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Free Alcohol
Screening |
Epidemiology of Alcohol Problems
Component 3: National Alcohol
Surveys Core (NAS11, NAS12)
Abstract:
The Center’s NAS provides critically needed
trend and current national findings by monitoring drinking patterns,
alcohol-related problems, potential risk and protective variables,
service use and community responses. NAS11 improves assessment of
ethanol content using drink brand and size assessment based on the
Center’s ongoing Methodological Studies. Analyses will help delineate
mechanisms by which particular drinking styles, interacting with
predisposing and environmental factors, generate consequences, thereby
advancing etiological knowledge. NAS11 builds earlier work by deepening
investigations and adding to predictive power in models of alcohol use
disorders.
This component analyzes NAS11 telephone survey data collected in current
Center years 24–25 (expected N = 10,000), part of the unique data series
with equivalent measures at 5-year intervals since 1979. Like its
predecessor NAS10, the survey samples a 50 state (plus DC) adult
household population, with large over-samples of African-American and
Hispanic respondents, expected to yield 2000 of each of these ethnic
minorities. Low population states are over-sampled to enable multi-level
analyses by state. Specific aims include: 1) to conduct trend analyses
important to alcohol epidemiology in the general population and
prioritized subgroups, using carefully validated methodologies and
age-period-cohort (APC) techniques to better understand 25-year trends;
2) to study alcohol-related health services, specifically, (a)
help-seeking and use of mutual-aid (Alcoholics Anonymous), (b) racial
disparities in treatment-seeking for alcohol problems, and (c) alcohol
and drug use in relation to ER services; 3) to test hypotheses related
to associations between interpersonal violence, particularly child and
adult physical and sexual abuse, and past year problematic drinking; and
also 4) to test a number of hypotheses about special populations
including race/gender groups, groups with varying sexual orientations,
and emerging adults (defined as18 to 25). Lastly, 5) we will test
hypotheses regarding drinking environments, especially bars and home
contexts but also those in which gambling is involved, examining
co-occurrence of alcohol and gambling problems. Analyses will take
account of demographic influences on consumption and problems,
predisposing variables, and a wide range of personal characteristics.
This component of the Center Grant also describes
the plans for 2009-2010 NAS (N12) as well as a follow-up study of a
subset of people from the 2005 NAS (N11). As part of the activities of
this component we intend to follow approximately one-third of our N11
cohort (expected n = 3,000) for three points in time (and possibly more
in future center grants). The longitudinal subgroup will be over sampled
for heavier drinkers, younger ages and those reporting interpersonal
violence. It is anticipated that a new sample of approximately 7,500
respondents will be drawn for the cross-sectional N12 sample.
The specific aims will focus on six different areas: 1) an extension of
age-period-cohort analyses, 2) alcohol, health and health harms, 3 )
interpersonal violence and alcohol, 4) a special focus on the drinking
patterns of the emerging adult segment of the population (18-25), 5) an
examination of contextual preferences (including gambling) and how these
are related to changes in drinking over time, and 6) alcohol and injury
in emergency rooms as well as the use of screening tools in such
environments. While there are other surveys that assess consumption and
problems such as the NIAAA intramural surveys or the NIDA household
survey, the NAS is unique in that it does an unusually broad assessment
of the nation’s drinking patterns and predictors. These indicators
include attitudes, contexts, injuries, health and health harms,
interpersonal violence and a range of other problems not usually tracked
in national surveys of substance use. These unique items will be
particularly valuable in the proposed longitudinal study. While
consumption and problems have been tracked cross-sectionally and
longitudinally, very few of these studies have looked at how such
changes are related to the social, physical and normative foundations in
which human lives and everyday drinking are embedded.
The current period will be an interesting time for tracking drinking
over time because there appears to be an upswing in drinking among the
youngest cohorts. This is exacerbated by social and political pressures
(e.g. war, uncertain economy) that are often associated with increases
in drinking. We plan to seek additional resources to expand our sample
through the submission of RO1s and R21s to address additional topics
such as longitudinal patterns of minority drinking and/or the influence
of religion on alcohol consumption.
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