Initiation and Progression through Early Drinking Milestones in Underage Drinkers

描述(由申请人提供)：这是一项申请，以资助PI正在进行的前瞻性研究“未成年饮酒者早期饮酒里程碑的启动和进展”(R01 AA016838)的竞争续签。最初的供资周期侧重于青春期早期至中期，其目的是确定界定饮酒阶段的里程碑(例如，第一次充分饮酒、大量饮酒)，并审查风险因素在多大程度上解释里程碑开始和进展的差异。基础研究的参与者被纳入中学(N=1,023)，并在3年内进行评估，使用基于网络的狭隘重点的密集(每月)评估和具有更广泛内容的半年评估的补充。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的评估非常丰富。样品保留率非常高，回复率非常高。这项更新研究的目的是在高中期间继续评估这一宝贵的队列，在这段时间里，大多数年轻人经历了从酒精依赖综合征的任何使用到早期表现的越来越多的酒精参与阶段。这也是年轻人经历青春期和获得驾照等重要发展转型的时期。在这一资助期，我们直接从多波、队列顺序的基础性设计转变为发展驱动型设计，将参与者置于相同的时间表上，并在12年级(或同等年级)进行季度评估。到研究结束时，每个参与者将提供15到29个跨越6-12年级的季度波动。基于网络的调查将继续评估饮酒里程碑以及一系列个人水平和背景风险因素。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脚手架，并帮助确定其轨迹。这些饮酒前体包括与酒精有关的认知和饮酒意愿，随着个人通过接触与酒精有关的规范(包括娱乐媒体和社交网络中提到的酒精)间接或直接通过个人饮酒经验熟悉酒精，这些前体会发生变化。更新研究还评估了与青春期后期相关的重要发育转变和发育结果。拥有关于整个青春期酒精参与的全部数据，提供了一个无与伦比的机会，可以明确比较青年与早发和晚发之间的差异，并评估在酒精参与方面，启动的风险因素是否不同于其他过渡的风险因素。收集的细粒度数据对于阐明个人内部的变化至关重要，不仅是关于结果和风险因素，而且对于作为这些关联的重要调节者的时机也是至关重要的。研究结果将通过确定导致未成年青年饮酒进展、维持和停止的可改变的阶段特定危险因素，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.