Examining Individuals' Exposure to Alcohol Environments Using Novel Responsive Buffers

项目摘要/摘要 在美国，酒精的使用和误用是可预防的死亡的主要原因。几十年的研究 已经确定了与饮酒有关的个人水平和环境特征，因此 可以进行改装以减少人群的酒精消费。酒精出口密度就是这样一种环境 这一特点一直是美国和世界各地大量研究的重点。虽然许多机构 组织已经利用这项研究来促进政策，倡导对酒精出口进行修改 例如，通过改变许可和分区，这一科学还远未确定下来。调查结果： 在考察个体水平时，出口密度与饮酒量之间的关系是矛盾的 生态层面的研究和每一个额外的酒精出口对酒精消费的影响也仍然存在 不清楚。对于酒精出口密度和酒精消费之间的真正关系缺乏共识 指出有必要进行严格的个人层面的研究，纳入影响个人 去酒类销售点的决定和酒精消费的多尺度性质以及潜在的风险因素 多个级别。这项研究的目标是创建一种新的酒精环境测量方法--a 响应性缓冲-结合了数十年来识别影响酒精的特征的研究 使用。这项研究的具体目的是(1)对研究的最新研究进行系统回顾 2014年11月发布的酒精出口密度对酒精消费或相关危害的影响 2023年11月综合生态和个人层面的研究结果，酒精出口密度 测量、方法进步、科学严谨性和方法限制，(2)比较距离 个人使用GPS旅行数据前往酒类销售点，并使用这些信息来开发响应缓冲区 用于评估接触酒精出口的情况，以及(3)表征酒精出口密度与 具有个别酒精消耗量(即饮酒天数、消耗量)的响应性缓冲 并将效果大小与酒精出口密度的常用测量(例如，人口普查区域，邮政编码， 住宅周围400米的缓冲区)。建议的目标和培训计划是基于我在酒精研究方面的经验 辅以酒精流行病学、空间流行病学和邻里研究方面的重点培训 流动性研究和暴露的瞬时评估的技术以及分层结构的分析 数据。这一新方法的研究和开发对环境保护具有重要意义 旨在通过减少酒精消费来改善人口健康的努力。通过创建创新的 测量酒精环境，这项研究将改进循证研究向 酒精预防政策，并促进NIAAA的使命，即为监管努力和创建 为所有人的健康生活和福祉创造环境。

PROJECT SUMMARY/ABSTRACT Alcohol use and misuse is a leading cause of preventable death in the United States (US). Decades of research have identified individual-level and environmental characteristics that are associated with alcohol use and thus can be modified to reduce population alcohol consumption. Alcohol outlet density is one such environmental characteristic that has been a focus of substantial research in the US and around the world. While many agencies and organizations have used this research to promote policy advocating for modifications in alcohol outlet density, such as through changes in licensing and zoning, the science is far from settled. The findings of the relationship between outlet density and alcohol consumption are contradictory when examining individual-level and ecological level studies and the effect of every additional alcohol outlet on alcohol consumption also remains unclear. The lack of consensus on the true relationship between alcohol outlet density and alcohol consumption points to the need for rigorous individual-level studies that incorporate characteristics that impact an individual’s decision to travel to an alcohol outlet and the multiscale nature of alcohol consumption with risk factors lying on multiple levels. The objective of this study is to create a new measurement of the alcohol environment — a responsive buffer — that incorporates the decades of research identifying characteristics that impact alcohol use. The specific aims of this study are to (1) conduct an updated systematic review of research studying the impact of alcohol outlet density on alcohol consumption or related harm published from November 2014 to November 2023 to synthesize the findings of ecological and individual-level studies, alcohol outlet density measurements, methodological advances, scientific rigor, and methodological limitations, (2) compare the distance individuals travel to alcohol outlets using GPS travel data and use this information to develop responsive buffers for assessing exposure to alcohol outlets, and (3) characterize associations between alcohol outlet density of responsive buffers with individual-level alcohol consumption (i.e., number of drinking days, quantity consumed) and compare effect sizes to commonly used measurements of alcohol outlet density (e.g., census tracts, ZIP codes, 400 m buffer around residence). The proposed aims and training plan build upon my experience in alcohol research supplemented by focused training in alcohol epidemiology, spatial epidemiology and neighborhood research techniques for mobility studies and momentary assessments of exposure and analyses of hierarchically structured data. This research and development of a new method has important implications for environmental prevention efforts aimed to improve population health by decreasing alcohol consumption. By creating an innovative measurement of the alcohol environment, this research will improve the translation of evidence-based research to alcohol prevention policy and promote the NIAAA’s mission to inform regulatory efforts and policy that create environments for healthy lives and well-being for all.