Department of Epidemiology & Biostatistics, College of Human Medicine, Michigan State University, West Fee Hall, 909 Fee Road, East Lansing, MI 48824, United States.
Department of Epidemiology & Biostatistics, College of Human Medicine, Michigan State University, West Fee Hall, 909 Fee Road, East Lansing, MI 48824, United States.
Addict Behav. 2018 Jul;82:101-104. doi: 10.1016/j.addbeh.2018.02.030. Epub 2018 Feb 26.
A mosaic of evidence links risk perceptions with drug use in adolescence, including population summaries to guide public health campaigns, as well as subject-specific estimates on preventing an adolescent's drug use by manipulating that individual's prior risk perceptions. We re-visit these issues with a public health perspective, asking whether population-level cannabis risk perceptions of school-attending adolescents at one grade level might predict cannabis use prevalence two and four grade levels later.
From 1991 to 2014, each year's United States "Monitoring the Future" (MTF) study population included 8th-, 10th-, & 12th-graders. Two and four years later, statistically independent school samples of the same cohorts were drawn and assessed (n ~ 16,000/year). Population-level modeling estimated cannabis use prevalence at time "t" (12th-grade) regressed on that same cohort's cannabis risk perceptions as had been measured at time "t-4" (8th-grade) and time "t-2" (10th-grade).
Higher cannabis risk perception levels for 10th-graders predict lower cannabis use prevalence when 10th-graders have become 12th-graders (β̂=-0.12), and higher cannabis risk perception levels of 8th-graders predict lower cannabis prevalence when 8th-graders have become 10th-graders (β̂=-0.27); p-values < 0.05. Across four-year spans, the prediction is null (p-value = 0.619).
This within-cohort across-grade population-level prediction prompts questions for drug prevention specialists, including "Would a relatively small upward shift in a local area population's appraisal of risk perceptions be followed, two years later, by reduced population prevalence of cannabis use?" Future randomized trial designs, health education, or prevention efforts focused on altering early adolescent cannabis risk perceptions might provide the most convincing and definitive evidence.
大量证据表明，风险认知与青少年时期的药物使用有关，包括为公共卫生运动提供指导的人群总结，以及通过操纵个体的先前风险认知来预防青少年药物使用的特定于主题的估计。我们从公共卫生的角度重新审视这些问题，询问一个年级水平的在校青少年的人群级大麻风险认知是否可以预测两年和四年后的大麻使用流行率。
1991 年至 2014 年，每年的美国“监测未来”（MTF）研究人群包括 8 年级、10 年级和 12 年级的学生。两年和四年后，从同一队列中抽取并评估了具有统计学独立性的学校样本（每年约 16,000 人）。在时间“t”（12 年级）上对人群水平建模，根据同一队列在时间“t-4”（8 年级）和时间“t-2”（10 年级）测量的大麻风险认知来预测大麻使用流行率。
10 年级学生的大麻风险认知水平较高，预示着 10 年级学生成为 12 年级学生时大麻使用流行率较低（β̂=-0.12），而 8 年级学生的大麻风险认知水平较高，预示着 8 年级学生成为 10 年级学生时大麻流行率较低（β̂=-0.27）；p 值均<0.05。在四年的跨度内，该预测无效（p 值=0.619）。
这种在同一年龄组内跨越年级的人群水平预测引发了药物预防专家的问题，包括“当地人群对风险认知的评估略有上升，两年后，大麻使用的人群流行率是否会降低？”未来的随机试验设计、健康教育或专注于改变青少年早期大麻风险认知的预防措施可能提供最有说服力和最明确的证据。
