The Social Context of Adolescent Marijuana Use: A Systems Approach

说明(申请人提供)：青少年吸食大麻的人数持续上升，预防青少年吸食大麻的干预措施成效有限，这可能是因为未能认识到同伴关系的复杂性，包括同伴对恋人的重要性的发展变化、恋爱关系的变化，以及同伴和恋人之间相互关联的关系，从而导致青少年吸食、继续使用和升级大麻。应聘者是流行病学家，在线性建模方面受过良好的培训，并了解伴侣环境对危险行为(即避孕套的使用和并发)的作用。为了成为一名成功的独立调查员，其职业生涯专注于解决青少年使用大麻这一重大而复杂的问题，候选人需要接受额外的培训，内容包括大麻使用和依赖的病因和轨迹，恋爱关系和同伴关系的发展及其对围绕健康危害行为的决策的影响，复杂系统动力学和数学建模方面的正式和实践培训，以及对与青少年药物使用研究相关的法律和伦理问题的深入理解。候选人的长期目标是通过确定促进健康的机会和适合发展的初级药物使用预防战略，成为一名专注于改善青少年健康的独立调查员。大麻的使用是一个重大的公共卫生问题，因为与使用大麻相关的广泛的健康和社会后果。青少年吸食大麻可能是一个棘手的问题，因为它植根于一个复杂的系统中。应聘者的短期目标是获得应用系统科学方法的知识和技能，以阐明浪漫关系的背景如何推动青少年吸食、继续和升级大麻使用。为实现这些短期和长期目标，该奖项的培训部分包括4项活动：1)发展青少年和青年大麻滥用和依赖的病因学、生理学和发展轨迹方面的专门知识；2)为青少年和青年异性恋发展过程中的性关系、约会和恋爱关系建立理论基础；3)获得系统科学方法方面的高级技能，包括群体建模和数学建模；以及4)了解脆弱青少年和青年吸毒研究中涉及的复杂伦理问题。该奖项的研究部分是量化情侣对青少年大麻使用的影响，并使用系统科学方法纳入同伴社会化过程的重要复杂性。具体目标1是使用纵向数据来估计情侣和非情侣同伴对青少年大麻使用的影响。这些知识将作为开发定量系统动力学模型的基础，该模型将检查是否存在浪漫伴侣的影响，以及随着时间的推移，浪漫伴侣和非浪漫同伴对青少年大麻使用频率的影响程度。具体目标2是利用参与性模式建设(例如，召集多学科学术和社区专家小组以及一群青年)，利用基于不同学科丰富理论的方法，创建一个系统图，纳入推动青少年随时间吸食、继续和逐步使用大麻的社会系统的关键组成部分。具体目标3是利用系统图开发同伴系统对大麻使用的影响的定量模拟模型，并利用包括经验文献在内的现有数据对该模型进行校准。在完成这一奖项后，候选人将成为一名富有成效的研究人员，他拥有必要的技能来进行创新和引人注目的跨学科研究，重点是青少年药物使用的病因学。她将了解社会环境，特别是青春期浪漫和非浪漫同伴关系的动态性质，如何影响大麻的使用。建立模型可能有助于识别同伴系统中延续健康和社会后果差异的反馈回路。这项工作的发现可能会确定系统中的杠杆点，这些点可能是新的、多学科的，理想情况下比以前确定的预防目标更具可变性。

DESCRIPTION (provided by applicant): The continued rise in adolescent marijuana use and the limited effectiveness of interventions to prevent adolescent marijuana use may be due to the failure to recognize the complexity of peer relationships, including developmental shifts in the prominence of peers vs. romantic partners, changes within romantic relationships, and the interconnected relationship between peers and romantic partners, that lead to the uptake, continuation, and escalation of adolescent marijuana use. The candidate is an epidemiologist, who has been well trained in linear modeling and brings an understanding of the role of partner context on risk behaviors (i.e. condom use and concurrency). To become a successful independent investigator with a career focused on addressing the significant and complex problem of adolescent marijuana use, the candidate requires additional training on the etiology and trajectories of marijuana use and dependence, the development and impact of romantic and peer relationships on decision-making around health compromising behaviors, formal and practical training in complex System Dynamics and mathematical modeling, and a deep understanding of legal and ethical issues associated with adolescent substance use research. The long-term goals of the candidate are to become an independent investigator focused on improving adolescent health by identifying opportunities for health promotion and developmentally appropriate primary drug use prevention strategies. Marijuana use is a significant public health problem due to the breadth of health and social consequences associated with its use. Adolescent marijuana use may be an intractable problem because it is embedded in a complex system. The short-term goals of the candidate are to gain the knowledge and skills to apply a systems science approach to illuminate how the context of romantic relationships drives adolescents' uptake, continuation and escalation of marijuana use. To attain these short- and long-term goals, the training component of the award includes 4 activities: 1) develop expertise in the etiology, physiology and trajectories of adolescent and young adult marijuana abuse and dependence, 2) build a theoretical foundation of sexual, dating and romantic relationships over the course of heterosexual adolescent and young adult development, 3) gain advanced skills in systems science methods, including group model building and mathematical modeling, and 4) gain an understanding of the complex ethical issues involved in drug use research with vulnerable adolescents and young adults. The research component of the award is to quantify the influence of romantic partners on adolescent marijuana use, and to use systems science methodology to incorporate important complexities of peer socialization processes. Specific Aim 1 is to use longitudinal data to estimate the contribution of romantic partner and non-romantic peer influence on adolescent marijuana use. This knowledge will serve as the foundation for developing a quantitative System Dynamics model, which will examine whether there is an effect of romantic partners and the relative magnitude of romantic partners and non-romantic peer influence on frequency of adolescent marijuana use over time. Specific Aim 2 is to use participatory model building (e.g., convened group of multidisciplinary academic and community experts and a group of youth) to create a system diagram incorporating key components of the social system that drive an adolescent's uptake, continuation and escalation of marijuana use over time using an approach grounded in rich theory from diverse disciplines. Specific Aim 3 is to use the system diagram to develop a quantitative simulation model of peer system effects on marijuana use and calibrate the model with available data, including the empirical literature. Upon completion of this award, the candidate will become a productive investigator who has the necessary skills to conduct innovative and compelling interdisciplinary research focused on the etiology of drug use in adolescents. She will understand how social context, specifically the dynamic nature of adolescent romantic and non-romantic peer relationships, affects marijuana use. Model building may help identify feedback loops in the peer system that perpetuates disparities in health and social consequences. Findings from this work may identify leverage points in the system that may be novel, multi-disciplinary and ideally more modifiable than previously identified prevention targets.