Initiation and Progression through Early Drinking Milestones in Underage Drinkers

描述（由申请人提供）：本申请旨在资助PI正在进行的前瞻性研究“未成年饮酒者通过早期饮酒治疗的启动和进展”（R 01 AA 016838）的竞争性更新。最初的供资周期侧重于青少年早期至中期，其目标是确定划分饮酒阶段的里程碑（例如，第一次充分饮酒，大量饮酒），并检查风险因素在多大程度上解释了里程碑的启动和进展的变异性。基础研究的参与者在中学（N= 1，023）注册，并在3年内使用集中（每月）基于网络的狭窄重点评估与更广泛内容的半年度评估相结合进行评估。到目前为止，这项研究对非特异性和酒精相关的风险因素以及早期酒精参与进行了非常丰富的评估。样本保留率极高，答复率也很高。这项更新研究的目的是继续评估这一宝贵的队列，通过高中时代，在此期间，大多数青年的进展阶段，标志着越来越多的参与酒精，从任何使用酒精依赖综合征的早期表现。这也是青少年经历重要的发育转变的时期，如青春期和获得驾驶执照。在此资助期间，我们直接从多波，队列顺序的基础设计转变为发展驱动的设计，将参与者置于与12年级（或同等年级）季度评估相同的时间表上。到研究结束时，每个参与者将提供跨越6 - 12年级的15至29个季度波。基于网络的调查将继续评估饮酒里程碑以及一系列个人层面和背景风险因素。此外，更新研究将利用对“饮酒前体”的丰富评估，这些评估提供了支持早期饮酒经历的框架，并有助于确定其轨迹。这些饮酒前体，包括与酒精相关的认知和饮酒意愿，随着个人通过接触酒精相关规范（包括娱乐媒体和社交网络中的酒精参考）或直接通过个人酒精体验间接熟悉酒精而改变。更新研究还评估了与青春期后期相关的重要发育过渡和发育结果。拥有关于整个青春期酒精参与的全方位数据提供了一个无与伦比的机会，可以明确比较早发与迟发青年，并评估启动的风险因素是否与其他过渡期的风险因素不同，沿着酒精参与的维度。收集的细粒度数据对于阐明人内变化至关重要，不仅涉及结果和风险因素，而且还涉及作为这些关联重要调节剂的时间。研究结果将通过确定未成年人饮酒进展、维持和停止的可改变的特定阶段风险因素，为预防工作提供信息。

DESCRIPTION (provided by applicant): This is an application to fund a competitive renewal for the PI's ongoing prospective study "Initiation and Progression through Early Drinking Milestones in Underage Drinkers" (R01 AA016838). The aims under the initial funding cycle, which focused on the period of early-to-mid adolescence, were to identify milestones demarcating drinking stages (e.g., first full drink, heavy drinking) and to examine the extent to which risk factors explain variability in initiation and progression through milestones. Participans in the base study were enrolled in middle school (N=1,023) and assessed over a 3-year period using a combination of intensive (monthly) web-based assessments of narrow focus complemented by semi-annual assessments with broader content. To date, the study has an incredibly rich assessment of nonspecific and alcohol-related risk factors as well as early alcohol involvement. Sample retention is exceptionally high, with outstanding response rates. The purpose of this renewal study is to continue to assess this valuable cohort through the high school years, a time during which the majority of youth progress through stages marked by increasing involvement with alcohol ranging from any use to early manifestation of the alcohol dependence syndrome. It is also a time during which youth undergo important developmental transitions such as puberty and attainment of a driver's license. In this funding period, we directly shift from a multi-wave, cohort-sequential foundational design to a developmentally driven design that places participants on the same schedule with quarterly assessments through 12th grade (or equivalent). By study end, each participant will provide between 15 and 29 quarterly waves spanning the 6th- 12th grade years. Web-based surveys will continue to assess drinking milestones as well as an array of individual-level and contextual risk factors. In additio, the renewal study will leverage a rich assessment of "drinking precursors" that provide the scaffolding that support early drinking experiences and help to determine its trajectory. These drinking precursors, which include alcohol-related cognitions and willingness to drink, change as individuals gain familiarity with alcohol either indirectly through exposure to alcohol-related norms (including alcohol references in entertainment media and social networking) or directly, through personal experience with alcohol. The renewal study also assesses important developmental transitions and developmental outcomes relevant to late adolescence. Having a full spectrum of data on alcohol involvement across the full span of adolescence provides an unparalleled opportunity to explicitly compare youth with early versus late onset and to evaluate whether risk factors for initiation to differ from risk factors for other transitions along the dimension of alcohol involvement. The fine grained data collected are critical for illuminating within- person change, not only with regard to outcomes and risk factors, but also for timing as an important moderator of these associations. Findings will inform prevention efforts by identifying modifiable stage-specific risk factors for progression, maintenance, and desistence of drinking in underage youth.