问委员会。该项目得到跨学科的支持 在这些主题以及种族和种族分布以及联系以及联系以及 大型数据集的分析。这项研究中确定的变量和关联将是与 未来，对PI进行了独立研究，包括机器学习模型，决策分析和 基于电子健康记录的干预措施。