Development of practical screening tools to support targeted prevention of early, high-risk drinking substance use

项目摘要/摘要 青春期早期高风险饮酒和吸毒会传递急性伤害和长期危害的风险 后果。NIDA在有针对性的预防计划上投入了大量资源，以减少、延误或 缓解这些后果。由于目前缺乏一种方法，这些项目对公共健康的影响有限 在这些计划启动之前，准确可靠地确定哪些青年将从这些计划中受益 参与其中。在#年开发了现有的筛查工具来量化物质天真青年的风险 小样本、不具代表性，在新数据中没有产生准确和可靠的预测。 响应RFA-DA-24-037，利用现有数据加快药物滥用研究的步伐，我们 建议利用史无前例的青少年大脑和认知发展SM(ABCD)研究来 开发和实施实用、准确和公平的筛查工具的初步验证，以用于真实- 世界预防环境。ABCD Study®规模庞大(N=11,880)，社会人口统计多样化，覆盖21个城市 在全美范围内，衡量了青少年药物使用的每一个公认的风险/弹性因素，并将 前瞻性跟踪10年，使我们能够区分早期、高风险饮酒/吸毒的青少年 使用来自同行的模式，这些同行展示出开发上规范的、不频繁的和短暂的 物质。因此，没有任何先前的研究提供了更好的机会来开发精确度和可推广性 筛选措施，以量化物质天真青年的风险。目标1：开发一个简短、准确、 公平、普遍的筛查措施。遵循一种系统的算法，旨在最大化 为了准确和消除不平等，我们将构建和完善基于调查的简短措施，量化以下方面的风险 早期、高风险饮酒和吸毒。目标2：对已开发的筛查进行初步验证 抵抗数据中的衡量标准(n=5,000)加权，以代表社会人口统计中的所有儿童 美国人口普查。为了预测这些工具在现实世界中的可能性能，我们将获得公正的估计 ，然后进行敏感性分析，以探测潜在的限制 概括性。这些目标加在一起，有可能提供能够解锁公共健康的筛查工具 现有有针对性的预防干预措施减少早期、高风险饮酒/吸毒的潜力，使更广泛的 以具有成本效益的规模实施。此开发/探索性研究(R21)利用现有数据 开发新的措施并进行初步验证。如果我们在制定措施方面取得成功 在抵抗数据中产生准确和公平的筛查决定，我们将进一步完善和外部验证 在后续的R01范围项目中的测量。

PROJECT SUMMARY/ABSTRACT Early, high-risk drinking and drug use during adolescence conveys risk of both acute harms and long-term consequences. NIDA has invested considerable resources in targeted prevention programs to reduce, delay, or mitigate these outcomes. The public health impact of these programs is limited by the current lack of a method to accurately and reliably identify which youth would benefit from these programs before they initiate substance involvement. Existing screening instruments to quantify risk among substance-naïve youth were developed in small, non-representative samples and have not yielded accurate and reliable predictions in new data. Responding to RFA-DA-24-037, Accelerating the Pace of Drug Abuse Research Using Existing Data, we propose to leverage the unprecedented Adolescent Brain and Cognitive DevelopmentSM (ABCD) Study to develop and conduct a preliminary validation of practical, accurate, and equitable screening tools for use in real- world prevention settings. The ABCD Study® is large (N=11,880), sociodemographically diverse, spans 21 cities across the U.S., measured every well-established risk/resilience factors for adolescent substance use, and will be followed prospectively for 10 years, enabling us to distinguish adolescents with early, high-risk drinking/drug use patterns from peers exhibiting developmentally normative, infrequent, and transient experimentation with substances. Thus, no prior study has offered a better opportunity for developing accurate and generalizable screening measures to quantify risk among substance-naïve youth. Aim 1: Develop a portfolio of brief, accurate, equitable, and generalizable screening measures. Following a systematic algorithm designed to maximize accuracy and eliminate inequities, we will construct and refine brief, survey-based measures quantifying risk for early, high-risk drinking and drug use. Aim 2: Conduct a preliminary validation of the developed screening measures in holdout data (n=5,000) weighted to be sociodemographically representative of all children in the U.S Census. To anticipate the tools’ likely performance in real-world settings, we will obtain unbiased estimates of screener performance in holdout data, then conduct sensitivity analyses probing potential limits on generalizability. Together, these aims have potential to deliver screening tools that can unlock the public health potential of existing targeted preventive interventions to reduce early, high-risk drinking/drug use, enabling wider implementation at cost-effective scale. This developmental/exploratory research (R21) leverages existing data to develop novel measures and conduct a preliminary validation. If we are successful at producing measures that yield accurate and equitable screening decisions in holdout data, we will further refine and externally validate the measure in a subsequent R01-scope project.