Substance Use in Reservists Social and Environmental Influences

描述（由申请人提供）：在社会生态框架的指导下，本申请将考虑个人层面的风险因素（例如，抑郁症状）以及社会（例如，伴侣/同伴行为）和环境（例如，生活压力）因素对美国预备役士兵物质使用变化的影响。药物滥用是退伍军人中最常见的健康问题，药物使用与创伤有关，无论是在战斗中还是在家中。与现役军人相比，预备役军人的饮酒问题和人际矛盾问题较多，因此，这些问题引起了人们的高度关注。由于目前有一半以上的军人已婚，因此检查预备役人员影响或被其伴侣影响的潜力非常重要。我们之前的研究和其他人的研究提供了证据，证明伴侣的影响是健康状况积极或消极变化的有力预测因素。我们还发现同伴网络与成年人酒精使用的变化有关，物质使用塑造了同伴网络。随着社会网络在部署期间的变化，社会/环境对预备役军人及其伴侣的影响可能特别突出。这些经历很可能会加强同伴群体的影响力，特别是如果同伴在部署后处于同伴网络中。因此，建议的研究将检查个人和更广泛的社会环境影响（例如，关系，社区和社会）对预备役军人及其伴侣的压力和物质使用之间的关系。使用多波设计，预备役人员及其伴侣（N = 400对夫妇）将在2年内（即基线，第1年，第2年）进行3次评估。参与者将使用最先进的触摸屏音频计算机辅助访谈进行评估。使用先进的纵向分析（例如，多层次和GEE模型），本提案将审查：1)在个人（例如，抑郁症状）、关系（例如，伴侣和同伴的物质使用）、社区（例如，工作场所/部署）和社会（例如，规范）因素的基础上，预备役士兵及其伴侣的物质使用（酒精、烟草和处方药的非医疗使用）随时间的变化；2)压力/创伤（如战斗暴露/生活压力）与物质使用之间的关系；3)物质使用对婚姻攻击和婚姻破裂的影响。重要的是，这对夫妇的每个成员都将提供独立的数据。本研究的创新之处在于：1)关注个人、伙伴和同伴的影响；2)对预备役人员的关注

DESCRIPTION (provided by applicant): Guided by a social ecological framework, this application will consider individual-level risk factors (e.g., depressive symptoms) and the influence of social (e.g., partner/peer behaviors) and environmental (e.g., life stress) factors on changes in substance use in US Reserve Soldiers. Substance abuse is the most common health problem among veterans and substance use is linked to trauma, either in combat or at home. These issues are of heightened concern among the Reserve as they have more drinking problems and interpersonal conflict relative to active duty soldiers post-deployment. With more than half of the Military currently married, it is important to examine the potential of a Reservist to influence, or be influenced, by his/her partner. Our previous research, and that of others, provides evidence that partner influences are powerful predictors of positive or negative changes in health. We also have found that peer networks are involved in changes in alcohol use among adults and that substance use shapes the peer network. Social/environmental influences may be particularly salient for Reservists and their partners as social networks change during deployments. These experiences are likely to strengthen the influence of a peer group, particularly if fellow soldiers are within one's peer networks post-deployment. Thus, the proposed study will examine individual and broader social environmental influences (e.g., relationship, community, and societal) on the association between stress and substance use for Reservists and their partners. Using a multi-wave design, Reservists and their partners (N = 400 couples) will be assessed 3 times over 2 years (i.e., baseline, Year 1, Year 2). Participants will be assessed using state-of-the-science Touch Screen Audio Enabled Computer Assisted Interviews. Using advanced longitudinal analyses (e.g., multilevel and GEE models), this proposal will examine: 1) changes in substance use (alcohol, tobacco, and nonmedical use of prescription drugs) over time in Reserve Soldiers and their partners on the basis of individual (e.g., depressive symptoms), relationship (e.g., partner and peer substance use), community (e.g., workplace/deployments) and societal (e.g., norms) factors; 2) the relation between stress/trauma (e.g., combat exposure/life stress) and substance use; and 3) how the integration of substance use into the relationship impacts marital aggression and dissolution. Importantly, each member of the couple will provide independent data. The proposed study is innovative in: 1) its focus on individual, partner, and peer influences; 2) its focus on Reservists and their partners; and 3) the application of an adapted social ecological model to a Reservist population. The proposed study is significant because it will add to our limited knowledge about the social (e.g., partner/peer influences) and environmental (e.g., stress/trauma) risk factors for substance use that are faced by Reservists. The knowledge gained from this conceptually and methodologically rigorous study will enhance the development of effective secondary prevention and intervention strategies to address the complex issues faced by military couples.